In This Article:
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Total Revenue: $3 billion, a 42% increase year over year.
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Net Income: Approximately $275 million, a $98 million improvement over the prior year period.
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Earnings from Operations: $297 million, a $112 million increase year over year.
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Operating Margin: Improved by 110 basis points year over year to 9.8%.
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Medical Loss Ratio (MLR): Increased 120 basis points year over year to 75.4%.
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SG&A Expense Ratio: 15.8%, a 260-basis point improvement year over year.
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Adjusted EBITDA: $329 million, improved by approximately $110 million year over year.
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Effectuated Members: Approximately 2 million, a 41% increase year over year.
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Cash and Investments: Approximately $4.9 billion at the end of the first quarter.
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Insurance Subsidiaries Capital and Surplus: Approximately $1.5 billion, including $907 million of excess capital.
Release Date: May 07, 2025
For the complete transcript of the earnings call, please refer to the full earnings call transcript.
Positive Points
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Oscar Health Inc (NYSE:OSCR) reported a 42% year-over-year increase in total revenue, reaching $3 billion for the first quarter of 2025.
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The company achieved a significant improvement in net income, reporting approximately $275 million, which is $98 million higher than the previous year.
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Oscar Health Inc (NYSE:OSCR) improved its operating margin by 110 basis points year over year to 9.8%.
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The company reported the lowest SG&A ratio in its history at 15.8%, a 260-basis point improvement year over year.
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Oscar Health Inc (NYSE:OSCR) closed the quarter with approximately 2 million effectuated members, marking a 41% increase year over year.
Negative Points
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The medical loss ratio (MLR) increased by 120 basis points year over year to 75.4%, primarily due to a risk adjustment true-up for 2024.
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Oscar Health Inc (NYSE:OSCR) anticipates membership to trend down in the latter half of the year due to the proposal to end the continuous SEP for individuals below 150% of the federal poverty level.
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The company faces potential challenges from CMS's proposed program integrity initiatives, which could constrain Americans' ability to shop for plans.
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Oscar Health Inc (NYSE:OSCR) is concerned about the impact of shortened enrollment windows on consumers' ability to find suitable plans.
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The company is preparing for potential pricing issues in 2026 due to changes in premium tax credits and integrity regulations, which could impact the uninsured rate.
Q & A Highlights
Q: How should we think about the membership numbers for the second quarter and the rest of the year? A: Membership in the first quarter exceeded expectations due to strong payment rates and SEP performance. We expect membership to trend up in the first half of the year but anticipate a decline in the second half due to the proposed end of the continuous SEP for individuals below 150% of the federal poverty level. We expect to end the year with around 1.8 million members. - Scott Black (Trades, Portfolio), CFO