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Oscar Health, Inc. to Limit Additional Growth in Florida in Light of Strong Open Enrollment
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Rhea-AI Summary
Oscar Health, Inc. (NYSE: OSCR) announced it will stop accepting new members in Florida starting December 13 at 12:00 a.m. EST, due to strong Open Enrollment performance. Current members can renew their plans without disruption. This decision follows Oscar's proactive engagement with regulators to manage membership growth and ensure financial stability, as they aim to maintain their target membership of approximately 1 million. Oscar remains committed to the Florida market and will continue to provide coverage throughout 2023 and beyond.
Positive
Strong Open Enrollment performance leading to a strategic decision to limit new membership in Florida.
Proactive engagement with regulators to manage growth and financial stability.
Continued commitment to providing coverage in Florida through 2023.
Negative
None.
NEW YORK--(BUSINESS WIRE)--
Oscar Health, Inc. (“Oscar”) (NYSE: OSCR), the first health insurance company built on a full stack technology platform, announced that based on strong Open Enrollment performance to date, it will temporarily stop accepting new members in the state of Florida, beginning December 13 at 12:00 a.m. EST. Individuals seeking Oscar coverage in Florida can continue to enroll without limitation until that time.
Current Oscar members in Florida who are seeking plan renewal for 2023 will not be impacted. They can renew their plan for 2023 throughout the remainder of Open Enrollment through the exchange or their broker. Any new Oscar member in Florida that has enrolled in Oscar for 2023 prior to December 13 at 12:00 a.m. EST will not be impacted. Oscar remains steadfast in the Florida market and intends to continue to provide coverage throughout 2023 and beyond.
As disclosed in Oscar’s Q3 2022 Form 10-Q, the company proactively engaged regulators, as a result of the changing market dynamics following market exits by certain carriers, regarding options to manage its membership growth. Prior to Open Enrollment, the company requested that regulators limit its membership growth in Florida so that total membership across all markets would be within its previously announced target range of 1M members, +/-10%. This limit will allow the company’s projected membership not to exceed the company’s targets for 2023 and maintain its strong financial position.
About Oscar Health
Oscar Health, Inc. (“Oscar”) is the first health insurance company built around a full stack technology platform and a relentless focus on serving its members. At Oscar, our mission is to make a healthier life accessible and affordable for all. Headquartered in New York City, Oscar has been challenging the health care system's status quo since our founding in 2012. The company’s member-first philosophy and innovative approach to care has earned us the trust of over one million members as of September 30, 2022. We offer Individual & Family, Small Group and Medicare Advantage plans, and +Oscar, our full stack technology platform, to others within the provider and payor space. Our vision is to refactor health care to make good care cost less. Refactor is a term used in software engineering that means to improve the design, structure, and implementation of the software, while preserving its functionality. At Oscar, we take this definition a step further. We improve our members’ experience by building trust through deep engagement, personalized guidance, and rapid iteration.
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 plans to stop enrollment in Florida; enrollment expectations for 2023; business and financial prospects, 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: the impact of COVID-19 on global markets, economic conditions, the healthcare industry and our results of operations, and the response by governments and other third parties; our ability to retain and expand our member base; our ability to execute our growth strategy and scale our operations; our ability to meet increased capital requirements as a result of expanding membership; our ability to maintain or enter into new partnerships, service arrangements or collaborations with healthcare industry participants; negative publicity, unfavorable shifts in perception of our digital platform or other member service channels; our ability to achieve and/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 accurately estimate our incurred claims expenses or effectively manage our claims costs or related administrative costs, including as a result of fluctuations in medical utilization rates due to the impact of COVID-19; our ability to comply with ongoing regulatory requirements and applicable performance standards, including as a result of our participation in government-sponsored programs, such as Medicare, and as a result of changing regulatory requirements; changes or developments in the health insurance markets in the United States, including the passage and implementation of a law to create a single-payer or government-run health insurance program; our ability to comply with applicable privacy, security, and data laws, regulations, and standards; our ability to maintain key in-network providers and good relations with the physicians, hospitals, and other providers within and outside our provider networks, or to arrange for the delivery of quality care; unfavorable or otherwise costly outcomes of lawsuits, regulatory investigations and audits and claims that arise from the extensive laws and regulations to which we are subject; unanticipated results of risk adjustment programs; delays in our receipt of premiums; disruptions or challenges to our relationship with the Oscar Medical Group; cyber-security breaches of our and our partners’ information and technology systems; unanticipated changes in population morbidity and large-scale changes in health care utilization; and the other factors set forth under the caption “Risk Factors” in our Quarterly Report on Form 10-Q for the quarterly period ended September 30, 2022, filed with the Securities and Exchange Commission (“SEC”), and our other filings with the SEC.
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.
