Clover has also missed internal financial targets, is reckoning with mounting losses and has seen its Medicare star rating dip from 3.5 out of 5 to 3, which is a problem because lower scores result in reduced payments from the government.
But the company is pushing ahead with some new hires and geographic expansion.
In September, it brought on Varsha Rao, the former head of operations at Airbnb, as COO. And the company is beginning to serve parts of Georgia, Texas and Pennsylvania in early 2018, after thus far being unable to operate outside of New Jersey.
The big-name venture capitalists, who have poured hundreds of millions of dollars into Clover, have plenty at stake in the company's success, as does board member Chelsea Clinton. They're all buying into an "entirely new approach to health insurance," as Clover proclaims on its website.
Sequoia Capital and First Round Capital are among Clover's top backers. In May, Alphabet's venture arm GV joined a $130 million financing round that put Clover in the billion-dollar start-up club. And here's what an investor at Greenoaks Capital said about Clover in May 2016, after leading a $160 million financing round.
"By combining a data-driven approach to improving health outcomes and a genuine desire to delight its members, Clover offers a Medicare Advantage plan that creates a truly positive impact on member health, while delivering a superior member experience and value that continues to get better and better at a rapid pace."
Clover was started in 2012 by Vivek Garipalli, who previously co-founded a New Jersey hospital chain called CarePoint Health.
At CarePoint, Garipalli's model involved cutting ties with large private insurers to make these hospitals out of network for most plans. That meant insurers generally ended up paying higher rates, a scheme that Aetna's former head of national networks described as "taking advantage of members who seek emergency services."
In 2013, a New York Times investigation revealed that Bayonne, one of the CarePoint medical centers, was the most expensive hospital in America, charging the highest amounts in the country for nearly one-quarter of the most common hospital treatments.
Those close to Garipalli say he knows the industry and has the entrepreneurial drive necessary to battle entrenched interests. First Round's Josh Kopelman was so struck by Garipalli that in 2015, his early-stage firm wrote a $4 million check to Clover, the biggest initial investment it had ever made.