<div id="readability-page-1"><div>Oscar Health, Inc., a leading health insurance provider specializing in individual market plans under the Affordable Care Act (ACA), has released its 2025 Form 10-K report. The report provides a comprehensive overview of the company's financial performance, business operations, strategic initiatives, and the challenges it faces in the evolving healthcare market. Financial Highlights <ul><li>Total Revenue: $11,701 million, a 28% increase from the previous year, driven by higher membership and above-market growth during the 2025 Open Enrollment.</li><li>Earnings (loss) from operations: $(396) million, compared to $57 million in 2024, reflecting increased operating expenses.</li><li>Net income (loss) attributable to Oscar Health, Inc.: $(443) million, compared to $25 million in 2024, primarily due to increased medical expenses and higher market morbidity.</li><li>Basic EPS: $(1.69), compared to $0.11 in 2024, reflecting the net loss for the year.</li><li>Diluted EPS: $(1.69), compared to $0.10 in 2024, indicating a significant decrease in earnings per share.</li></ul> Business Highlights <ul><li>Revenue Segments: Oscar's business is primarily driven by its health insurance offerings in the individual market, which include plans under the ACA's five metal categories: Catastrophic, Bronze, Silver, Gold, and Platinum. The company also generates revenue through its +Oscar platform, which serves providers and payors, and its brokerage services and enrollment platform.</li><li>Geographical Performance: In 2025, Oscar offered coverage in 18 states and expanded to 20 states for 2026. Florida and Texas were significant markets, with Florida having the highest membership at 1,179,934 members as of December 31, 2025.</li><li>Sales Units: As of December 31, 2025, Oscar had approximately 2.0 million effectuated members, reflecting growth from 1,676,970 members in 2024. The majority of membership growth was attributed to the individual and small group market.</li><li>New Product Launches: In 2025, Oscar acquired early-stage businesses to enhance its capabilities in Individual Coverage Health Reimbursement Arrangements (ICHRA), including Lucie, Inc., IHC Specialty Benefits, Inc., and Healthinsurance.org, LLC.</li><li>Future Outlook: Oscar aims to build the leading consumer health marketplace by focusing on ICHRA as a disruptive force in employer group coverage. The company plans to expand its offerings and improve its technology platform to enhance member engagement and operational efficiencies.</li><li>Operational Efficiency: Oscar's technology platform is a key driver of its business, providing a cloud-native infrastructure that supports member engagement and operational efficiencies. The platform includes AI and machine learning technologies to enhance personalization and service delivery.</li><li>Regulatory Impact: The expiration of enhanced Advanced Premium Tax Credits (eAPTCs) at the end of 2025 and new CMS regulations are expected to impact enrollment and market dynamics in 2026. Oscar is monitoring these changes to adapt its strategies accordingly.</li></ul> Strategic Initiatives <ul><li>Expansion and Acquisitions: Oscar Health, Inc. has undertaken strategic initiatives to expand its capabilities in the individual market by acquiring Lucie, Inc., IHC Specialty Benefits, Inc., and Healthinsurance.org, LLC. These acquisitions are aimed at enhancing the company's direct enrollment technology platform and diversifying its offerings.</li><li>Market Exit: The company has exited the small group market by not renewing its Cigna+Oscar Small Group arrangement, allowing it to focus resources on its core individual and family plans.</li><li>Capital Management: Oscar Health, Inc. has been active in capital management through the issuance of convertible senior notes. In 2025, the company issued $410 million in aggregate principal amount of convertible senior notes due 2030, and also managed the conversion of $250 million of its 2031 Notes into Class A common stock. The company has utilized quota share reinsurance arrangements to manage capital requirements efficiently and has made capital contributions to its Health Insurance Subsidiaries to maintain statutory capital levels. Additionally, Oscar Health, Inc. has entered into capped call transactions to mitigate potential dilution from convertible notes.</li><li>Future Outlook: Looking ahead, Oscar Health, Inc. plans to continue leveraging its technology platform to drive growth and improve member experiences. The company aims to manage its capital efficiently through strategic reinsurance arrangements and potential capital market activities. Oscar Health, Inc. is also focused on maintaining liquidity and capital adequacy to support its growth initiatives and navigate regulatory changes in the healthcare market.</li></ul> Challenges and Risks <ul><li>Regulatory and Operational Risks: The company faces significant risks related to its strategy execution and growth management, including the expansion into new markets and lines of business, which may incur substantial expenses and regulatory challenges. The need to obtain regulatory approvals and licenses, as well as meeting Health Insurance Marketplaces' requirements, poses a risk to operational and financial performance. Additionally, capital requirements for Health Insurance Subsidiaries could increase significantly, potentially exceeding net income and requiring additional funding through debt or equity.</li><li>Competitive Pressures: The company also faces competitive pressures that may force price reductions, impacting profitability. Entering new business lines without prior experience could result in unexpected liabilities and financial harm. The monetization of the +Oscar platform involves obtaining necessary licenses and approvals, which may not be achieved on the expected timeline, posing operational and financial risks.</li><li>Regulatory Changes: Regulatory changes, such as the CMS Program Integrity Rules and the OBBBA, could impact enrollment processes and APTC eligibility, affecting the company's membership and financial condition. The expiration of eAPTCs at the end of 2025 introduces uncertainty, with potential renewal in 2026 causing operational disruptions and financial strain.</li><li>Market Risks: The company is exposed to market risks, including interest rate fluctuations that could affect the value of its investment portfolio. Adverse market conditions may also impact liquidity and the ability to meet financing needs, potentially affecting operations and financial stability. The company's reliance on quota share reinsurance to meet capital requirements introduces additional risk, as changes in reinsurance terms or regulatory approvals could necessitate raising additional capital.</li><li>Management Strategies: Management acknowledges the challenges in maintaining profitability, as demonstrated by the return to losses in 2025 after achieving profitability in 2024. The company plans to focus on margin expansion and optimizing plan design to improve financial performance. However, the success of these strategies is uncertain, given the volatile market conditions and regulatory environment.</li></ul>SEC Filing: Oscar Health, Inc. [ OSCR ] - 10-K - Feb. 13, 2026</div></div>

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Oscar Health, Inc. has released its 2025 Form 10-K report, highlighting a total revenue of $11.7 billion, a 28% increase from the previous year. However, the company reported a net loss of $443 million, primarily due to increased medical expenses. Oscar's membership grew to approximately 2 million, with significant expansion in Florida and Texas. The company is focusing on enhancing its technology platform and expanding its offerings, while also facing regulatory and competitive challenges. Strategic initiatives include acquisitions to improve its enrollment technology and a shift away from the small group market.

Oscar Health, Inc. SEC 10-K Report