Oscar Health, Inc.
For the period ended Mar 31, 2025. Filed May 8, 2025.
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A company's report for each of its first three quarters. The financial statements are not audited. It shows how the business has moved since the last annual report, and what management says changed.
Mar 31, 2025 · Filed May 8, 2025
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Item 2. Results of Operations
Results of Operations
The following table sets forth our results of operations for the periods indicated:
| Three Months Ended March 31, | ||
|---|---|---|
| (in thousands, except percentages) | 2025 | 2024 |
| Revenue | ||
| Premium | $2,995,821 | $2,093,682 |
| Investment income | 46,112 | 42,989 |
| Services and other | 4,330 | 5,634 |
| Total revenue | 3,046,263 | 2,142,305 |
| Operating Expenses | ||
| Medical | 2,259,651 | 1,554,774 |
| Selling, general, and administrative | 482,759 | 394,162 |
| Depreciation and amortization | 6,730 | 7,811 |
| Total operating expenses | 2,749,140 | 1,956,747 |
| Earnings from operations | 297,123 | 185,558 |
| Interest expense | 5,994 | 5,902 |
| Other expenses | 2,918 | 1,178 |
| Earnings before income taxes | 288,211 | 178,478 |
| Income tax expense | 12,705 | 996 |
| Net income | 275,506 | 177,482 |
| Less: Net income attributable to noncontrolling interests | 235 | 114 |
| Net income attributable to Oscar Health, Inc. | $275,271 | $177,368 |
| Medical Loss Ratio (MLR) | 75.4% | 74.2% |
| SG&A Expense Ratio | 15.8% | 18.4% |
Premium
Premium revenue increased by $902.1 million, or 43%, for the three months ended March 31, 2025, compared to the same period in 2024. This increase was driven by higher membership.
The following table summarizes the Company’s membership by offering:
| As of March 31, | ||
|---|---|---|
| Membership by Offering | 2025 | 2024 |
| Individual and Small Group | 2,021,484 | 1,386,980 |
| Cigna+Oscar (1) | 17,983 | 61,428 |
| Total Members (2) | 2,039,467 | 1,448,408 |
(1) Represents total membership for our former co-branded partnership with Cigna.
(2) Represents effectuated members. Effectuated members are those who are actively enrolled in one of our plans and whose required premium payments have either been made or are within the payment grace period. A member covered under more than one of our health plans counts as a single member for the purposes of this metric.
Investment Income
Investment income increased by $3.1 million, or 7%, for the three months ended March 31, 2025, compared to the same period in 2024, primarily due to a larger asset base.
Medical Expenses and MLR
Medical expenses increased by $704.9 million, or 45%, for the three months ended March 31, 2025, compared to the same period in 2024. This increase was primarily due to increased membership. MLR increased by 120 basis points for the three months ended March 31, 2025, compared to the same period in 2024, driven by unfavorable prior period development primarily due to our 2024 Risk Adjustment payable, partially offset by favorable claims runout and a cost sharing reduction (“CSR”) recovery accrual.
| Three Months Ended March 31, | ||
|---|---|---|
| (in thousands, except percentages) | 2025 | 2024 |
| Medical | $2,259,651 | $1,554,774 |
| Less: Ceded quota share reinsurance claims(1) | — | (1,055) |
| Net claims before ceded quota share reinsurance (A) | $2,259,651 | $1,555,829 |
| Premium | $2,995,821 | $2,093,682 |
| Less: Ceded quota share reinsurance premiums (1) | — | (2,016) |
| Net premiums before ceded quota share reinsurance (B) | $2,995,821 | $2,095,698 |
| Medical Loss Ratio (A divided by B) | 75.4% | 74.2% |
| (1)Represents prior period development for claims and premiums, respectively, ceded to reinsurers pursuant to quota share treaties accounted for under reinsurance accounting, which are in runoff. | ||
Selling, General and Administrative Expenses and SG&A Expense Ratio
Selling, general and administrative expenses increased by $88.6 million, or 22%, for the three months ended March 31, 2025, compared to the same period in 2024. This increase was driven by higher distribution and selling expenses associated with higher membership year over year. The SG&A Expense Ratio improved 260 basis points for the three months ended March 31, 2025, compared to the same period in 2024, due to fixed cost leverage, lower exchange fee rates, and variable cost efficiencies.
Income Tax Expense (Benefit)
Our effective tax rate was approximately 4.41% and 0.56% for the three months ended March 31, 2025 and 2024, respectively.
The text of this filing, as the company filed it with the SEC, without its images or exhibits. This is not investment advice.