Oscar Health, Inc. (OSCR)

Key figures

The last twelve months reported, with the latest price and balance sheet.

Revenue, last twelve months

$15.3B

Revenue growth

42.8%

Net income, last twelve months

$550.7M

Earnings per share

$1.40

Operating margin

4.1%

Net margin

3.6%

Free cash flow

$4.4B

Return on equity

26.8%

Market value

$10.2B

Price to earnings

21.8x

Cash

$4.1B

Debt

$431.6M

Debt to equity

0.21

Financial statements

Revenue, profit and cash flow by fiscal year, each year linked to its annual report.

By quarter

What the company said with its results

From the second quarter of 2026 results, filed 6 August 2026.

• Record first-half profitability; guidance raised. Management said the company delivered record profitability in the first half and is raising its full-year 2026 guidance.
• Earnings from operations turned positive. Earnings from operations were $388.6 million in the second quarter, against a loss of $230.5 million a year earlier.
• Diluted EPS of $1.10. Net income attributable to Oscar was $361.8 million, or $1.10 diluted EPS, against a diluted loss of $(0.89) a year earlier.
• Adjusted EBITDA reached $415.3 million. Adjusted EBITDA was $415.3 million, against a loss of $199.4 million in the second quarter of 2025.
• Total revenue near $4.9 billion. Total revenue was about $4.9 billion, against $2.9 billion a year earlier, on higher membership and rate increases, partly offset by a higher net risk adjustment accrual.
• MLR fell to 79.2%. Medical loss ratio was 79.2% against 91.1% a year earlier, with management citing disciplined pricing and favorable prior period reserve development.
• SG&A expense ratio fell to 14.2%. SG&A expense ratio was 14.2% against 18.7%, which management attributed to expense management, fixed cost leverage and lower risk adjustment as a share of premium.
• $164 million favorable reserve development. Management attributed the lower MLR to disciplined pricing and $164 million of favorable prior period reserve development in the quarter.
• Six-month MLR and SG&A ratios. For the first half, MLR was 75.0% against 83.0% and the SG&A expense ratio was 14.7% against 17.2%.
• Risk adjustment transfers rose. Risk adjustment transfers were $871.5 million in the quarter against $692.2 million a year earlier, and $2,314.3 million in the first half against $1,066.0 million.
• Q1 favorable development was $68 million. The first-quarter release reported $68 million of favorable development, against $31 million of unfavorable development a year earlier.
• Prior-year risk adjustment accrual change. The prior years change in net risk adjustment accrual was $(59,151) thousand in the first half of 2026, against $77,532 thousand in the first half of 2025.
• Effectuated membership at June 30. Effectuated individual and small group members were 2,963,002 at June 30, 2026, against 2,017,058 a year earlier and 3,174,489 at March 31, 2026.
• Workforce shifts cited for individual market. Management said more people are moving between full- and part-time jobs, gig work and retirement, a shift it expects AI to accelerate.

Company events

The newest 8-K filings of 62 held.

Every filing

The newest filings with the SEC of 137 held.

Insider trades

Form 4 trades by officers, directors and 10% owners, last 12 months.

Planned insider sales

Form 144 notices, filed when the sell order goes to the broker.

Large holders

Schedule 13D and 13G filings by holders of more than 5% of the voting shares.

Short interest

Shares sold short and not yet bought back, on each FINRA settlement date.

Funds that hold it

From each fund's latest Form 13F.

455 funds held it at 30 Jun 2026: 252 added and 99 trimmed in the quarter. The largest:

Peers

Companies in the same industry.

• UnitedHealth Group Inc. (UNH): revenue $450.1B, market value $368.6B
• Elevance Health, Inc. (ELV): revenue $201.8B, market value $89.5B
• Cigna Group (CI): revenue $282.4B, market value $78.0B
• Humana Inc. (HUM): revenue $145.7B, market value $49.5B
• Centene Corp. (CNC): revenue $203.9B, market value $33.2B
• Molina Healthcare, Inc. (MOH): revenue $44.1B, market value $10.3B
• Alignment Healthcare, Inc. (ALHC): revenue $4.6B, market value $1.7B
• Trupanion, Inc. (TRUP): revenue $1.5B, market value $1.3B

What the company does

Oscar Health, Inc. sells health insurance plans under the Affordable Care Act (ACA) to individuals, families and employees. It also offers a technology platform to other healthcare companies. As of 31 December 2025 it had approximately 2.0 million effectuated members, meaning people who are actively enrolled and have either paid their premium or are within the grace period. It offered coverage in 18 states for the 2025 policy year and had approximately 2,305 employees.

How the business is organised

Oscar describes three parts: its insurance business, the +Oscar platform, and brokerage services and an enrollment platform. The insurance business runs on the company's own cloud-native technology platform. Through +Oscar, the company offers Campaign Builder, an engagement and recommendation platform for providers and payors. As of 31 December 2025 it served nearly 0.6 million client lives, in addition to the approximately 2.0 million Oscar members.

In 2025 the company acquired three early-stage businesses. Lucie, Inc. is a direct enrollment technology platform and, in the filing's words, one of only 11 CMS-approved solutions. IHC Specialty Benefits, Inc. is an individual market brokerage offering individual medical and supplemental health products across carriers in all 50 states. Healthinsurance.org, LLC is a consumer education website. The company says these support its strategy around Individual Coverage Health Reimbursement Arrangements (ICHRA).

What it sells

Oscar's health plans are sold in the individual market. Buyers include people using the Health Insurance Marketplaces, people buying off-exchange, and employees whose employers offer an ICHRA. Plans come in the five ACA metal categories: Catastrophic, Bronze, Silver, Gold and Platinum. They differ in monthly premium and in how medical costs are shared between Oscar and the member. Some products are aimed at particular needs, such as diabetes, asthma or menopause. Oscar has exclusive provider organization plans in most markets and HMO plans in select markets. State and federal regulators must approve its premium rates, and the company chooses each year whether to take part in a given individual market.

Who pays and how members enrol

The vast majority of revenue comes from health insurance premiums. For the year ended 31 December 2025, 93% of premiums were earned directly from the Centers for Medicare & Medicaid Services (CMS) through the advance premium tax credits program, and 7% came from members.

Members are acquired through brokers, directly through the Health Insurance Marketplaces, and directly through Oscar's digital platform. The company also works with ICHRA platform companies to enroll employees. The vast majority of members come through brokers, who typically use an enhanced direct enrollment platform. Oscar therefore competes partly through the commissions and bonuses it pays them.

Where it operates

Oscar offers coverage in 18 states for the 2025 policy year and has expanded to 20 states for 2026.

How it competes

Its main competitors in the individual market are plans from national carriers, regional carriers, Medicaid-focused insurers offering Health Insurance Marketplaces products, and local Blue Cross plans. The company says it competes on the range and prices of plans, provider network breadth and quality, benefits, service and member experience. Its model is to contract with selected health systems and other providers rather than all of them in an area. Contracts are set market by market and can use fee-for-service, value-based or capitation payment.

Technology, regulation and risk

Oscar built a single-threaded platform covering member and provider data, utilization management, claims, billing and benefits. It uses AI technologies for administrative automation, member personalization and digital self-service. It works with Amazon and Google for its information technology systems and runs its Amazon Web Services platform across multiple availability zones. It owns four registered trademarks in the United States and holds no patents.

The business is regulated at federal and state levels. The minimum medical loss ratio for the individual market set by the Department of Health and Human Services is 80%, and New York requires 82%. Insurers that fall short must pay rebates to members. CMS also runs a risk adjustment program that moves funds between plans based on member risk scores. Oscar uses quota share and excess of loss reinsurance for risk management and capital efficiency. It provides virtual care through Oscar Medical Group, which consists of five physician-owned professional corporations.

*From Oscar Health's annual report on Form 10-K for the year ended 31 December 2025. [The filing](https://www.sec.gov/Archives/edgar/data/1568651/000156865126000011/oscr-20251231.htm)*

From the company's 10-K.