Oscar Health Announces Results for Third Quarter 2024
Oscar Health reported Q3 2024 results with total revenue of $2.4 billion, up 68% year-over-year. The company posted a Medical Loss Ratio of 84.6% (up 80 bps) and improved SG&A Expense Ratio of 19.0% (down 360 bps). Net loss was $54.6 million, improving by $10.8 million, while Adjusted EBITDA loss was $11.6 million, an $8.7 million improvement. The company updated its 2024 outlook, raising revenue guidance to $9.2-9.3 billion and projecting net income profitability for the year. Total membership reached 1,654,284, primarily driven by Individual and Small Group growth.
Oscar Health ha riportato i risultati del terzo trimestre 2024, con un fatturato totale di 2,4 miliardi di dollari, in aumento del 68% rispetto all'anno precedente. L'azienda ha registrato un rapporto di perdita medica del 84,6% (in aumento di 80 punti base) e un miglioramento del rapporto di spese SG&A al 19,0% (in diminuzione di 360 punti base). La perdita netta è stata di 54,6 milioni di dollari, con un miglioramento di 10,8 milioni, mentre la perdita dell'EBITDA rettificato è stata di 11,6 milioni di dollari, con un miglioramento di 8,7 milioni. L'azienda ha aggiornato le previsioni per il 2024, aumentando la previsione di fatturato a 9,2-9,3 miliardi di dollari e proiettando una redditività netta per l'anno. Il totale degli iscritti ha raggiunto 1.654.284, principalmente grazie alla crescita degli segmenti Individuali e Piccole Imprese.
Oscar Health informó los resultados del tercer trimestre de 2024, con un ingreso total de 2.4 mil millones de dólares, un aumento del 68% en comparación con el año anterior. La empresa presentó un Ratio de Pérdida Médica del 84.6% (un aumento de 80 puntos básicos) y mejoró el Ratio de Gastos SG&A al 19.0% (una disminución de 360 puntos básicos). La pérdida neta fue de 54.6 millones de dólares, mejorando en 10.8 millones, mientras que la pérdida de EBITDA Ajustado fue de 11.6 millones de dólares, una mejora de 8.7 millones. La empresa actualizó su pronóstico para 2024, elevando la guía de ingresos a entre 9.2 y 9.3 mil millones de dólares y proyectando rentabilidad neta para el año. El total de miembros alcanzó 1,654,284, impulsado principalmente por el crecimiento de Individuos y Pequeños Grupos.
오스카 헬스는 2024년 3분기 실적을 보고했으며, 총 수익이 24억 달러로 이전 해 대비 68% 증가했습니다. 회사의 의료 손실 비율은 84.6%(80bp 상승)였고, SG&A 비용 비율은 19.0%(360bp 감소)로 개선되었습니다. 순손실은 5460만 달러로 1080만 달러 개선되었고, 조정된 EBITDA 손실은 1160만 달러로 870만 달러 개선되었습니다. 회사는 2024년 전망을 업데이트하며 수익 지침을 92억-93억 달러로 상향 조정하고, 올해 순이익을 예상했습니다. 총 가입자는 1,654,284명에 이르렀으며, 주로 개인 및 소규모 그룹의 성장에 의해 주도되었습니다.
Oscar Health a présenté ses résultats du troisième trimestre 2024, avec un chiffre d'affaires total de 2,4 milliards de dollars, en hausse de 68 % par rapport à l'année précédente. La société a affiché un ratio de perte médicale de 84,6 % (en hausse de 80 points de base) et a amélioré le ratio des dépenses SG&A à 19,0 % (en baisse de 360 points de base). La perte nette a été de 54,6 millions de dollars, s'améliorant de 10,8 millions, tandis que la perte d'EBITDA ajusté était de 11,6 millions de dollars, soit une amélioration de 8,7 millions. La société a mis à jour ses prévisions pour 2024, relevant les prévisions de chiffre d'affaires à 9,2-9,3 milliards de dollars et projetant une rentabilité nette pour l'année. Le nombre total de membres a atteint 1 654 284, principalement en raison de la croissance des segments individuels et de petits groupes.
Oscar Health berichtete über die Ergebnisse des dritten Quartals 2024 mit einem Gesamtumsatz von 2,4 Milliarden Dollar, was einem Anstieg von 68% im Vergleich zum Vorjahr entspricht. Das Unternehmen wies eine medizinische Verlustquote von 84,6% auf (ein Anstieg um 80 Basispunkte) und verbesserte das SG&A-Kostenverhältnis auf 19,0% (ein Rückgang um 360 Basispunkte). Der Nettoverlust betrug 54,6 Millionen Dollar, was eine Verbesserung um 10,8 Millionen Dollar bedeutet, während der bereinigte EBITDA-Verlust bei 11,6 Millionen Dollar lag, was eine Verbesserung um 8,7 Millionen Dollar darstellt. Das Unternehmen aktualisierte seine Prognose für 2024 und erhöhte die Umsatzprognose auf 9,2-9,3 Milliarden Dollar und erwartet für das Jahr eine Nettorentabilität. Die Gesamtmitgliedschaft erreichte 1.654.284, primär getrieben durch das Wachstum im Einzel- und Kleingruppenbereich.
- Revenue grew 68% YoY to $2.4 billion
- SG&A Expense Ratio improved by 360 bps to 19.0%
- Net loss improved by $10.8 million YoY
- Membership increased to 1.65M from 983K YoY
- Raised full-year revenue guidance by $200M to $9.2-9.3B
- Projects achieving net income profitability in 2024
- Medical Loss Ratio increased 80 bps to 84.6%
- Continued net loss of $54.6 million in Q3
- Adjusted EBITDA remains negative at -$11.6 million
Insights
The Q3 results show significant progress in Oscar Health's financial trajectory. Revenue surged
While the Medical Loss Ratio increased slightly to
The membership growth to 1.65 million members, up from 983,160 year-over-year, validates the company's market penetration strategy and technology-driven approach.
Oscar's technology-first approach is proving to be a key differentiator in scaling operations efficiently. The significant improvement in the SG&A ratio while maintaining strong membership growth demonstrates the platform's scalability. The ability to handle a
The company's success in the Individual and Small Group segment, growing to over 1.6 million members, indicates strong product-market fit and effective digital engagement. However, the exit from Medicare Advantage and declining Cigna+Oscar membership suggests a strategic focus on core markets where their technology platform delivers the most value.
-
For the quarter ended September 30, 2024:
-
Total Revenue of
$2.4 billion 68% increase year-over-year -
Medical Loss Ratio of
84.6% , an 80 bps increase year-over-year -
SG&A Expense Ratio of
19.0% , a 360 bps improvement year-over-year -
Net loss attributable to Oscar of
$54.6 million $(0.22) of earnings per share, a$10.8 million -
Adjusted EBITDA loss of
$11.6 million $8.7 million
-
Total Revenue of
“Oscar reported positive third quarter results with strong revenue growth and improved financial performance," said Mark Bertolini, CEO of Oscar Health. “Our technology continues to enhance our growth and positions us to efficiently scale the business. We expect to deliver positive Adjusted EBITDA and net income profitability this year, setting a solid foundation to achieve our long-term targets.”
Total Revenue of
The Medical Loss Ratio increased 80 bps year-over-year to
Adjusted EBITDA loss of
Oscar is updating its full year 2024 outlook to reflect year-to-date performance. The Company projects Revenue to be in the
Key Metrics and Non-GAAP Financial Metrics |
|||||||||||||||
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|
|
|
|
|
||||||||
|
Three Months Ended September 30, |
|
Nine Months Ended September 30, |
||||||||||||
(in thousands, except percentages) |
|
2024 |
|
|
|
2023 |
|
|
|
2024 |
|
|
|
2023 |
|
Total revenue |
$ |
2,423,482 |
|
|
$ |
1,439,991 |
|
|
$ |
6,785,128 |
|
|
$ |
4,431,211 |
|
Medical Loss Ratio (MLR) |
|
84.6 |
% |
|
|
83.8 |
% |
|
|
79.5 |
% |
|
|
80.0 |
% |
SG&A Expense Ratio |
|
19.0 |
% |
|
|
22.6 |
% |
|
|
19.0 |
% |
|
|
24.0 |
% |
Adjusted EBITDA(1) |
$ |
(11,563 |
) |
|
$ |
(20,285 |
) |
|
$ |
311,877 |
|
|
$ |
66,355 |
|
(1) |
Adjusted EBITDA is a non-GAAP measure. See “Key Operating and Non-GAAP Financial Metrics - Adjusted EBITDA” in this release for a reconciliation to net loss, the most directly comparable GAAP measure, and for information regarding Oscar’s use of Adjusted EBITDA. |
|
|
|
|
|
As of September 30, |
||
Membership by Offering |
2024 |
|
2023 |
Individual and Small Group |
1,602,993 |
|
912,761 |
Medicare Advantage |
— |
|
1,840 |
Cigna+Oscar (1) |
51,291 |
|
68,559 |
Total Members (2) |
1,654,284 |
|
983,160 |
(1) |
Represents total membership for Oscar’s co-branded partnership with Cigna. |
(2) |
A member covered under more than one of our health plans counts as a single member for the purposes of this metric. |
Quarterly Conference Call Details
Oscar will host a conference call to discuss the financial results today, November 7, 2024, at 8:00 a.m. (ET). A live audio webcast will be available via the Investor Relations page of Oscar’s website at ir.hioscar.com. A replay of the webcast will be available for on-demand listening shortly after the completion of the call, at the same web link, and will remain available for approximately 90 days.
Non-GAAP Financial Information
This release presents Adjusted EBITDA, a non-GAAP financial metric, which is provided as a complement to the results provided in accordance with accounting principles generally accepted in
Oscar has not provided a quantitative reconciliation of forecasted Adjusted EBITDA to forecasted GAAP net income (loss) within this press release because Oscar is unable, without making unreasonable efforts, to calculate certain reconciling items with confidence. These items include, but are not limited to, stock-based compensation expense. These items, which could materially affect the computation of forecasted GAAP net income (loss), are inherently uncertain and depend on various factors, some of which are outside of Oscar’s control. As such, any associated estimate and its impact on GAAP net income (loss) could vary materially.
Cautionary Note Regarding Forward-Looking Statements
This press release contains forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. All statements other than statements of historical fact contained herein are forward-looking statements. These statements include, but are not limited to, statements about our financial outlook and estimates, including Total revenue, Medical Loss Ratio, SG&A Expense Ratio and Adjusted EBITDA and other financial performance metrics, and the related underlying assumptions, our profitability goals, our business and financial prospects, including potential future growth, and our management’s plans and objectives for future operations, expectations and business strategy. In some cases, you can identify forward-looking statements by terms such as “may,” “will,” “should,” “expects,” “plans,” “anticipates,” “could,” “intends,” “targets,” “projects,” “contemplates,” “believes,” “estimates,” “predicts,” “potential,” or “continue” or the negative of these terms or other similar expressions. Accordingly, we caution you that any such forward-looking statements are not guarantees of future performance and are subject to risks, assumptions, and uncertainties that are difficult to predict and generally beyond our control.
Although we believe that the expectations reflected in these forward-looking statements are reasonable as of the date made, there are or will be important factors that could cause our actual results to differ materially from those indicated in these forward-looking statements, including, but not limited to, the following: our ability to execute our strategy and manage our growth effectively; our ability to retain and expand our member base; heightened competition in the markets in which we participate; our ability to accurately estimate our incurred medical expenses or effectively manage our medical costs or related administrative costs; our ability to achieve or maintain profitability in the future; changes in federal or state laws or regulations, including changes with respect to the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010, as amended (collectively, the “ACA”), and any regulations enacted thereunder; our ability to comply with ongoing regulatory requirements, including capital reserve and surplus requirements and applicable performance standards; changes or developments in the health insurance markets in
You are cautioned not to place undue reliance on any forward-looking statements made in this press release. Any forward-looking statement speaks only as of the date as of which it is made, and, except as otherwise required by law, we do not undertake any obligation to publicly update or review any forward-looking statement, whether as a result of new information, future developments or otherwise. New factors emerge from time to time, and it is not possible for us to predict which will arise.
About Oscar Health
Oscar Health, Inc. (“Oscar”) is a leading healthcare technology company built around a full stack technology platform and a relentless focus on serving our members. We have been challenging the status quo in the healthcare system since our founding in 2012, and are dedicated to making a healthier life accessible and affordable for all. Oscar offers Individual & Family plans and health technology solutions that power the healthcare industry through +Oscar. Our technology drives superior experiences, deep engagement, and high-value clinical care, earning us the trust of approximately 1.65 million members, as of September 30, 2024.
Oscar Health, Inc.
|
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|
Three Months Ended September 30, |
|
Nine Months Ended September 30, |
|||||||||||
(in thousands, except per share amounts) |
2024 |
|
2023 |
|
2024 |
|
2023 |
|||||||
Revenue |
|
|
|
|
|
|
|
|||||||
Premium |
$ |
2,368,257 |
|
|
$ |
1,392,082 |
|
|
$ |
6,626,055 |
|
$ |
4,295,674 |
|
Investment income |
|
50,326 |
|
|
|
42,368 |
|
|
|
143,309 |
|
|
119,908 |
|
Services and other |
|
4,899 |
|
|
|
5,541 |
|
|
|
15,764 |
|
|
15,629 |
|
Total revenue |
|
2,423,482 |
|
|
|
1,439,991 |
|
|
|
6,785,128 |
|
|
4,431,211 |
|
Operating Expenses |
|
|
|
|
|
|
|
|||||||
Medical |
|
2,003,979 |
|
|
|
1,163,194 |
|
|
|
5,267,475 |
|
|
3,436,785 |
|
Selling, general, and administrative |
|
460,377 |
|
|
|
325,850 |
|
|
|
1,289,745 |
|
|
1,061,612 |
|
Depreciation and amortization |
|
7,500 |
|
|
|
9,191 |
|
|
|
22,912 |
|
|
22,952 |
|
Total operating expenses |
|
2,471,856 |
|
|
|
1,498,235 |
|
|
|
6,580,132 |
|
|
4,521,349 |
|
Earnings (loss) from operations |
|
(48,374 |
) |
|
|
(58,244 |
) |
|
|
204,996 |
|
|
(90,138 |
) |
Interest expense |
|
5,815 |
|
|
|
6,130 |
|
|
|
17,708 |
|
|
18,386 |
|
Other expenses (income) |
|
(1,877 |
) |
|
|
414 |
|
|
|
173 |
|
|
8,132 |
|
Earnings (loss) before income taxes |
|
(52,312 |
) |
|
|
(64,788 |
) |
|
|
187,115 |
|
|
(116,656 |
) |
Income tax expense |
|
2,076 |
|
|
|
915 |
|
|
|
7,709 |
|
|
4,100 |
|
Net income (loss) |
|
(54,388 |
) |
|
|
(65,703 |
) |
|
|
179,406 |
|
|
(120,756 |
) |
Less: Net income (loss) attributable to noncontrolling interests |
|
208 |
|
|
|
(305 |
) |
|
|
427 |
|
|
(58 |
) |
Net income (loss) attributable to Oscar Health, Inc. |
$ |
(54,596 |
) |
|
$ |
(65,398 |
) |
|
$ |
178,979 |
|
$ |
(120,698 |
) |
|
|
|
|
|
|
|
|
|||||||
Earnings (Loss) per Share |
|
|
|
|
|
|
|
|||||||
Basic |
$ |
(0.22 |
) |
|
$ |
(0.29 |
) |
|
$ |
0.75 |
|
$ |
(0.55 |
) |
Diluted |
$ |
(0.22 |
) |
|
$ |
(0.29 |
) |
|
$ |
0.65 |
|
$ |
(0.55 |
) |
Weighted Average Common Shares Outstanding |
|
|
|
|
|
|
|
|||||||
Basic |
|
243,106 |
|
|
|
223,099 |
|
|
|
237,759 |
|
|
219,827 |
|
Diluted |
|
243,106 |
|
|
|
223,099 |
|
|
|
301,459 |
|
|
219,827 |
|
Oscar Health, Inc.
|
|||||||
(in thousands) |
September 30, 2024 |
|
December 31, 2023 |
||||
Assets |
|
|
|
||||
Current Assets: |
|
|
|
||||
Cash and cash equivalents |
$ |
1,206,145 |
|
|
$ |
1,870,315 |
|
Short-term investments |
|
503,784 |
|
|
|
689,833 |
|
Premiums and accounts receivable (net of allowance for credit losses of |
|
300,635 |
|
|
|
201,269 |
|
Risk adjustment transfer receivable |
|
63,512 |
|
|
|
51,925 |
|
Reinsurance recoverable |
|
273,317 |
|
|
|
241,194 |
|
Other current assets |
|
20,661 |
|
|
|
6,564 |
|
Total current assets |
|
2,368,054 |
|
|
|
3,061,100 |
|
Property, equipment, and capitalized software, net |
|
66,631 |
|
|
|
61,930 |
|
Long-term investments |
|
1,933,892 |
|
|
|
365,309 |
|
Restricted deposits |
|
30,069 |
|
|
|
29,870 |
|
Other assets |
|
84,369 |
|
|
|
83,271 |
|
Total assets |
$ |
4,483,015 |
|
|
$ |
3,601,480 |
|
|
|
|
|
||||
Liabilities and Stockholders' Equity |
|
|
|
||||
Current Liabilities: |
|
|
|
||||
Benefits payable |
$ |
1,356,726 |
|
|
$ |
965,986 |
|
Risk adjustment transfer payable |
|
1,083,880 |
|
|
|
1,056,941 |
|
Premium deficiency reserve |
|
1,444 |
|
|
|
5,776 |
|
Unearned premiums |
|
66,129 |
|
|
|
65,918 |
|
Accounts payable and other liabilities |
|
395,481 |
|
|
|
273,367 |
|
Reinsurance payable |
|
51,117 |
|
|
|
61,024 |
|
Total current liabilities |
|
2,954,777 |
|
|
|
2,429,012 |
|
Long-term debt |
|
299,361 |
|
|
|
298,777 |
|
Other liabilities |
|
63,537 |
|
|
|
67,574 |
|
Total liabilities |
|
3,317,675 |
|
|
|
2,795,363 |
|
Commitments and contingencies |
|
|
|
||||
Stockholders' Equity |
|
|
|
||||
Class A common stock ( |
|
2 |
|
|
|
2 |
|
Class B common stock ( |
|
— |
|
|
|
— |
|
Treasury stock (315 thousand shares as of September 30, 2024 and December 31, 2023) |
|
(2,923 |
) |
|
|
(2,923 |
) |
Additional paid-in capital |
|
3,837,369 |
|
|
|
3,682,294 |
|
Accumulated deficit |
|
(2,697,736 |
) |
|
|
(2,876,715 |
) |
Accumulated other comprehensive income |
|
26,051 |
|
|
|
1,309 |
|
Total Oscar Health, Inc. stockholders' equity |
|
1,162,763 |
|
|
|
803,967 |
|
Noncontrolling interests |
|
2,577 |
|
|
|
2,150 |
|
Total stockholders' equity |
|
1,165,340 |
|
|
|
806,117 |
|
Total liabilities and stockholders' equity |
$ |
4,483,015 |
|
$ |
3,601,480 |
|
|
Oscar Health, Inc.
|
|||||||
|
Nine Months Ended September 30, |
||||||
(in thousands) |
2024 |
|
2023 |
||||
Cash Flows from Operating Activities: |
|
|
|
||||
Net income (loss) |
$ |
179,406 |
|
|
$ |
(120,756 |
) |
Adjustments to reconcile net income (loss) to net cash provided by operating activities: |
|
|
|
||||
Deferred taxes |
|
(68 |
) |
|
|
95 |
|
Net realized loss on sale of financial instruments |
|
2 |
|
|
|
70 |
|
Depreciation and amortization expense |
|
22,912 |
|
|
|
22,952 |
|
Amortization of debt issuance costs |
|
583 |
|
|
|
583 |
|
Stock-based compensation expense |
|
83,969 |
|
|
|
133,541 |
|
Net accretion of investments |
|
(18,956 |
) |
|
|
(22,856 |
) |
Change in provision for credit losses |
|
(1,500 |
) |
|
|
12,000 |
|
Changes in assets and liabilities: |
|
|
|
||||
(Increase) / decrease in: |
|
|
|
||||
Premiums and accounts receivable |
|
(97,867 |
) |
|
|
(2,622 |
) |
Risk adjustment transfer receivable |
|
(11,587 |
) |
|
|
(4,265 |
) |
Reinsurance recoverable |
|
(32,123 |
) |
|
|
615,084 |
|
Other assets |
|
(15,127 |
) |
|
|
3,854 |
|
Increase / (decrease) in: |
|
|
|
||||
Benefits payable |
|
390,740 |
|
|
|
(27,278 |
) |
Unearned premiums |
|
211 |
|
|
|
(7,396 |
) |
Premium deficiency reserve |
|
(4,332 |
) |
|
|
(4,035 |
) |
Accounts payable and other liabilities |
|
118,079 |
|
|
|
(41,366 |
) |
Reinsurance payable |
|
(9,907 |
) |
|
|
(360,335 |
) |
Risk adjustment transfer payable |
|
26,938 |
|
|
|
(766,297 |
) |
Net cash provided by (used in) operating activities |
|
631,373 |
|
|
|
(569,027 |
) |
Cash Flows from Investing Activities: |
|
|
|
||||
Purchase of investments |
|
(2,023,049 |
) |
|
|
(622,183 |
) |
Sale of investments |
|
21,188 |
|
|
|
26,656 |
|
Maturity of investments |
|
663,011 |
|
|
|
1,019,612 |
|
Purchase of property, equipment and capitalized software |
|
(21,078 |
) |
|
|
(19,475 |
) |
Change in restricted deposits |
|
3,942 |
|
|
|
100 |
|
Net cash (used in) provided by investing activities |
|
(1,355,986 |
) |
|
|
404,710 |
|
Cash Flows from Financing Activities: |
|
|
|
||||
Proceeds from joint venture contribution |
|
— |
|
|
|
2,491 |
|
Proceeds from exercise of stock options |
|
64,571 |
|
|
|
2,886 |
|
Net cash provided by financing activities |
|
64,571 |
|
|
|
5,377 |
|
Decrease in cash, cash equivalents and restricted cash equivalents |
|
(660,042 |
) |
|
|
(158,940 |
) |
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 |
|
1,231,929 |
|
|
|
1,421,557 |
|
Cash and cash equivalents |
|
1,206,145 |
|
|
|
1,399,791 |
|
Restricted cash and cash equivalents included in restricted deposits |
|
25,784 |
|
|
|
21,766 |
|
Total cash, cash equivalents and restricted cash and cash equivalents |
$ |
1,231,929 |
|
|
$ |
1,421,557 |
|
Supplemental Disclosures: |
|
|
|
||||
Interest payments |
$ |
22,480 |
|
|
$ |
22,893 |
|
Income tax payments |
$ |
636 |
|
|
$ |
1,000 |
|
Key Operating and Non-GAAP Financial Metrics
We regularly review the following key operating and Non-GAAP financial metrics to evaluate our business, measure our performance, identify trends in our business, prepare financial projections, and make strategic decisions. We believe these operational and financial measures are useful in evaluating our performance, in addition to our financial results prepared in accordance with GAAP.
Members
Members are defined as any individual covered by a health plan that we offer directly or through a co-branded arrangement. We view the number of members enrolled in our health plans as an important metric to help evaluate and estimate revenue and market share. Additionally, the more members we enroll, the more data we have, which allows us to improve the functionality of our platform.
Total Revenue
Total revenue includes Premium revenue, Investment income, and Services and other revenue. We believe Total revenue is an important metric to assess the growth of our business, as well as the earnings potential of our investment portfolio.
Medical Loss Ratio
Medical Loss Ratio is a metric used to calculate medical expenses as a percentage of net premiums before ceded quota share reinsurance. Medical expenses are the total expenses incurred by members in order to utilize health care services less any member cost sharing. These services include inpatient, outpatient, pharmacy, and physician costs. Medical claims also include fee-for-service claims, pharmacy benefits, capitation payments to providers, provider disputed claims, risk sharing arrangements with certain of our providers, and various other medical-related costs. The impact of the federal risk adjustment program is included in the denominator of our MLR. We believe MLR is an important metric to demonstrate the ratio of our costs to pay for healthcare of our members to the net premium before ceded reinsurance. MLR in our existing products are subject to various federal and state minimum requirements.
|
Three Months Ended September 30, |
|
Nine Months Ended September 30, |
||||||||||||
(in thousands, except percentages) |
2024 |
|
2023 |
|
2024 |
|
2023 |
||||||||
Medical |
$ |
2,003,979 |
|
|
$ |
1,163,194 |
|
|
$ |
5,267,475 |
|
|
$ |
3,436,785 |
|
Less: Ceded quota share reinsurance claims (1) |
|
2,036 |
|
|
|
(4,870 |
) |
|
|
(2,879 |
) |
|
|
(1,221 |
) |
Net claims before ceded quota share reinsurance (A) |
$ |
2,001,942 |
|
|
$ |
1,168,064 |
|
|
$ |
5,270,353 |
|
|
$ |
3,438,006 |
|
|
|
|
|
|
|
|
|
||||||||
Premium |
$ |
2,368,257 |
|
|
$ |
1,392,082 |
|
|
$ |
6,626,055 |
|
|
$ |
4,295,674 |
|
Less: Ceded quota share reinsurance premiums (2) |
|
2,971 |
|
|
|
(1,448 |
) |
|
|
(1,865 |
) |
|
|
(2,131 |
) |
Net premiums before ceded quota share reinsurance (B) |
$ |
2,365,286 |
|
|
$ |
1,393,530 |
|
|
$ |
6,627,920 |
|
|
$ |
4,297,805 |
|
Medical Loss Ratio (A divided by B) |
|
84.6 |
% |
|
|
83.8 |
% |
|
|
79.5 |
% |
|
|
80.0 |
% |
(1) |
Represents prior period development for claims ceded to reinsurers pursuant to quota share treaties accounted for under reinsurance accounting, which are in runoff. |
(2) |
Represents prior period development for premiums ceded to reinsurers pursuant to quota share treaties accounted for under reinsurance accounting, which are in runoff. |
SG&A Expense Ratio
The SG&A Expense Ratio reflects the Company’s selling, general and administrative ("SG&A") expenses, as a percentage of Total revenue. Selling, general and administrative expenses primarily include distribution expenses, wages, benefits, costs of software and hardware, the impact of quota share reinsurance, stock-based compensation, and other administrative costs. We believe the SG&A Expense Ratio is useful to evaluate our ability to manage our overall selling, general, and administrative cost base.
Adjusted EBITDA
Adjusted EBITDA is defined as Net income (loss) for the Company and its consolidated subsidiaries before interest expense, income tax expense (benefit), and depreciation and amortization, as further adjusted for stock-based compensation and other items that are considered unusual or not representative of underlying trends of our business, where applicable for the period presented. We present Adjusted EBITDA because we consider it to be an important supplemental measure of our performance and believe it is frequently used by securities analysts, investors, and other interested parties in the evaluation of companies in our industry. Adjusted EBITDA is a non-GAAP measure. Management believes that investors’ understanding of our performance is enhanced by including this non-GAAP financial measure as a reasonable basis for comparing our ongoing results of operations.
We caution investors that amounts presented in accordance with our definition of Adjusted EBITDA may not be comparable to similar measures disclosed by our competitors, because not all companies and analysts calculate Adjusted EBITDA in the same manner.
By providing this non-GAAP financial measure, together with a reconciliation to the most comparable
|
Three Months Ended September 30, |
|
Nine Months Ended September 30, |
|||||||||||
(in thousands) |
2024 |
|
2023 |
|
2024 |
|
2023 |
|||||||
Net income (loss) |
$ |
(54,388 |
) |
|
$ |
(65,703 |
) |
|
$ |
179,406 |
|
$ |
(120,756 |
) |
Interest expense |
|
5,815 |
|
|
|
6,130 |
|
|
|
17,708 |
|
|
18,386 |
|
Other expenses |
|
(1,877 |
) |
|
|
414 |
|
|
|
173 |
|
|
8,132 |
|
Income tax expense |
|
2,076 |
|
|
|
915 |
|
|
|
7,709 |
|
|
4,100 |
|
Depreciation and amortization |
|
7,500 |
|
|
|
9,191 |
|
|
|
22,912 |
|
|
22,952 |
|
Stock-based compensation(1) |
|
29,311 |
|
|
|
28,768 |
|
|
|
83,969 |
|
|
133,541 |
|
Adjusted EBITDA |
$ |
(11,563 |
) |
|
$ |
(20,285 |
) |
|
$ |
311,877 |
|
$ |
66,355 |
|
(1) |
Represents non-cash expenses related to equity-based compensation programs, which vary from period to period depending on various factors including the timing, number, and the valuation of awards. The nine months ended September 30, 2023 includes a non-recurring charge of |
Appendix
Reinsurance Impact |
|||||||||||||||
|
Three Months Ended September 30, |
|
Nine Months Ended September 30, |
||||||||||||
(in thousands) |
2024 |
|
2023 |
|
2024 |
|
2023 |
||||||||
Quota share ceded premiums |
$ |
1,300 |
|
|
$ |
284 |
|
|
$ |
(3,120 |
) |
|
$ |
7,107 |
|
Quota share ceded claims |
|
(2,036 |
) |
|
|
4,869 |
|
|
|
2,879 |
|
|
|
1,221 |
|
Ceding commission, net of deposit accounting impact (1) |
|
(13,747 |
) |
|
|
(7,169 |
) |
|
|
(39,273 |
) |
|
|
(23,431 |
) |
Experience refund |
|
1,671 |
|
|
|
(1,732 |
) |
|
|
1,255 |
|
|
|
(9,238 |
) |
Net quota share impact |
$ |
(12,812 |
) |
|
$ |
(3,748 |
) |
|
$ |
(38,259 |
) |
|
$ |
(24,341 |
) |
(1) |
Includes ceding commissions received from reinsurers, net of the impact of deposit accounting of |
The Company records Premium revenue net of reinsurance. The following table reconciles total reinsurance premiums ceded and reinsurance premiums assumed, which are included as components of total Premium revenue in the Condensed Consolidated Statements of Operations:
|
Three Months Ended September 30, |
|
Nine Months Ended September 30, |
||||||||||||
(in thousands) |
2024 |
|
2023 |
|
2024 |
|
2023 |
||||||||
Direct policy premiums |
$ |
2,687,883 |
|
|
$ |
1,548,571 |
|
|
$ |
7,542,098 |
|
|
$ |
4,796,819 |
|
Assumed premiums |
|
55,062 |
|
|
|
57,836 |
|
|
|
173,134 |
|
|
|
174,166 |
|
Risk adjustment transfers |
|
(374,828 |
) |
|
|
(211,422 |
) |
|
|
(1,077,121 |
) |
|
|
(665,200 |
) |
Reinsurance premiums ceded |
|
140 |
|
|
|
(2,903 |
) |
|
|
(12,056 |
) |
|
|
(10,111 |
) |
Premium |
$ |
2,368,257 |
|
|
$ |
1,392,082 |
|
|
$ |
6,626,055 |
|
|
$ |
4,295,674 |
|
The Company records Medical expenses net of reinsurance recoveries. The following table reconciles total Medical expenses to the amount presented in the Condensed Consolidated Statements of Operations:
|
Three Months Ended September 30, |
|
Nine Months Ended September 30, |
||||||||||||
(in thousands) |
2024 |
|
2023 |
|
2024 |
|
2023 |
||||||||
Direct claims incurred |
$ |
1,986,189 |
|
|
$ |
1,116,679 |
|
|
$ |
5,189,901 |
|
|
$ |
3,301,424 |
|
Ceded reinsurance claims |
|
(41,171 |
) |
|
|
(15,266 |
) |
|
|
(90,823 |
) |
|
|
(33,833 |
) |
Assumed reinsurance claims |
|
58,961 |
|
|
|
61,781 |
|
|
|
168,397 |
|
|
|
169,194 |
|
Medical expenses |
$ |
2,003,979 |
|
|
$ |
1,163,194 |
|
|
$ |
5,267,475 |
|
|
$ |
3,436,785 |
|
The Company records Selling, general and administrative ("SG&A") expenses net of reinsurance ceding commissions and assumed SG&A expenses. The following table reconciles total Selling, general and administrative expenses to the amount presented in the Condensed Consolidated Statements of Operations:
|
Three Months Ended September 30, |
|
Nine Months Ended September 30, |
||||||||
(in thousands) |
2024 |
|
2023 |
|
2024 |
|
2023 |
||||
Selling, general and administrative expenses, gross |
$ |
459,522 |
|
$ |
325,820 |
|
$ |
1,289,362 |
|
$ |
1,060,636 |
Reinsurance ceding commissions |
|
855 |
|
|
30 |
|
|
383 |
|
|
976 |
Selling, general and administrative expenses |
$ |
460,377 |
|
$ |
325,850 |
|
$ |
1,289,745 |
|
$ |
1,061,612 |
The Company classifies Reinsurance recoverable within current assets on its Condensed Consolidated Balance Sheets. The composition of the Reinsurance recoverable balance is as follows:
(in thousands) |
September 30, 2024 |
|
December 31, 2023 |
|||
Reinsurance premium and claim recoverables |
$ |
272,478 |
|
|
$ |
224,837 |
Reinsurance ceding commissions |
|
6,915 |
|
|
|
7,054 |
Experience refunds on reinsurance agreements |
|
(6,076 |
) |
|
|
9,303 |
Reinsurance recoverable |
$ |
273,317 |
|
|
$ |
241,194 |
View source version on businesswire.com: https://www.businesswire.com/news/home/20241107962943/en/
Investor Contact:
Chris Potochar
VP of Investor Relations
ir@hioscar.com
Media Contact:
Kristen Prestano
VP of Communications
press@hioscar.com
Source: Oscar Health, Inc.
Source: Oscar Health, Inc.
FAQ
What was Oscar Health's (OSCR) revenue in Q3 2024?
What was OSCR's membership count as of September 30, 2024?
What is Oscar Health's (OSCR) revenue guidance for full-year 2024?
Did OSCR achieve profitability in Q3 2024?
