5/6/2026

speaker
Jeannie
Conference Operator

Good morning. My name is Jeannie and I will be your conference operator today. At this time, I would like to welcome everyone to Oscar Health's first quarter 2026 earnings conference call. All lines have been placed on mute to prevent any background noise. After the speaker's remarks, there will be a question and answer session. If you would like to ask a question during this time, simply press star followed by the number one on your telephone keypad. If you would like to withdraw your question, Press star 1 again. Today, we ask you to limit to one question and one follow-up. Thank you. I will now turn the conference over to Chris Potichar, Vice President of Treasury and Investor Relations.

speaker
Chris Potichar
Vice President of Treasury and Investor Relations

Good morning, everyone. Thank you for joining us for our first quarter 2026 earnings call. Mark Bertolini, Oscar Hell's Chief Executive Officer, and Scott Blackley, Oscar Hell's Chief Financial Officer, will host this morning's call. This call can also be accessed through our investor relations website at ir.highoscar.com. Full details of our results and additional management commentary are available in our earnings release, which can be found on our investor relations website at ir.highoscar.com. Any remarks that Oscar makes about the future constitute forward-looking statements within the meaning of safe harbor provisions under the Private Securities Litigation Reform Act of 1995. Actual results may differ materially from those indicated by those forward-looking statements as a result of various important factors, including those discussed in our annual report on Form 10-K for the period ended December 31, 2025, filed with the Securities and Exchange Commission, and other filings with the SEC, including our quarterly report on Form 10-Q for the period ended March 31, 2026, to be filed with the SEC. Such forward-looking statements are based on current expectations as of today. Oscar anticipates that subsequent events and developments may cause estimates to change. While the company may elect to update these forward-looking statements at some point in the future, we specifically disclaim any obligation to do so. The call will also refer to certain non-GAAP measures. A reconciliation of these measures to the most directly comparable GAAP measures can be found in the first quarter earnings press release available on the company's investor relations website at ir.highoscar.com. We have not provided a quantitative reconciliation of estimated full year 2026 adjusted EBITDA as described on this call to gap net income because OSCAR is unable without making unreasonable efforts to calculate certain reconciling items with confidence. With that, I will turn the call over to our CEO, Mark Bertolini.

speaker
Mark Bertolini
Chief Executive Officer

Good morning. Thank you, Chris, and thank you all for joining us. Today, OSCAR Health announced strong first quarter 2026 results with year-over-year improvement across all core metrics. Oscar reported revenue of $4.6 billion, an increase of 53% year-over-year. Our SG&A ratio improved 60 basis points year-over-year to 15.2%, driven by discipline expense management, top-line growth, and the growing impact of AI across our operations and member services. MLR improved 490 basis points year-over-year to 70.5%, with utilization largely in line with expectations. We delivered $704 million in earnings from operations, an increase of nearly two and a half times over the same period last year. Oscar is the largest carrier fully dedicated to the individual market. Our tech-first approach, ability to efficiently scale the business and deliver measurable value to our members, positions us for continued expansion. We are reaffirming our full-year guidance and remain on track to deliver meaningful profitability in 2026. Before diving into our business highlights, I will share our early view on trends in the individual market. The individual market is resilient at 23 million lives and is a fundamental pillar of American healthcare. Consumers now expect to shop for coverage like they do for everyday products, comparing options, prices, and value. The individual market has the opportunity to deliver that level of choice and transparency. We are working with federal and state policymakers to advance policies that strengthen transparency while increasing product choice and innovation with consistent quality across plans. While early in the year initial reports show market dynamics are in line to favorable to our expectations, weekly's new report shows market contraction is tracking in line to favorable to our 20 to 30 percent estimate. We took a cautious approach to risk adjustment in the first quarter. Our reserves are built on market morbidity assumptions consistent with our pricing. We look forward to further clarity with the first 2026 weekly report in Q2. The healthcare landscape is undergoing a major structural shift. The small group market is contracting, and consumers are rejecting the legacy model. OSCAR is shaping the individual market to meet the needs of the modern workforce, including entrepreneurs, gig workers, part-time employees, and early retirees. Now I will review our business highlights. OSCAR entered the first quarter with 3.2 million members, an increase of 56% year over year. Our innovative and affordable plan designs and superior member experience are fueling strong growth and retention. Our record membership underscores the strength of OSCAR's strategic plan and positions us for sustained growth and meaningful profitability. OSCAR is rapidly evolving our technology and deploying AI use cases at ever-increasing speeds. to drive growth, lower costs, and help members make smart choices. We recently launched several new transparency tools, including a real-time drug pricing feature that predicts when costs may cause a member to abandon a prescription. The tool instantly cross-references deductible status, local supply, and pricing, and guides members to lower-cost pharmacies or equally efficacious alternatives in the network. We are also scaling new bilingual voice agents to support care navigation and improve speed to care. ICRA is gaining traction as employees demand choice and flexibility, and employers seek predictable healthcare costs. Oscar recently brought the industry together to launch ICRAx to meet the rising demand. ICRAx will be a plug-and-play data exchange connecting carriers, benefit brokers, and ICRA platforms to create a more consistent employee experience. States like Mississippi and Illinois are taking steps to incentivize ICRA adoption by giving tax credits to businesses. OSCQR is now working with other state legislatures and business groups to advance similar ICRA policies that support local economies and reduce the friction of traditional employer coverage. Building on this momentum, we recently launched the Lucy Health Marketplace. Lucy is a carrier-agnostic shopping platform for consumers, brokers, and employers built on one of 11 CMS-approved systems. Lucy brings together a wide selection of ACA plans with leading ancillary and supplemental products, like Aflac. We are combining our technology capabilities with individual networks in nearly every zip code nationwide. This broad coverage network allows consumers and brokers to shop, bundle, and build their own personalized coverage in a few clicks. We will continue to add more AI solutions and health services on the LUCI platform to bring more people into the individual market. LUCI represents a key step in our long-term strategy to build a consumer-driven healthcare market. In summary, Oscar Health is off to a strong start in 2026. Our innovative technology products focused on user experience and discipline execution are delivering clear results. No one understands the individual market better than us. Our strong results in the first quarter are ahead of plan, and we are well positioned to meet or exceed our current guidance. We expect to significantly expand margins and achieve meaningful profitability in 2026. Oscar is unlocking even greater possibilities in the individual market. The entire U.S. economy is modernized except healthcare. It is the only major market where consumers are stripped of their purchasing power and have zero visibility into cost or quality. Our team is arming consumers with technology that puts them in control. Today, it's about choosing the medical coverage that fits your needs. Tomorrow, it's about making all of healthcare shoppable. OSCAR is shaping the new consumer health economy to lower costs and make healthcare work like every modern market. Thank you to the OSCAR team for making our vision of consumer-driven healthcare a reality. I look forward to sharing more details on our long-term strategic plan at Oscar House Investor Day on September 16. I will now turn the call over to Scott. Scott?

Disclaimer

This conference call transcript was computer generated and almost certianly contains errors. This transcript is provided for information purposes only.EarningsCall, LLC makes no representation about the accuracy of the aforementioned transcript, and you are cautioned not to place undue reliance on the information provided by the transcript.

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