Oscar Health, Inc.
For the period ended Sep 30, 2026. Filed Nov 5, 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.
Sep 30, 2026 · Filed Nov 5, 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 September 30, | Nine Months Ended September 30, | |||
|---|---|---|---|---|
| (in thousands, except percentages) | 2026 | 2025 | 2026 | 2025 |
| Revenue | ||||
| Premium | $5,041,987 | $2,923,968 | $14,412,180 | $8,723,233 |
| Investment income | 91,016 | 53,215 | 236,424 | 153,331 |
| Other revenues | 6,295 | 8,801 | 18,108 | 19,628 |
| Total revenue | 5,139,298 | 2,985,984 | 14,666,712 | 8,896,192 |
| Operating Expenses | ||||
| Medical | 4,232,845 | 2,586,330 | 11,257,147 | 7,398,954 |
| Selling, general, and administrative | 721,892 | 521,592 | 2,119,206 | 1,538,836 |
| Depreciation and amortization | 6,543 | 7,312 | 19,621 | 21,012 |
| Total operating expenses | 4,961,280 | 3,115,234 | 13,395,974 | 8,958,802 |
| Earnings (loss) from operations | 178,018 | (129,250) | 1,270,738 | (62,610) |
| Interest expense | 4,726 | 6,857 | 14,818 | 18,698 |
| Other expenses (income) | (2,089) | 3,184 | (1,245) | 3,308 |
| Earnings (loss) before income taxes | 175,381 | (139,291) | 1,257,165 | (84,616) |
| Income tax expense (benefit) | 8,077 | (1,807) | 49,010 | 5,853 |
| Net income (loss) | 167,304 | (137,484) | 1,208,155 | (90,469) |
| Less: Net income (loss) attributable to noncontrolling interests | 23 | (34) | 70 | 71 |
| Net income (loss) attributable to Oscar Health, Inc. | $167,281 | $(137,450) | $1,208,085 | $(90,540) |
| MLR | 84.0% | 88.5% | 78.1% | 84.8% |
| SG&A expense ratio | 14.0% | 17.5% | 14.4% | 17.3% |
Premium
Premium revenue increased $2.1 billion, or 72%, for the three months ended September 30, 2026, compared to the same period in 2025, driven by rate increases and higher membership. Premium revenue increased $5.7 billion, or 65%, for the nine months ended September 30, 2026, compared to the same period in 2025, driven by rate increases and higher membership, partially offset by an increase in the net risk adjustment transfer accrual.
As of September 30, 2026, effectuated membership increased by 0.6 million, or 27%, compared to September 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 September 30, | ||
|---|---|---|
| Effectuated Membership by Offering | 2026 | 2025 |
| Individual and Small Group (1) | 2,691,885 | 2,111,736 |
| Cigna+Oscar (2) | — | 5,168 |
| Total Members (3) | 2,691,885 | 2,116,904 |
| (1) Membership includes members enrolled through a Custom Health Option and Individual Care Expense Arrangement (“CHOICE”). 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. | ||
Investment Income
Investment income increased $37.8 million, or 71%, for the three months ended September 30, 2026, compared to the same period in 2025, and increased $83.1 million, or 54%, for the nine months ended September 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 $1.6 billion, or 64%, for the three months ended September 30, 2026, compared to the same period in 2025, and increased $3.9 billion, or 52%, for the nine months ended September 30, 2026, compared to the same period in 2025. These increases were primarily due to increased membership, as well as medical cost trend. MLR decreased for the three months and nine months ended September 30, 2026, compared to the same periods in 2025. The decrease was primarily driven by our disciplined pricing strategy.
| Three Months Ended September 30, | Nine Months Ended September 30, | |||
|---|---|---|---|---|
| (in thousands, except percentages) | 2026 | 2025 | 2026 | 2025 |
| Net claims before ceded quota share reinsurance (A) | $4,232,845 | $2,586,330 | $11,257,147 | $7,398,954 |
| Net premiums before ceded quota share reinsurance (B) | $5,041,987 | $2,923,968 | $14,412,180 | $8,723,233 |
| Medical Loss Ratio (A divided by B) | 84.0% | 88.5% | 78.1% | 84.8% |
Selling, General, and Administrative Expenses and SG&A Expense Ratio
Selling, general, and administrative expenses increased $200.3 million, or 38%, for the three months ended September 30, 2026, compared to the same period in 2025, and increased $580.4 million, or 38%, for the nine months ended September 30, 2026, compared to the same period in 2025. These increases were driven by higher membership year over year, resulting in higher volume-driven costs such as taxes and fees and broker commissions, as well as higher year-over-year exchange user fee rates.
The SG&A expense ratio decreased 350 basis points to 14.0% for the three months ended September 30, 2026 compared to 17.5% for the same period in 2025, primarily due to lower risk adjustment as a percentage of premium, greater fixed cost leverage, and disciplined expense management. The SG&A expense ratio decreased 290 basis points to 14.4% for the nine months ended September 30, 2026, compared to 17.3% for the same period in 2025, primarily due to greater fixed cost leverage and disciplined expense management.
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