Oscar(OSCR)2024-11-07 21:11Membership and Growth - As of September 30, 2024, Oscar Health, Inc. has approximately 1.65 million members, reflecting the company's member-first philosophy and innovative approach to care[93] - Membership increased by 671,124, or 68%, as of September 30, 2024, compared to September 30, 2023, driven by strong retention and new enrollments[117] - The company expects transitions from Medicaid and CHIP coverage to ACA marketplace plans to contribute to growth in the ACA marketplace[110] Financial Performance - Total revenue for the three months ended September 30, 2024, was 1,440.0 million in the same period of 2023, representing a 68.3% increase[1] - Premium revenue increased by 840.8 million, or 72%, for the three months ended September 30, 2024, compared to the same period in 2023[121] - Adjusted EBITDA for the nine months ended September 30, 2024, was 66.4 million for the same period in 2023[127] - Selling, general, and administrative expenses increased by 8.0 million, or 19%, for the three months ended September 30, 2024, compared to the same period in 2023[119] Medical Loss Ratio and Expenses - The medical loss ratio (MLR) is a key metric indicating the ratio of medical expenses to net premiums, which is subject to federal and state minimum requirements[97] - Medical Loss Ratio (MLR) was 84.6% for the three months ended September 30, 2024, compared to 83.8% for the same period in 2023[122] - Medical expenses are influenced by seasonal patterns, with higher costs typically occurring in the second half of the year due to various factors[107] Capital and Cash Flow - The combined statutory capital and surplus of health insurance subsidiaries was 133 million to the Parent during the nine months ended September 30, 2024[133] - For the nine months ended September 30, 2024, the company made capital contributions of 16.5 million for the same period in 2023[134] - Net cash provided by operating activities for the nine months ended September 30, 2024, was 569.0 million for the same period in 2023[146] - Net cash used in investing activities for the nine months ended September 30, 2024, was 404.7 million for the same period in 2023[147] - Net cash provided by financing activities for the nine months ended September 30, 2024, was 5.4 million for the same period in 2023, primarily due to proceeds from stock option exercises[148] Regulatory and Operational Developments - The company has announced it will not renew the Cigna+Oscar Small Group arrangement, effective December 31, 2024, and will exit the small group market entirely by December 15, 2024[112] - Oscar Health is monitoring regulatory developments, including changes to the ACA broker process to address unauthorized enrollment changes[111] - A cybersecurity incident involving Change Healthcare occurred on February 21, 2024, but no breach of member data has been reported[113] Investment and Financial Strategy - The company estimates that without quota share reinsurance arrangements, its health insurance subsidiaries would have needed to hold approximately 447.1 million of additional capital as of September 30, 2024, and December 31, 2023, respectively[134] - The fair value of the company's investments would decrease by approximately 115.0 million available to draw under its Revolving Credit Facility until December 2025, with no outstanding borrowings as of September 30, 2024[141] - The company expects cash flows from operations to primarily fund its long-term cash requirements under various contractual obligations[138] - The company’s investment policies are designed to provide liquidity, preserve capital, and maximize total return on invested assets, consistent with state requirements[144]