(State or Other Jurisdiction of Incorporation) | (Commission File Number) | (IRS Employer Identification No.) | ||||||||||||
| Written communications pursuant to Rule 425 under the Securities Act (17 CFR 230.425). | |||||
| Soliciting material pursuant to Rule 14a-12 under the Exchange Act (17 CFR 240.14a-12). | |||||
| Pre-commencement communications pursuant to Rule 14d-2(b) under the Exchange Act (17 CFR 240.14d-2(b)). | |||||
| Pre-commencement communications pursuant to Rule 13e-4(c) under the Exchange Act (17 CFR 240.13e-4(c)). | |||||
| Title of each class | Trading Symbols | Name of each exchange on which registered | ||||||||||||
| Exhibit No. | Description | |||||||
| 99.1 | ||||||||
| 99.2 | ||||||||
| 104 | Cover Page Interactive Data File (embedded within the Inline XBRL document). | |||||||
| Oscar Health, Inc. | |||||||||||
| By: | /s/ R. Scott Blackley | ||||||||||
| Name: | R. Scott Blackley | ||||||||||
| Title: | Chief Financial Officer | ||||||||||
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Oscar Health, Inc. ir.hioscar.com News Release | |||||
| Financial Results Summary | |||||||||||
| Three Months Ended March 31, | |||||||||||
| (in thousands) | 2024 | 2023 | |||||||||
| Premium | $ | 2,093,682 | $ | 1,428,626 | |||||||
| Total revenue | $ | 2,142,305 | $ | 1,469,685 | |||||||
| Total operating expenses | $ | 1,956,747 | $ | 1,495,050 | |||||||
| Net income (loss) attributable to Oscar Health, Inc. | $ | 177,368 | $ | (39,772) | |||||||
Key Metrics and Non-GAAP Financial Metrics | |||||||||||
| Three Months Ended March 31, | |||||||||||
| (in thousands, except percentages) | 2024 | 2023 | |||||||||
| Total revenue | $ | 2,142,305 | $ | 1,469,685 | |||||||
| Medical Loss Ratio (MLR) | 74.2 | % | 76.3 | % | |||||||
| SG&A Expense Ratio | 18.4 | % | 27.1 | % | |||||||
Adjusted EBITDA(1) | $ | 219,314 | $ | 51,068 | |||||||
| As of March 31, | |||||||||||
| Membership by Offering | 2024 | 2023 | |||||||||
| Individual and Small Group | 1,386,980 | 948,431 | |||||||||
| Medicare Advantage | — | 1,793 | |||||||||
Cigna + Oscar (1) | 61,428 | 67,108 | |||||||||
Total Members (2) | 1,448,408 | 1,017,332 | |||||||||
| Three Months Ended March 31, | |||||||||||
| (in thousands, except per share amounts) | 2024 | 2023 | |||||||||
| Revenue | |||||||||||
| Premium | $ | 2,093,682 | $ | 1,428,626 | |||||||
| Investment income | 42,989 | 36,056 | |||||||||
| Services and other | 5,634 | 5,003 | |||||||||
| Total revenue | 2,142,305 | 1,469,685 | |||||||||
| Operating Expenses | |||||||||||
| Medical | 1,554,774 | 1,091,592 | |||||||||
| Selling, general, and administrative | 394,162 | 398,519 | |||||||||
| Depreciation and amortization | 7,811 | 4,939 | |||||||||
| Total operating expenses | 1,956,747 | 1,495,050 | |||||||||
| Earnings (loss) from operations | 185,558 | (25,365) | |||||||||
| Interest expense | 5,902 | 6,136 | |||||||||
| Other expenses | 1,178 | 6,106 | |||||||||
| Earnings (loss) before income taxes | 178,478 | (37,607) | |||||||||
| Income tax expense | 996 | 2,021 | |||||||||
| Net income (loss) | 177,482 | (39,628) | |||||||||
| Less: Net income attributable to noncontrolling interests | 114 | 144 | |||||||||
| Net income (loss) attributable to Oscar Health, Inc. | $ | 177,368 | $ | (39,772) | |||||||
| Earnings (Loss) per Share | |||||||||||
| Basic | $ | 0.77 | $ | (0.18) | |||||||
| Diluted | $ | 0.62 | $ | (0.18) | |||||||
| Weighted Average Common Shares Outstanding | |||||||||||
| Basic | 231,443 | 216,913 | |||||||||
| Diluted | 293,796 | 216,913 | |||||||||
| (in thousands, except share amounts) | March 31, 2024 | December 31, 2023 | |||||||||
| Assets | |||||||||||
| Current Assets: | |||||||||||
| Cash and cash equivalents | $ | 2,230,799 | $ | 1,870,315 | |||||||
| Short-term investments | 616,134 | 689,833 | |||||||||
| Premiums and accounts receivable (net of allowance for credit losses of $30,600 and $31,600) | 342,904 | 201,269 | |||||||||
| Risk adjustment transfer receivable | 62,037 | 51,925 | |||||||||
| Reinsurance recoverable | 242,935 | 241,194 | |||||||||
| Other current assets | 8,983 | 6,564 | |||||||||
| Total current assets | 3,503,792 | 3,061,100 | |||||||||
| Property, equipment, and capitalized software, net | 61,406 | 61,930 | |||||||||
| Long-term investments | 736,624 | 365,309 | |||||||||
| Restricted deposits | 29,814 | 29,870 | |||||||||
| Other assets | 87,217 | 83,271 | |||||||||
| Total assets | $ | 4,418,853 | $ | 3,601,480 | |||||||
| Liabilities and Stockholders' Equity | |||||||||||
| Current Liabilities: | |||||||||||
| Benefits payable | $ | 1,248,347 | $ | 965,986 | |||||||
| Risk adjustment transfer payable | 1,336,022 | 1,056,941 | |||||||||
| Premium deficiency reserve | 4,332 | 5,776 | |||||||||
| Unearned premiums | 65,541 | 65,918 | |||||||||
| Accounts payable and other liabilities | 303,245 | 273,367 | |||||||||
| Reinsurance payable | 61,938 | 61,024 | |||||||||
| Total current liabilities | 3,019,425 | 2,429,012 | |||||||||
| Long-term debt | 298,972 | 298,777 | |||||||||
| Other liabilities | 66,169 | 67,574 | |||||||||
| Total liabilities | 3,384,566 | 2,795,363 | |||||||||
| Commitments and contingencies | |||||||||||
| Stockholders' Equity | |||||||||||
| Class A common stock ($0.00001 par value; 825,000 thousand shares authorized, 200,497 thousand and 193,875 thousand shares outstanding as of March 31, 2024 and December 31, 2023, respectively) | 2 | 2 | |||||||||
| Class B common stock ($0.00001 par value; 82,500 thousand shares authorized, 35,514 thousand and 35,514 thousand shares outstanding as of March 31, 2024 and December 31, 2023, respectively) | — | — | |||||||||
| Treasury stock (315 thousand shares as of March 31, 2024 and December 31, 2023) | (2,923) | (2,923) | |||||||||
| Additional paid-in capital | 3,736,885 | 3,682,294 | |||||||||
| Accumulated deficit | (2,699,347) | (2,876,715) | |||||||||
| Accumulated other comprehensive income (loss) | (2,594) | 1,309 | |||||||||
| Total Oscar Health, Inc. stockholders' equity | 1,032,023 | 803,967 | |||||||||
| Noncontrolling interests | 2,264 | 2,150 | |||||||||
| Total stockholders' equity | 1,034,287 | 806,117 | |||||||||
| Total liabilities and stockholders' equity | $ | 4,418,853 | $ | 3,601,480 | |||||||
| Three Months Ended March 31, | |||||||||||
| (in thousands) | 2024 | 2023 | |||||||||
| Cash Flows from Operating Activities: | |||||||||||
| Net income (loss) | $ | 177,482 | $ | (39,628) | |||||||
| Adjustments to reconcile net income (loss) to net cash provided by operating activities: | |||||||||||
| Deferred taxes | (79) | (183) | |||||||||
| Net realized loss on sale of financial instruments | — | 43 | |||||||||
| Depreciation and amortization expense | 7,811 | 4,939 | |||||||||
| Amortization of debt issuance costs | 194 | 194 | |||||||||
| Stock-based compensation expense | 25,945 | 71,494 | |||||||||
| Net accretion of investments | (6,226) | (7,322) | |||||||||
| Change in provision for credit losses | (1,000) | 8,491 | |||||||||
| Changes in assets and liabilities: | |||||||||||
| (Increase) / decrease in: | |||||||||||
| Premiums and accounts receivable | (140,635) | 21,949 | |||||||||
| Risk adjustment transfer receivable | (10,112) | 1,740 | |||||||||
| Reinsurance recoverable | (1,741) | 440,652 | |||||||||
| Other assets | (6,285) | (4,526) | |||||||||
| Increase / (decrease) in: | |||||||||||
| Benefits payable | 282,361 | 16,349 | |||||||||
| Unearned premiums | (376) | (5,648) | |||||||||
| Premium deficiency reserve | (1,444) | (14) | |||||||||
| Accounts payable and other liabilities | 28,473 | 714 | |||||||||
| Reinsurance payable | 914 | (387,191) | |||||||||
| Risk adjustment transfer payable | 279,081 | 292,662 | |||||||||
| Net cash provided by operating activities | 634,363 | 414,715 | |||||||||
| Cash Flows from Investing Activities: | |||||||||||
| Purchase of investments | (556,693) | (202,650) | |||||||||
| Sale of investments | — | 15,052 | |||||||||
| Maturity of investments | 261,428 | 330,486 | |||||||||
| Purchase of property, equipment and capitalized software | (5,950) | (7,379) | |||||||||
| Change in restricted deposits | 626 | — | |||||||||
| Net cash (used in) provided by investing activities | (300,589) | 135,509 | |||||||||
| Cash Flows from Financing Activities: | |||||||||||
| Proceeds from joint venture contribution | — | 471 | |||||||||
| Proceeds from exercise of stock options | 27,309 | 35 | |||||||||
| Net cash provided by financing activities | 27,309 | 506 | |||||||||
| Increase in cash, cash equivalents and restricted cash equivalents | 361,083 | 550,730 | |||||||||
| Cash, cash equivalents, restricted cash and cash equivalents—beginning of period | 1,891,971 | 1,580,497 | |||||||||
| Cash, cash equivalents, restricted cash and cash equivalents—end of period | 2,253,054 | 2,131,227 | |||||||||
| Cash and cash equivalents | 2,230,799 | 2,109,571 | |||||||||
| Restricted cash and cash equivalents included in restricted deposits | 22,255 | 21,656 | |||||||||
| Total cash, cash equivalents and restricted cash and cash equivalents | $ | 2,253,054 | $ | 2,131,227 | |||||||
| Supplemental Disclosures: | |||||||||||
| Interest payments | $ | 11,118 | $ | 11,319 | |||||||
| Three Months Ended March 31, | |||||||||||
| (in thousands, except percentages) | 2024 | 2023 | |||||||||
| Medical | $ | 1,554,774 | $ | 1,091,592 | |||||||
Less: Ceded quota share reinsurance claims (1) | (1,055) | 6,435 | |||||||||
Net claims before ceded quota share reinsurance (A) | $ | 1,555,829 | $ | 1,085,157 | |||||||
| Premium | $ | 2,093,682 | $ | 1,428,626 | |||||||
Less: Ceded quota share reinsurance premiums (2) | (2,016) | 6,655 | |||||||||
Net premiums before ceded quota share reinsurance (B) | $ | 2,095,698 | $ | 1,421,971 | |||||||
Medical Loss Ratio (A divided by B) | 74.2 | % | 76.3 | % | |||||||
| Three Months Ended March 31, | |||||||||||
| (in thousands) | 2024 | 2023 | |||||||||
| Net income (loss) | $ | 177,482 | $ | (39,628) | |||||||
| Interest expense | 5,902 | 6,136 | |||||||||
| Other expenses | 1,178 | 6,106 | |||||||||
| Income tax expense | 996 | 2,021 | |||||||||
| Depreciation and amortization | 7,811 | 4,939 | |||||||||
Stock-based compensation(1) | 25,945 | 71,494 | |||||||||
| Adjusted EBITDA | $ | 219,314 | $ | 51,068 | |||||||
| Three Months Ended March 31, | |||||||||||
| (in thousands) | 2024 | 2023 | |||||||||
| Quota share ceded premiums | $ | (4,994) | $ | 12,360 | |||||||
| Quota share ceded claims | 1,055 | (6,435) | |||||||||
Ceding commission, net of deposit accounting impact (1) | (12,172) | (9,295) | |||||||||
| Experience refund | 2,979 | (5,705) | |||||||||
| Net quota share impact | $ | (13,132) | $ | (9,075) | |||||||
| Three Months Ended March 31, | |||||||||||
| (in thousands) | 2024 | 2023 | |||||||||
| Direct policy premiums | $ | 2,310,100 | $ | 1,663,474 | |||||||
| Assumed premiums | 57,612 | 55,935 | |||||||||
| Risk adjustment | (269,398) | (293,147) | |||||||||
| Premiums before ceded reinsurance | 2,098,314 | 1,426,262 | |||||||||
| Reinsurance premiums ceded | (4,632) | 2,364 | |||||||||
| Premium | $ | 2,093,682 | $ | 1,428,626 | |||||||
| Three Months Ended March 31, | |||||||||||
| (in thousands) | 2024 | 2023 | |||||||||
| Direct claims incurred | $ | 1,523,646 | $ | 1,048,058 | |||||||
| Ceded reinsurance claims | (19,698) | (3,624) | |||||||||
| Assumed reinsurance claims | 50,826 | 47,158 | |||||||||
| Medical expenses | $ | 1,554,774 | $ | 1,091,592 | |||||||
| Three Months Ended March 31, | |||||||||||
| (in thousands) | 2024 | 2023 | |||||||||
| Selling, general and administrative expenses, gross | $ | 394,696 | $ | 396,984 | |||||||
| Reinsurance ceding commissions | (534) | 1,535 | |||||||||
| Selling, general and administrative expenses | $ | 394,162 | $ | 398,519 | |||||||
| (in thousands) | March 31, 2024 | December 31, 2023 | |||||||||
| Reinsurance premium and claim recoverables | $ | 235,216 | $ | 224,837 | |||||||
| Reinsurance ceding commissions | 7,613 | 7,054 | |||||||||
| Experience refunds on reinsurance agreements | 106 | 9,303 | |||||||||
| Reinsurance recoverable | $ | 242,935 | $ | 241,194 | |||||||
![]() | |||||
Oscar Health, Inc. ir.hioscar.com | |||||
Three Months Ended | Year Ended | ||||||||||||||||||||||||||||
| (in thousands) | March 31, 2023 | June 30, 2023 | September 30, 2023 | December 31, 2023 | December 31, 2023 | ||||||||||||||||||||||||
Revenue | |||||||||||||||||||||||||||||
| Premium | $ | 1,428,626 | $ | 1,474,966 | $ | 1,392,082 | $ | 1,390,395 | $ | 5,686,069 | |||||||||||||||||||
| Investment income | 36,056 | 41,484 | 42,368 | 35,539 | 155,447 | ||||||||||||||||||||||||
| Services and other | 5,003 | 5,085 | 5,541 | 5,724 | 21,353 | ||||||||||||||||||||||||
Total revenue | 1,469,685 | 1,521,535 | 1,439,991 | 1,431,658 | 5,862,869 | ||||||||||||||||||||||||
Operating Expenses | |||||||||||||||||||||||||||||
Medical | 1,091,592 | 1,181,999 | 1,163,194 | 1,205,239 | 4,642,024 | ||||||||||||||||||||||||
| Selling, general, and administrative | 398,519 | 337,244 | 325,850 | 364,155 | 1,425,768 | ||||||||||||||||||||||||
Depreciation and amortization | 4,939 | 8,821 | 9,191 | 7,741 | 30,692 | ||||||||||||||||||||||||
Total operating expenses | 1,495,050 | 1,528,064 | 1,498,235 | 1,577,135 | 6,098,484 | ||||||||||||||||||||||||
Earnings (loss) from operations | (25,365) | (6,529) | (58,244) | (145,477) | (235,615) | ||||||||||||||||||||||||
Interest expense | 6,136 | 6,120 | 6,130 | 6,217 | 24,603 | ||||||||||||||||||||||||
| Other expenses | 6,106 | 1,612 | 414 | (1,050) | 7,082 | ||||||||||||||||||||||||
Earnings (loss) before income taxes | (37,607) | (14,261) | (64,788) | (150,644) | (267,300) | ||||||||||||||||||||||||
Income tax expense | 2,021 | 1,164 | 915 | (806) | 3,294 | ||||||||||||||||||||||||
Net income (loss) | (39,628) | (15,425) | (65,703) | (149,838) | (270,594) | ||||||||||||||||||||||||
| Less: Net income attributable to noncontrolling interests | 144 | 103 | (305) | 192 | 134 | ||||||||||||||||||||||||
| Net income (loss) attributable to Oscar Health, Inc. | $ | (39,772) | $ | (15,528) | $ | (65,398) | $ | (150,030) | $ | (270,728) | |||||||||||||||||||
Three Months Ended | Year Ended | ||||||||||||||||||||||||||||
| (in thousands, except percentages) | March 31, 2023 | June 30, 2023 | September 30, 2023 | December 31, 2023 | December 31, 2023 | ||||||||||||||||||||||||
| Total revenue | $ | 1,469,685 | $ | 1,521,535 | $ | 1,439,991 | $ | 1,431,658 | $ | 5,862,869 | |||||||||||||||||||
Medical Loss Ratio (MLR)(1) | 76.3 | % | 79.9 | % | 83.8 | % | 86.4 | % | 81.6 | % | |||||||||||||||||||
| SG&A Expense Ratio | 27.1 | % | 22.2 | % | 22.6 | % | 25.4 | % | 24.3 | % | |||||||||||||||||||
Adjusted EBITDA(2) | $ | 51,068 | $ | 35,572 | $ | (20,285) | $ | (111,593) | $ | (45,238) | |||||||||||||||||||
Three Months Ended | Year Ended | ||||||||||||||||||||||||||||
| (in thousands, except percentages) | March 31, 2023 | June 30, 2023 | September 30, 2023 | December 31, 2023 | December 31, 2023 | ||||||||||||||||||||||||
| Medical | $ | 1,091,592 | $ | 1,181,999 | $ | 1,163,194 | $ | 1,205,239 | $ | 4,642,024 | |||||||||||||||||||
Less: Ceded quota share reinsurance claims (1) | $ | (6,435) | $ | 2,786 | $ | 4,870 | $ | (3,277) | $ | (2,056) | |||||||||||||||||||
Net claims before ceded quota share reinsurance (A) | $ | 1,085,157 | $ | 1,184,785 | $ | 1,168,064 | $ | 1,201,962 | $ | 4,639,968 | |||||||||||||||||||
| Premium | $ | 1,428,626 | $ | 1,474,966 | $ | 1,392,082 | $ | 1,390,395 | $ | 5,686,069 | |||||||||||||||||||
Less: Ceded quota share reinsurance premiums (2) | $ | (6,655) | $ | 7,338 | $ | 1,448 | $ | 80 | $ | 2,211 | |||||||||||||||||||
Net premiums before ceded quota share reinsurance (B) | $ | 1,421,971 | $ | 1,482,304 | $ | 1,393,530 | $ | 1,390,475 | $ | 5,688,280 | |||||||||||||||||||
Medical Loss Ratio (A divided by B) | 76.3 | % | 79.9 | % | 83.8 | % | 86.4 | % | 81.6 | % | |||||||||||||||||||
Three Months Ended | Year Ended | ||||||||||||||||||||||||||||
| (in thousands) | March 31, 2023 | June 30, 2023 | September 30, 2023 | December 31, 2023 | December 31, 2023 | ||||||||||||||||||||||||
| Net income (loss) | $ | (39,628) | $ | (15,425) | $ | (65,703) | $ | (149,838) | $ | (270,594) | |||||||||||||||||||
| Interest expense | 6,136 | 6,120 | 6,130 | 6,217 | 24,603 | ||||||||||||||||||||||||
| Other expenses (income) | 6,106 | 1,612 | 414 | (1,050) | 7,082 | ||||||||||||||||||||||||
| Income tax expense (benefit) | 2,021 | 1,164 | 915 | (806) | 3,294 | ||||||||||||||||||||||||
| Depreciation and amortization | 4,939 | 8,822 | 9,191 | 7,742 | 30,694 | ||||||||||||||||||||||||
Stock-based compensation (1) | 71,494 | 33,279 | 28,768 | 26,142 | 159,683 | ||||||||||||||||||||||||
| Adjusted EBITDA | $ | 51,068 | $ | 35,572 | $ | (20,285) | $ | (111,593) | $ | (45,238) | |||||||||||||||||||