# EDGAR Filing Document

**Accession Number:** 0001839260
**File Stem:** 0001801170-26-000013
**Filing Date:** 2026-1
**Character Count:** 8236
**Document Hash:** 59cd3c678d28e2876edbc867bc95ffae
**Contains OCR:** False
**Source Format:** 

## Filing Content

## Filing Summary
**0001801170-26-000013.hdr.sgml**: 20260109

**ACCESSION NUMBER**: 0001801170-26-000013

**CONFORMED SUBMISSION TYPE**: 4

**PUBLIC DOCUMENT COUNT**: 1

**CONFORMED PERIOD OF REPORT**: 20260107

**FILED AS OF DATE**: 20260109

**DATE AS OF CHANGE**: 20260109

**REPORTING-OWNER**: 

**OWNER DATA:**
- **COMPANY CONFORMED NAME:** Garipalli Vivek
- **CENTRAL INDEX KEY:** 0001839260

**ORGANIZATION NAME:**

**FILING VALUES:**
- **FORM TYPE:** 4
- **SEC ACT:** 1934 Act
- **SEC FILE NUMBER:** 001-39252
- **FILM NUMBER:** 26523146

**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]
- **ORGANIZATION NAME:** 02 Finance
- **EIN:** 981515192
- **STATE OF INCORPORATION:** DE
- **FISCAL YEAR END:** 1231

**BUSINESS ADDRESS:**
- **STREET 1:** 30 MONTGOMERY STREET
- **CITY:** JERSEY CITY
- **STATE:** NJ
- **ZIP:** 07302
- **BUSINESS PHONE:** (201) 432-2133

**MAIL ADDRESS:**
- **STREET 1:** C/O THE CORPORATION TRUST COMPANY
- **STREET 2:** 1209 ORANGE STREET
- **CITY:** WILMINGTON
- **STATE:** DE
- **ZIP:** 19801

**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

### UNITED STATES SECURITIES AND EXCHANGE COMMISSION
**Washington, D.C. 20549**

## FORM 4

### STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

[ ] Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).

[ ] Check this box to indicate that a transaction was made pursuant to a contract, instruction or written plan for the purchase or sale of equity securities of the issuer that is intended to satisfy the affirmative defense conditions of Rule 10b5-1(c). See Instruction 10.

---

| | | |
|:---|:---|:---|
| **1. Name and Address of Reporting Person**<sup>*</sup><br>Garipalli Vivek<br><sub>(Last) (First) (Middle)</sub><br>C/O CLOVER HEALTH INVESTMENTS, CORP.<br>NOT APPLICABLE<br><sub>(Street)</sub><br>WILMINGTON, DE 19801<br><sub>(City) (State) (Zip)</sub> | **3. Date of Earliest Transaction (Month/Day/Year)**<br>2026-01-07 | **5. Relationship of Reporting Person(s) to Issuer**<br>(Check all applicable)<br>[X] Director [X] 10% Owner<br>[ ] Officer (give title below) [ ] Other (specify below)<br>_ _ |
| **2. Issuer Name and Ticker or Trading Symbol**<br>CLOVER HEALTH INVESTMENTS, CORP. /DE [ CLOV ] | **4. If Amendment, Date of Original Filed (Month/Day/Year)**<br>  | **6. Individual or Joint/Group Filing (Check Applicable Line)**<br>[X] Form filed by One Reporting Person<br>[ ] Form filed by More than One Reporting Person |

---

## Table I - Non-Derivative Securities

---

|  |  |  |  |  |  |  |  |  |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| 1. Title of Security | 2. Transaction Date | 2A. Deemed Execution Date | 3. Transaction Code (V) | 3. Transaction Code (V) | 4. Securities Acquired (A) or Disposed of (D) | 4. Securities Acquired (A) or Disposed of (D) | 4. Securities Acquired (A) or Disposed of (D) | 5. Amount of Securities Beneficially Owned | 6. Ownership Form | 7. Nature of Indirect Beneficial Ownership |
| 1. Title of Security | 2. Transaction Date | 2A. Deemed Execution Date | Code | V | Amount | (A) or (D) | Price | 5. Amount of Securities Beneficially Owned | 6. Ownership Form | 7. Nature of Indirect Beneficial Ownership |
| Class A Common Stock<sup>(1)</sup> | 2026-01-07 |  | M |  | 1655949<sup>(2)</sup> | A | 0<sup>(1)</sup> | 3512196 | D |  |
| Class A Common Stock<sup>(1)</sup> | 2026-01-07 |  | F |  | 1655949<sup>(2)</sup> | D | $2.59 | 1856247 | D |  |

---

## Table II - Derivative Securities

---

|  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| 1. Title of Derivative Security | 2. Conversion or Exercise Price | 3. Transaction Date | 3A. Deemed Execution Date | 4. Transaction Code (V) | 4. Transaction Code (V) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) | 6. Date Exercisable and Expiration Date | 6. Date Exercisable and Expiration Date | 7. Title and Amount of Underlying Securities | 7. Title and Amount of Underlying Securities | 8. Price of Derivative Security | 9. Number of Derivative Securities Beneficially Owned | 10. Ownership Form | 11. Nature of Indirect Beneficial Ownership |
| 1. Title of Derivative Security | 2. Conversion or Exercise Price | 3. Transaction Date | 3A. Deemed Execution Date | Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | 8. Price of Derivative Security | 9. Number of Derivative Securities Beneficially Owned | 10. Ownership Form | 11. Nature of Indirect Beneficial Ownership |
| Restricted Stock Unit | <sup>(3)</sup> | 2026-01-07 |  | M |  |  | 3342699 | <sup>(3)</sup> | <sup>(3)</sup> | Class B Common Stock<sup>(3)</sup> | 3342699 | <sup>(1)</sup> | 0 | D |  |
| Class B Common Stock | <sup>(1)(2)</sup> | 2026-01-07 |  | M |  | 3342699 |  | <sup>(1)</sup> | <sup>(1)</sup> | Class A Common Stock | 3342699 | <sup>(1)</sup> | 10247042 | D |  |
| Class B Common Stock | <sup>(1)(2)</sup> | 2026-01-07 |  | M |  |  | 1655949 | <sup>(1)</sup> | <sup>(1)</sup> | Class A Common Stock | 1655949 | <sup>(1)</sup> | 8591093 | D |  |
| Class B Common Stock | <sup>(1)</sup> |  |  |  |  |  |  | <sup>(1)</sup> | <sup>(1)</sup> | Class A Common Stock | 75694143 |  | 72084543 | I | Held by NJ Healthcare Investments, LLC<sup>(4)</sup> |
| Class B Common Stock | <sup>(1)</sup> |  |  |  |  |  |  | <sup>(1)</sup> | <sup>(1)</sup> | Class A Common Stock | 11500000 |  | 11500000 | I | Held by Ceasar Clover, LLC<sup>(4)</sup> |

---

### Footnotes:

(1) The Issuer's Class B Common Stock is convertible into shares of the Issuer's Class A Common Stock on a one-to-one basis at the option of the holders of the Issuer's Class B Common Stock at any time upon written notice to the Issuer, and automatically in the event of certain transfers, including, but not limited to, a transfer of shares to the Issuer.

(2) On January 7, 2026, the final 20% of the original number of restricted stock units ("RSUs") in respect of a Class B Common Stock granted to the Reported Person on January 7, 2021 vested, with 1,686,750 shares of the Issuer's Class B Common Stock being delivered to the Reporting Person and 1,655,949 shares of the Issuer's Class B Common Stock automatically converting into an equal number of shares of the Issuer's Class A Common Stock and being withheld by the Issuer to cover the Reporting Person's tax obligations in connection with the vesting event.

(3) Each RSU represents a contingent right to receive one share of the Issuer's Class B Common Stock upon settlement for no consideration. The RSU award vested in equal installments on the first five anniversaries of January 7, 2021.

(4) The Reporting Person serves as the sole manager of each of NJ Healthcare Investments, LLC and Caesar Clover, LLC.

**Signature:** /s/Peter J. Rivas as attorney-in-fact for Vivek Garipalli  
**Date:** 2026-01-09

### Remarks:

Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.

* If the form is filed by more than one reporting person, see Instruction 4 (b)(v).

** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).

Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.

**Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.**