0000895345-23-000533.txt : 20230918 0000895345-23-000533.hdr.sgml : 20230918 20230918171930 ACCESSION NUMBER: 0000895345-23-000533 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230914 FILED AS OF DATE: 20230918 DATE AS OF CHANGE: 20230918 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Reynoso Jamie L. CENTRAL INDEX KEY: 0001839066 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39252 FILM NUMBER: 231261881 MAIL ADDRESS: STREET 1: C/O CLOVER HEALTH INVESTMENTS, CORP. STREET 2: 725 COOL SPRINGS BLVD., SUITE 320 CITY: FRANKLIN STATE: TN ZIP: 37067 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: CLOVER HEALTH INVESTMENTS, CORP. /DE CENTRAL INDEX KEY: 0001801170 STANDARD INDUSTRIAL CLASSIFICATION: HOSPITAL & MEDICAL SERVICE PLANS [6324] IRS NUMBER: 981515192 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 3401 MALLORY LANE, SUITE 210 CITY: FRANKLIN STATE: TN ZIP: 37067 BUSINESS PHONE: (201) 432-2133 MAIL ADDRESS: STREET 1: 3401 MALLORY LANE, SUITE 210 CITY: FRANKLIN STATE: TN ZIP: 37067 FORMER COMPANY: FORMER CONFORMED NAME: CLOVER HEALTH INVESTMENTS, CORP. DATE OF NAME CHANGE: 20210107 FORMER COMPANY: FORMER CONFORMED NAME: Social Capital Hedosophia Holdings Corp. III DATE OF NAME CHANGE: 20200124 4 1 form4.xml X0508 4 2023-09-14 0001801170 CLOVER HEALTH INVESTMENTS, CORP. /DE CLOV 0001839066 Reynoso Jamie L. C/O CLOVER HEALTH INVESTMENTS, CORP. 3401 MALLORY LANE, SUITE 210 FRANKLIN TN 37067 true CEO of Medicare Advantage false Class A Common Stock 2023-09-14 4 F 0 7776 1.13 D 1972594 D Class A Common Stock 2023-09-15 4 F 0 21511 1.13 D 1951083 D Represents shares of Class A Common Stock that were automatically withheld to cover tax obligations upon the vesting, on September 14, 2023, of 6.25% of the original number of time-based restricted stock units ("RSUs") granted to the Reporting Person on March 14, 2022, and timely reported on a Form 4 filed on March 16, 2022. The remaining RSUs vest quarterly in equal installments of 6.25%, with the final vesting date occurring on March 14, 2026, subject to the continued service of the Reporting Person on each such vesting date. Represents shares of Class A Common Stock that were automatically withheld to cover tax obligations upon the vesting, on September 15, 2023, of 25% of the original number of RSUs granted to the Reporting Person on September 16, 2022, and timely reported on a Form 4 filed on September 20, 2022. The remaining RSUs will vest in twelve equal quarterly installments beginning on the date that is three months after September 15, 2023, in each case subject to the continued service of the Reporting Person on such vesting date. /s /Scott Leffler, as attorney-in-fact for Jamie L. Reynoso 2023-09-18