Oscar Health Inc
NYSE:OSCR

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Oscar Health Inc
NYSE:OSCR
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Price: 15.48 USD 7.13% Market Closed
Market Cap: $4.6B

Oscar Health Inc
Investor Relations

Oscar Health Inc., a pioneer in the health insurance industry, was founded with a mission to simplify healthcare by aligning technology with the needs of its members. Emerging out of the tech-savvy environment of New York City in 2012, Oscar took a bold step towards modernizing a traditionally stagnant industry. By utilizing data-driven insights and an intuitive digital platform, Oscar reimagined the insurance experience, making it more transparent and user-friendly. Focused on individual and family plans, Oscar offers its members round-the-clock telemedicine services, real-time claim tracking, and a comprehensive network of healthcare providers. This tech-forward approach not only enhances the customer experience but also enables Oscar to streamline its operations, reducing overhead costs and increasing efficiency.

The company's business model revolves around a few key levers: premium collection, risk selection, and rigorous cost management. Oscar generates revenue primarily through premiums paid by its members. To ensure financial viability, the company employs sophisticated risk assessment technologies designed to select and price plans based on accurate estimations of patient healthcare needs. With significant investments in technology, Oscar is able to better predict healthcare costs and manage its risk pool effectively. Additionally, its emphasis on preventive care and patient engagement further distinguishes its model, encouraging healthy lifestyles that may reduce long-term healthcare expenses. Through these strategies, Oscar aims not only to drive profitability but also to reshape the health insurance landscape by placing greater emphasis on customer experience and cost transparency.

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Last Earnings Call
Fiscal Period
Q4 2025
Call Date
Feb 10, 2026
AI Summary
Q4 2025

Revenue Growth: Oscar Health reported total revenue of $11.7 billion for 2025, up 28% year-over-year, with continued strong membership gains.

Losses Driven by Risk Adjustment: The company reported a net loss from operations of $396 million in 2025, primarily due to higher market morbidity and a substantial risk adjustment payable.

Turnaround for 2026: Management expects a nearly $750 million improvement in earnings from operations in 2026 and a return to profitability, with projected operating earnings between $250 million and $450 million.

Membership Surge: Record open enrollment resulted in 3.4 million members as of February 2026; paid membership is expected to be around 3 million by Q2, a 58% year-over-year increase.

Margin Expansion: Medical loss ratio (MLR) is forecasted to improve by 450 basis points at the midpoint in 2026, with a projected range of 82.4% to 83.4%.

AI-Driven Efficiency: Administrative expense ratio improved by 160 basis points in 2025 and is expected to further improve to 15.8%–16.3% in 2026, reflecting AI and tech-driven cost controls.

Market Dynamics: Management noted a 5% market contraction so far and expects total market decline to the lower end of their original 20%–30% projection.

Strategic Product and Pricing: The company introduced new product offerings and adjusted rates to respond to shifting market conditions post-enhanced premium tax credits.

Key Financials
Revenue
$11.7 billion
SG&A Expense Ratio
17.5%
Medical Loss Ratio
87.4%
Loss from Operations
$396 million
Net Loss
$443 million
Risk Transfer as Percentage of Direct Premiums
18.5%
Adjusted EBITDA Loss
$280 million
Membership (as of February 2026)
3.4 million
Market Share
30% in 2026
Operating Earnings (2026 Guidance)
$250–$450 million
Operating Margin (2026 Guidance)
approximately 1.9%
Cash and Investments
$5.5 billion (including $414 million at parent)
Insurance Subsidiaries Capital Surplus
$1 billion
Excess Capital
$315 million
Earnings Call Recording
Other Earnings Calls

Management

Mr. Mark Thomas Bertolini
CEO & Director
No Bio Available
Mr. Mario Tobias Schlosser
Co-Founder, CTO & Director
No Bio Available
Mr. Richard Scott Blackley CPA
Chief Financial Officer
No Bio Available
Ms. Ranmali Bopitiya
Chief Legal Officer
No Bio Available
Ms. Alessandrea Corinne Quane
Executive VP & Chief Insurance Officer
No Bio Available
Mr. Joshua Kushner
Co-Founder & Vice Chairman
No Bio Available
Mr. Steven Wolin
Chief Operating Officer
No Bio Available
Ms. Victoria Baltrus
Chief Accounting Officer
No Bio Available
Chris Potochar
Vice President of Treasury & Investor Relations
No Bio Available
Ms. Rebecca Krouse
Chief People Officer
No Bio Available

Contacts

Address
NEW YORK
New York City
75 Varick Street, 5Th Floor
Contacts
+1646403367.0
www.hioscar.com
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