Oscar Health, Inc.
For the period ended Sep 30, 2025. Filed Nov 6, 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.
Sep 30, 2025 · Filed Nov 6, 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 September 30, | Nine Months Ended September 30, | |||
|---|---|---|---|---|
| (in thousands, except percentages) | 2025 | 2024 | 2025 | 2024 |
| Revenue | ||||
| Premium | $2,923,968 | $2,368,257 | $8,723,233 | $6,626,055 |
| Investment income | 53,215 | 50,326 | 153,331 | 143,309 |
| Other revenues | 8,801 | 4,899 | 19,628 | 15,764 |
| Total revenue | 2,985,984 | 2,423,482 | 8,896,192 | 6,785,128 |
| Operating Expenses | ||||
| Medical | 2,586,330 | 2,003,979 | 7,398,954 | 5,267,475 |
| Selling, general, and administrative | 521,592 | 460,377 | 1,538,836 | 1,289,745 |
| Depreciation and amortization | 7,312 | 7,500 | 21,012 | 22,912 |
| Total operating expenses | 3,115,234 | 2,471,856 | 8,958,802 | 6,580,132 |
| Earnings (loss) from operations | (129,250) | (48,374) | (62,610) | 204,996 |
| Interest expense | 6,857 | 5,815 | 18,698 | 17,708 |
| Other expenses (income) | 3,184 | (1,877) | 3,308 | 173 |
| Earnings (loss) before income taxes | (139,291) | (52,312) | (84,616) | 187,115 |
| Income tax expense (benefit) | (1,807) | 2,076 | 5,853 | 7,709 |
| Net income (loss) | (137,484) | (54,388) | (90,469) | 179,406 |
| Less: Net income (loss) attributable to noncontrolling interests | (34) | 208 | 71 | 427 |
| Net income (loss) attributable to Oscar Health, Inc. | $(137,450) | $(54,596) | $(90,540) | $178,979 |
| Medical loss ratio (MLR) | 88.5% | 84.6% | 84.8% | 79.5% |
| SG&A expense ratio | 17.5% | 19.0% | 17.3% | 19.0% |
Premium
Premium revenue increased $555.7 million or 23% for the three months ended September 30, 2025, compared to the same period in 2024, and increased $2,097.2 million, or 32%, for the nine months ended September 30, 2025, compared to the same period in 2024. This increase was driven by higher membership, partially offset by an increase in the net risk adjustment transfer accrual. As of September 2025, membership increased by 0.5 million, or 28%, compared to September 2024, primarily driven by above market growth during the 2025 Open Enrollment period.
The following table summarizes the Company’s membership by offering:
| As of September 30, | ||
|---|---|---|
| Membership by Offering | 2025 | 2024 |
| Individual and Small Group | 2,111,736 | 1,602,993 |
| Cigna+Oscar (1) | 5,168 | 51,291 |
| Total Members (2) | 2,116,904 | 1,654,284 |
(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 $2.9 million or 6% for the three months ended September 30, 2025, compared to the same period in 2024, and increased $10.0 million, or 7%, for the nine months ended September 30, 2025, compared to the same period in 2024, primarily due to a larger asset base, partially offset by lower yield.
Medical Expenses and MLR
Medical expenses increased $582.4 million, or 29% for the three months ended September 30, 2025, compared to the same period in 2024, and increased $2,131.5 million, or 40%, for the nine months ended September 30, 2025, compared to the same period in 2024. This increase was primarily due to increased membership and medical cost trend.
MLR increased for the three months and nine months ended September 30, 2025, compared to the same periods in 2024, primarily driven by an increase in average market morbidity that resulted in an increase in the net risk adjustment transfer accrual, partially offset by favorable prior period development.
| Three Months Ended September 30, | Nine Months Ended September 30, | |||
|---|---|---|---|---|
| (in thousands, except percentages) | 2025 | 2024 | 2025 | 2024 |
| Medical | $2,586,330 | $2,003,979 | $7,398,954 | $5,267,475 |
| Less: Ceded quota share reinsurance claims (1) | — | 2,036 | — | (2,879) |
| Net claims before ceded quota share reinsurance (A) | $2,586,330 | $2,001,943 | $7,398,954 | $5,270,354 |
| Premium | $2,923,968 | $2,368,257 | $8,723,233 | $6,626,055 |
| Less: Ceded quota share reinsurance premiums (1) | — | 2,971 | — | (1,865) |
| Net premiums before ceded quota share reinsurance (B) | $2,923,968 | $2,365,286 | $8,723,233 | $6,627,920 |
| Medical loss ratio (A divided by B) | 88.5% | 84.6% | 84.8% | 79.5% |
| (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 $61.2 million or 13% for the three months ended September 30, 2025, compared to the same period in 2024, and increased $249.1 million, or 19%, for the nine months ended September 30, 2025, compared to the same period in 2024. This increase was primarily driven by higher membership year over year, resulting in higher volume-driven costs such as broker commissions and taxes and fees, partially offset by lower unit cost economics.
The SG&A expense ratio decreased 153 basis points to 17.5% for the three months ended September 30, 2025, compared to 19.0% for the same period in 2024. The SG&A expense ratio also decreased 170 basis points to 17.3% for the nine months ended September 30, 2025, compared to 19.0% for the same period in 2024. The decrease was primarily due to greater fixed cost leverage, lower exchange fee rates, and disciplined cost management, partially offset by the impact of higher risk adjustment as a percentage of premium.
The text of this filing, as the company filed it with the SEC, without its images or exhibits. This is not investment advice.