Oscar Health, Inc.
For the period ended Jun 30, 2026. Filed Aug 7, 2026.
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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.
Jun 30, 2026 · Filed Aug 7, 2026
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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 June 30, | Six Months Ended June 30, | |||
|---|---|---|---|---|
| (in thousands, except percentages) | 2026 | 2025 | 2026 | 2025 |
| Revenue | ||||
| Premium | $4,789,331 | $2,803,444 | $9,370,193 | $5,799,265 |
| Investment income | 84,794 | 54,004 | 145,408 | 100,116 |
| Other revenues | 6,095 | 6,497 | 11,813 | 10,827 |
| Total revenue | 4,880,220 | 2,863,945 | 9,527,414 | 5,910,208 |
| Operating Expenses | ||||
| Medical | 3,794,445 | 2,552,973 | 7,024,302 | 4,812,624 |
| Selling, general, and administrative | 691,080 | 534,485 | 1,397,314 | 1,017,244 |
| Depreciation and amortization | 6,060 | 6,970 | 13,078 | 13,700 |
| Total operating expenses | 4,491,585 | 3,094,428 | 8,434,694 | 5,843,568 |
| Earnings (loss) from operations | 388,635 | (230,483) | 1,092,720 | 66,640 |
| Interest expense | 4,709 | 5,847 | 10,092 | 11,841 |
| Other expenses (income) | 915 | (2,794) | 844 | 124 |
| Earnings (loss) before income taxes | 383,011 | (233,536) | 1,081,784 | 54,675 |
| Income tax expense (benefit) | 21,183 | (5,045) | 40,933 | 7,660 |
| Net income (loss) | 361,828 | (228,491) | 1,040,851 | 47,015 |
| Less: Net income (loss) attributable to noncontrolling interests | 20 | (130) | 47 | 105 |
| Net income (loss) attributable to Oscar Health, Inc. | $361,808 | $(228,361) | $1,040,804 | $46,910 |
| MLR | 79.2% | 91.1% | 75.0% | 83.0% |
| SG&A expense ratio | 14.2% | 18.7% | 14.7% | 17.2% |
Premium
Premium revenue increased $2.0 billion or 71% for the three months ended June 30, 2026, compared to the same period in 2025, and increased $3.6 billion, or 62%, for the six months ended June 30, 2026, compared to the same period in 2025. This increase was driven by higher membership and rate increases, partially offset by an increase in the net risk adjustment transfer accrual. As of June 30, 2026, effectuated membership increased by 0.9 million, or 46% compared to June 30, 2025, driven by above market growth during the 2026 OEP and strong retention.
The following table summarizes the Company’s membership by offering:
| As of June 30, | ||
|---|---|---|
| Effectuated Membership by Offering | 2026 | 2025 |
| Individual and Small Group (1) | 2,963,002 | 2,017,058 |
| Cigna+Oscar (2) | — | 10,090 |
| Total Members (3) | 2,963,002 | 2,027,148 |
| (1) Membership includes members enrolled through an Individual Coverage Health Reimbursement Arrangement (“ICHRA”). 2025 membership includes small group members. The Company no longer offers small group plans effective December 15, 2024. | ||
| (2) Represents total membership for our former co-branded partnership with Cigna. We did not renew the Cigna+Oscar Small Group arrangement after its initial term ended on December 31, 2024. | ||
| (3) 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. | ||
As of July 1, 2026, there were approximately 250 thousand to 300 thousand members who we expect will be retroactively disenrolled in connection with CMS program integrity requirements or fraud, waste and abuse laws and regulations. For more information on the recognition of premium related to membership, see“Note 3 - Revenue Recognition”.
Investment Income
Investment income increased $30.8 million or 57% for the three months ended June 30, 2026, compared to the same period in 2025, and increased $45.3 million, or 45%, for the six months ended June 30, 2026, compared to the same period in 2025, primarily due to higher invested assets, partially offset by lower yield.
Medical Expenses and MLR
Medical expenses increased $1.2 billion or 49% for the three months ended June 30, 2026, compared to the same period in 2025, and increased $2.2 billion, or 46%, for the six months ended June 30, 2026, compared to the same period in 2025. This increase was primarily due to increased membership, as well as medical cost trend. MLR decreased for the three months ended June 30, 2026, compared to the same period in 2025, which included the full first half impact of 2025 risk adjustment true-up driven by higher average market morbidity. The decrease was primarily driven by our disciplined pricing strategy and favorable prior period reserve development. MLR decreased for the six months ended June 30, 2026, compared to the same period in 2025, primarily due to our disciplined pricing strategy.
| Three Months Ended June 30, | Six Months Ended June 30, | |||
|---|---|---|---|---|
| (in thousands, except percentages) | 2026 | 2025 | 2026 | 2025 |
| Net claims before ceded quota share reinsurance (A) | $3,794,445 | $2,552,973 | $7,024,302 | $4,812,624 |
| Net premiums before ceded quota share reinsurance (B) | $4,789,331 | $2,803,444 | $9,370,193 | $5,799,265 |
| Medical Loss Ratio (A divided by B) | 79.2% | 91.1% | 75.0% | 83.0% |
Selling, General, and Administrative Expenses and SG&A Expense Ratio
Selling, general, and administrative expenses increased $156.6 million or 29% for the three months ended June 30, 2026, compared to the same period in 2025, and increased $380.1 million, or 37%, for the six months ended June 30, 2026, compared to the same period in 2025. This increase was driven by higher membership year over year, resulting in higher volume-driven costs such as taxes and fees and broker commissions. The SG&A expense ratio decreased 450 basis points to 14.2% for the three months ended June 30, 2026 compared to 18.7% for the same period in 2025, primarily due to disciplined expense management and greater fixed cost leverage, as well as the impact of lower risk adjustment as a percentage of premium. The SG&A expense ratio decreased 250 basis points to 14.7% for the six months ended June 30, 2026, compared to 17.2% for the same period in 2025 primarily due to greater fixed cost leverage and disciplined expense management.
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