Financial Data and Key Metrics Changes - Total revenue for Q3 2025 was approximately $3 billion, representing a 23% year-over-year increase [5][14] - Medical Loss Ratio (MLR) increased by approximately 380 basis points to 88.5% due to higher market morbidity [5][15] - SG&A expense ratio improved by approximately 150 basis points year-over-year to 17.5% [5][16] - Loss from operations was $129 million, a change of $81 million year-over-year, while net loss was $137 million, an $83 million change year-over-year [5][16] - Adjusted EBITDA loss was $101 million in the quarter, a change of $90 million year-over-year [5][16] Business Line Data and Key Metrics Changes - Membership grew to over 2 million, a 28% increase year-over-year [8] - The company continues to diversify its product mix, introducing new plans like Hello Meno for women experiencing menopause [9] Market Data and Key Metrics Changes - The total addressable market for plan year 2026 is approximately $12 million, up $500,000 year-over-year [9] - The weighted average rate increase for 2026 is approximately 28%, reflecting elevated market morbidity and the expiration of enhanced premium tax credits [8][20] Company Strategy and Development Direction - The company aims to expand margins and return to profitability in 2026, focusing on disciplined pricing strategies [12][20] - Oscar is positioned to capture market share as other carriers retreat or price themselves out of the market [8][20] - The introduction of an AI health agent, Oswell, is part of the strategy to enhance member experience and operational efficiency [11] Management's Comments on Operating Environment and Future Outlook - Management noted that 2025 is a reset moment for the individual market, with expectations of rational pricing in the 2026 open enrollment period [7][20] - The company remains optimistic about Congress reaching a compromise on tax credits to address affordability issues [7] - Management expressed confidence in the ability to navigate market dynamics and improve profitability [20][39] Other Important Information - The company completed a $410 million convertible notes offering, strengthening its capital position [17] - Oscar's innovative plans and AI integration are expected to redefine the healthcare experience [11] Q&A Session Summary Question: Regarding the September weekly report and market morbidity shifts - Management indicated that market morbidity increased by about 1.5 to 2 points across several markets, with no significant changes expected through the end of the year [24] Question: On G&A targets for 2027 - Management believes there is room for improvement in SG&A, leveraging AI to streamline operating costs [27] Question: On underlying cost trends in the quarter - Favorable development of $84 million was noted, primarily related to risk adjustment and claims [30] Question: On enrollment trends and member retention - Stronger than expected membership growth was driven by lower churn, positively impacting MLR dynamics [70] Question: On competitive dynamics and pricing strategy - Management noted that they are positioned competitively, with a focus on taking market share from higher-priced competitors [51][66]

Core Insights - Oscar Health, Inc. reported a quarterly loss of $0.53 per share, which was better than the Zacks Consensus Estimate of a loss of $0.55, but worse than a loss of $0.22 per share a year ago, indicating an earnings surprise of +3.64% [1] - The company generated revenues of $2.99 billion for the quarter ended September 2025, missing the Zacks Consensus Estimate by 3.37%, compared to $2.42 billion in the same quarter last year [2] - Oscar Health shares have increased by approximately 26.7% year-to-date, outperforming the S&P 500's gain of 15.6% [3] Earnings Outlook - The current consensus EPS estimate for the upcoming quarter is -$0.87 on revenues of $3.06 billion, and for the current fiscal year, it is -$1.42 on revenues of $12.06 billion [7] - The estimate revisions trend for Oscar Health was unfavorable prior to the earnings release, resulting in a Zacks Rank 4 (Sell), indicating expected underperformance in the near future [6] Industry Context - The Insurance - Multi line industry, to which Oscar Health belongs, is currently ranked in the top 27% of over 250 Zacks industries, suggesting a favorable outlook compared to lower-ranked industries [8] - Empirical research indicates a strong correlation between near-term stock movements and trends in earnings estimate revisions, which can be tracked by investors [5]

Core Insights - Oscar Health reported a third quarter loss of $137 million but anticipates a return to profitability as the health insurance industry navigates rising costs and policy uncertainties in Washington [2][3][5] Financial Performance - Oscar's total membership increased by 28% to over 2.1 million compared to the same quarter last year, contributing to a 23% rise in total revenue to nearly $2.9 billion [4] - The company reported a loss of $137.5 million, or 53 cents per share, compared to a loss of $54.6 million, or 22 cents per share in the previous year [4] Industry Context - Oscar is part of a group of health insurers providing government-subsidized insurance that have faced significant challenges due to rising costs, leading to lowered profit forecasts and plans to increase rates next year [5] - The company aims to achieve positive net income next year by balancing membership growth with profitability [5] Future Outlook - Oscar has resubmitted rate filings in states covering nearly 99% of its current membership for 2026, reflecting elevated cost trends and higher market morbidity [6] - The company sees an opportunity to gain market share as competitors like CVS Health's Aetna withdraw from the market, while Oscar's CEO believes the individual market will continue to expand due to macroeconomic trends [6][8]

Financial Performance - Total revenue for Q3 2025 was approximately $2.99 billion, a 23.3% increase from $2.42 billion in Q3 2024[3]. - Loss from operations for Q3 2025 was $129.3 million, compared to a loss of $48.4 million in Q3 2024[3][12]. - Net loss attributable to Oscar Health, Inc. was $137.5 million, or $(0.53) per diluted share, compared to a net loss of $54.6 million, or $(0.22) per diluted share, in Q3 2024[3][12]. - Adjusted EBITDA loss for Q3 2025 was $101.5 million, compared to a loss of $11.6 million in Q3 2024[3][12]. - Operating expenses for Q3 2025 totaled $3,115,234, a significant rise from $2,471,856 in Q3 2024, reflecting a 26% increase[21]. - Net income attributable to Oscar Health, Inc. for the three months ended September 30, 2025, was $(137,484) thousand, compared to $(54,388) thousand for the same period in 2024, indicating a significant increase in losses[36]. - The company reported earnings (loss) from operations of $(129,250) thousand for the three months ended September 30, 2025, compared to $(48,374) thousand in 2024, indicating a worsening operational performance[36]. Membership and Revenue Growth - Total membership reached 2,116,904 as of September 30, 2025, up from 1,654,284 in 2024, indicating strong growth in individual and small group offerings[4]. - Premium revenue for the nine months ended September 30, 2025, was $8,723,233, up 31.8% from $6,626,055 in the same period of 2024[21]. - Direct policy premiums for the three months ended September 30, 2025, reached $3,646,308 thousand, up from $2,687,883 thousand in 2024, representing a growth of approximately 35.8%[38]. Medical Loss Ratio and Expenses - Medical loss ratio for Q3 2025 was 88.5%, up from 84.6% in Q3 2024, primarily due to increased average market morbidity[3][12]. - Medical Loss Ratio (MLR) for Q3 2025 was 88.5%, compared to 84.6% in Q3 2024, indicating an increase in medical expenses relative to premiums[30]. - Medical expenses for the three months ended September 30, 2025, totaled $2,586,330 thousand, compared to $2,003,979 thousand in 2024, reflecting an increase of about 29.0%[38]. Cost Management - SG&A expense ratio improved to 17.5% in Q3 2025 from 19.0% in Q3 2024, attributed to better fixed cost leverage and disciplined cost management[3][12]. - SG&A expenses for the nine months ended September 30, 2025, were $1,538,836, up from $1,289,745 in the same period of 2024, reflecting a 19.3% increase[21]. - Selling, general, and administrative expenses for the three months ended September 30, 2025, were $521,592 thousand, compared to $459,522 thousand in 2024, marking an increase of approximately 13.5%[38]. Capital Structure and Guidance - Oscar Health entered into an exchange agreement to manage its capital structure, involving approximately $250 million of convertible senior notes[10][11]. - Full year 2025 revenue guidance is set between $12.0 billion and $12.2 billion, with a medical loss ratio expected between 86.0% and 87.0%[5]. - The company is focused on expanding margins and returning to profitability in 2026, supported by disciplined pricing and geographic expansion strategies[2]. Assets and Liabilities - Cash and cash equivalents as of September 30, 2025, were $2,148,865, an increase from $1,527,186 at the end of 2024[23]. - Total assets increased to $5,745,877 as of September 30, 2025, compared to $4,840,496 at the end of 2024, representing an 18.7% growth[23]. - Long-term debt rose to $686,294 as of September 30, 2025, compared to $299,555 at the end of 2024, indicating a significant increase in leverage[23]. - Net cash provided by operating activities for the nine months ended September 30, 2025, was $422,951, down from $631,373 in the same period of 2024[25]. Reinsurance and Interest Expense - Reinsurance recoverable as of September 30, 2025, was $159,391 thousand, down from $291,537 thousand as of December 31, 2024, indicating a decrease of approximately 45.5%[38]. - Interest expense for the nine months ended September 30, 2025, was $18,698 thousand, compared to $17,708 thousand in 2024, reflecting a rise of about 5.6%[36]. Stock-Based Compensation - Stock-based compensation for the nine months ended September 30, 2025, was $69,569 thousand, down from $83,969 thousand in 2024, representing a decrease of approximately 17.2%[36].

Core Insights - Oscar Health is launching new health plans for individuals, families, and businesses in Tampa for the 2026 Open Enrollment period [1] Group 1 - The new health plans will be available on the individual marketplace [1]

Core Insights - Oscar Health is launching new health plans for individuals, families, and businesses in Orlando for the 2026 Open Enrollment period [1] Group 1 - The new health plans will be available on the individual marketplace [1]

Core Insights - Oscar Health is launching affordable, tech-powered health insurance plans for individuals and families in Charlotte for the 2026 Open Enrollment period [1] Company Overview - Oscar Health is focusing on providing accessible health insurance options in the individual marketplace [1]

Core Insights - Oscar Health is launching new health plans for individuals in San Antonio as part of the 2026 Open Enrollment period [1] Group 1 - The new health plans are specifically designed for the individual marketplace in San Antonio [1]

Core Insights - Oscar Health is launching new health plans for individuals, families, and businesses in Arizona for the 2026 Open Enrollment period [1] Group 1 - The new health plans will be available on the individual marketplace [1] - The introduction of these plans aims to enhance access to healthcare for various demographics in Arizona [1]

Core Insights - Oscar Health (OSCR) is a health insurance provider that has gained significant attention from investors and traders in recent years [1] Company Overview - Oscar Health differentiates itself from other health insurance providers through its unique selling points [1]