Intelligence Feed event · Policy · 2026-10-09

    Clover Health PPO Plans Secure 5-Star CMS Quality Rating for 2027

    Question

    Clover Health PPO Plans Secure 5-Star CMS Quality Rating for 2027

    Direct answer

    The Centers for Medicare & Medicaid Services (CMS) published quality ratings for Medicare Advantage plans for 2027, awarding Clover Health's PPO plans a top-tier 5-Star score and HMO plans a 4.5-Star score. The ratings follow an expansion phase where Clover's Medicare Advantage membership grew roughly 48% year-over-year to exceed 157,000 members. Top CMS Star ratings qualify plans for bonus benchmark revenue adjustments and continuous open enrollment.

    Original publisher
    Market Ontology
    Evidence through
    2026-10-09
    Published
    2026-10-20
    Revision
    1 · 2026-10-20

    Cite as: Market Ontology, “Clover Health PPO Plans Secure 5-Star CMS Quality Rating for 2027”, revision 1, evidence through 2026-10-09. https://marketontology.com/market-events/2026-10-09/clover-health-ppo-plans-secure-5-star-cms-quality-rating-for-2027-601d5b

    POLICY
    Clover Health PPO Plans Secure 5-Star CMS Quality Rating for 2027
    The Centers for Medicare & Medicaid Services (CMS) published quality ratings for Medicare Advantage plans for 2027, awarding Clover Health's PPO plans a top-tier 5-Star score and HMO plans a 4.5-Star score. The ratings follow an expansion phase where Clover's Medicare Advantage membership grew roughly 48% year-over-year to exceed 157,000 members. Top CMS Star ratings qualify plans for bonus benchmark revenue adjustments and continuous open enrollment.
    CLOV
    Impact
    68
    OCT 9
    SIG
    90%
    CLOV
    Clover Health PPO Plans Secure 5-Star CMS Quality Rating for 2027
    The Centers for Medicare & Medicaid Services (CMS) published quality ratings for Medicare Advantage plans for 2027, awarding Clover Health's PPO plans a top-tier 5-Star score and HMO plans a 4.5-Star score. The ratings follow an expansion phase where Clover's Medicare Advantage membership grew roughly 48% year-over-year to exceed 157,000 members. Top CMS Star ratings qualify plans for bonus benchmark revenue adjustments and continuous open enrollment.
    → CMS 5-Star and 4.5-Star ratings trigger higher quality bonus payments and expanded marketing enrollment flexibility for CLOV.
    Impact
    The Centers for Medicare & Medicaid Services (CMS) published quality ratings for Medicare Advantage plans for 2027, awarding Clover Health's PPO plans a top-tier 5-Star score and HMO plans a 4.5-Star score. The ratings follow an expansion phase where Clover's Medicare Advantage membership grew roughly 48% year-over-year to exceed 157,000 members. Top CMS Star ratings qualify plans for bonus benchmark revenue adjustments and continuous open enrollment.
    Affected
    CLOV
    Transmission
    CMS 5-Star and 4.5-Star ratings trigger higher quality bonus payments and expanded marketing enrollment flexibility for CLOV.

    How this development reaches the affected companies

    AssetExposure and channelDirectionEvidence
    CLOVregulatory quality bonus payment revenue expansion and open enrollment accessUp1-3mCMS awarded 5-Star PPO and 4.5-Star HMO ratings to Clover Health for 2027.

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    What happened next

    Price follow-up pending — no stored daily closes for these assets yet.

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