Payer Overview

Clover Health Group Market Analysis: Market Share and Coverage by State

Clover Health Group is a regional-focused health insurer with a concentrated presence in a small set of states. Its scale supports targeted provider partnerships and selective market strategies rather than broad national contracting.

Clover Health GroupHealth InsuranceHealthcare MarketProvider ContractingReimbursementNew JerseyGeorgiaSouth CarolinaPennsylvania

Payer Overview

Clover Health Group occupies a modest but distinct position in the US accident & health market as the #84 largest US A&H payer by reported premium, writing $1.34B in the US. The company reports a US market share of 0.09% and operates across 4 states, serving an estimated 188.7K members through its operations and affiliated entities. Clover Health Group does not hold a #1 position in any state and operates through 2 affiliated subsidiaries.

Clover Health Group's footprint is concentrated in a handful of states rather than evenly distributed nationwide, which shapes both competitive dynamics and contracting leverage. The firm's premium base of $1.34B in the US suggests focused regional relationships with providers that are especially important for network adequacy and value-based arrangements.

Premium by Scope

Scope	Jurisdictions	Premium	Share of Payer Total
US States & DC	4	$1.34B	100.00%
Total	4	$1.34B	100.00%

Clover Health Group's premium is exclusively reported in the US States & DC scope, accounting for 100.00% of its reported premium across scopes. There is no reported premium in US territories or foreign jurisdictions in the authoritative data.

This concentration on US states implies that provider contracting and network strategy should be prioritized within the mainland footprint; national or territory-level strategies are not supported by the reported premium distribution.

Subsidiary	Domicile
Clover HMO of New Jersey Inc	NJ
Clover Insurance Company	NJ

Subsidiary

Domicile

Clover HMO of New Jersey Inc

Clover Insurance Company

State	Market Share	Premium Written	Estimated Members
GA	0.19%	$85.1M	14.2K
NJ	2.52%	$1.24B	171.7K
PA	0.01%	$7.59M	0.87K
SC	0.05%	$12.2M	1.94K
National Total	—	$1.34B

State

Market Share

Premium Written

Estimated Members

0.19%

$85.1M

14.2K

2.52%

$1.24B

171.7K

0.01%

$7.59M

0.87K

0.05%

$12.2M

1.94K

National Total

—

$1.34B

Age Band	New Jersey	Georgia	South Carolina	Pennsylvania	National Total
Under 6	10635	826	103	48	11612
6–18	26717	2239	272	127	29355
19–25	14544	1361	176	81	16162
26–34	20512	1800	232	105

Age Band

New Jersey

Georgia

South Carolina

Pennsylvania

National Total

Under 6

10635

826

103

11612

6–18

26717

2239

272

127

29355

19–25

14544

1361

176

16162

26–34

20512

1800

232

105

State-by-State Market Position

Clover Health Group's presence is strongest in the Northeast, led by New Jersey where it writes $1.24B in premium and holds 2.52% market share. The Southeast shows secondary presence with $85.1M in Georgia and smaller positions in South Carolina ($12.2M) and Pennsylvania ($7.59M). The concentration in New Jersey suggests the payer's competitive activity and provider contracting focus are predominantly regional rather than national.

For multi-state provider groups, Clover Health Group's distribution implies that a deep, high-value agreement in New Jersey will capture the majority of the payer's membership and premium exposure, while lighter-touch arrangements or selective participation may be appropriate in Georgia, South Carolina, and Pennsylvania. The payer's limited state footprint reduces complexity for nationwide contracting but increases the strategic importance of localized relationship management and performance guarantees in its core markets.

Estimated Members by State

CLOVER HLTH GRP's estimated member distribution is highly concentrated in New Jersey, with 171,688 members, accounting for the vast majority of the payer's national membership. Georgia follows with 14,165 members, while South Carolina and Pennsylvania have much smaller populations at 1,935 and 871 respectively. This geographic concentration aligns with the payer's premium volume and market share, as New Jersey is also the state with the highest market share and premium written.

The alignment between member counts and market share rank is clear: New Jersey is the primary market, both in terms of premium and membership. Georgia, while a distant second, still represents a meaningful population for providers. South Carolina and Pennsylvania are minor markets, with limited member impact. For providers, this means that contracting and care delivery strategies should be most robust in New Jersey, with tailored approaches for Georgia and minimal focus required for the other states. Multi-state provider groups will find the greatest opportunity in New Jersey, with only niche relevance elsewhere.

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Payer Overview

Clover Health Group Market Analysis: Market Share and Coverage by State

Payer Overview

Premium by Scope

National Market Presence

National Market Footprint

Estimated Member Demographics

State-by-State Market Position

Estimated Members by State