0000895345-23-000255.txt : 20230426 0000895345-23-000255.hdr.sgml : 20230426 20230426215657 ACCESSION NUMBER: 0000895345-23-000255 CONFORMED SUBMISSION TYPE: 4/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220131 FILED AS OF DATE: 20230426 DATE AS OF CHANGE: 20230426 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Reynoso Jamie L. CENTRAL INDEX KEY: 0001839066 FILING VALUES: FORM TYPE: 4/A SEC ACT: 1934 Act SEC FILE NUMBER: 001-39252 FILM NUMBER: 23851543 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/A 1 form4.xml X0407 4/A 2022-01-31 2022-02-02 0001801170 CLOVER HEALTH INVESTMENTS, CORP. /DE CLOV 0001839066 Reynoso Jamie L. C/O CLOVER HEALTH INVESTMENTS, CORP. 3401 LORY LANE, SUITE 210 FRANKLIN TN 37067 true CEO of Medicare Advantage false Class A Common Stock 2022-01-31 4 F 0 1281 2.58 D 235310 D This Form 4/A, amends the original Form 4, filed on February 2, 2022, solely to report the number of shares of the Issuer's Class A Common Stock that were automatically withheld by the Issuer to cover the Reporting Person's tax obligations upon the vesting, on January 31, 2022, of 1/3rd of the original number of time-based restricted stock units ("RSUs") granted to the Reporting Person on January 31, 2022 upon the achievement of certain performance criteria. The RSUs vest in equal installments on January 31, 2022, January 1, 2023 and January 1, 2024. The original Form 4 inadvertently omitted the 1,281 shares that were withheld in connection with the January 31, 2022 vesting event. /s/ Joseph R. Martin as attorney-in-fact for Jamie L. Reynoso 2023-04-26