08:53:10 EST Tue 10 Feb 2026
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Oscar Health Announces Financial Results for Fourth Quarter and Full-Year 2025

2026-02-10 06:00 ET - News Release

Achieves Record Membership of ~3.4 Million and Provides Full-Year 2026 Outlook Including More Than $18 Billion in Revenue


Company Website: https://www.hioscar.com
NEW YORK -- (Business Wire)

Oscar Health, Inc. (“Oscar” or the “Company”) (NYSE: OSCR) announced today its financial results for the fourth quarter and full year ended December 31, 2025.

“2025 was a reset year for the individual market, and we took decisive actions to return to profitability in 2026,” said Mark Bertolini, CEO of Oscar Health. “Our new suite of affordable products, agentic AI features, and exceptional member experience drove record-high membership – positioning us to achieve significantly improved financial performance in 2026. Oscar’s growth demonstrates consumers vote where they find value. We are creating a loyal customer base and building a healthcare market that serves the needs of all employers and consumers at every stage of life.”

Fourth Quarter and Full Year 2025 Financial Highlights

 

Three Months Ended December 31,

 

Year Ended December 31,

(in thousands, except percentages)

2025

 

2024

 

2025

 

2024

Total revenue

$2,805,235

 

$2,392,436

 

$11,701,427

 

$9,177,564

Medical loss ratio

95.4%

 

88.1%

 

87.4%

 

81.7%

SG&A expense ratio

18.2%

 

19.5%

 

17.5%

 

19.1%

Earnings (loss) from operations

$(333,747)

 

$(147,731)

 

$(396,357)

 

$57,265

Net income (loss) attributable to Oscar Health, Inc.

$(352,611)

 

$(153,547)

 

$(443,151)

 

$25,432

Adjusted EBITDA (1)

$(307,782)

 

$(112,643)

 

$(279,811)

 

$199,234

(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 income (loss), the most directly comparable GAAP measure, and for information regarding Oscar’s use of Adjusted EBITDA.

 

As of December 31,

 

 

 

Membership by Offering

2025

 

2024

 

 

 

Individual and Small Group

2,042,449

 

1,636,400

 

 

 

Cigna+Oscar (1)

 

40,570

 

 

 

Total Members (2)

2,042,449

 

1,676,970

 

 

 

(1) Represents total membership for our co-branded partnership with Cigna. We did not renew the Cigna+Oscar Small Group arrangement after its initial term ended on December 31, 2024.

 

 

 

(2) A member covered under more than one of our health plans counts as a single member for the purpose of this metric.

 

 

 

Oscar Health, Inc.

 

2026 Financial Guidance Summary

 

 

 

 

 

 

 

 

 

Full Year 2026 Outlook

 

(in thousands, except percentages)

 

Low

 

High

 

Total Revenue (1)

 

$18.7 billion

 

$19.0 billion

 

Medical Loss Ratio (2)

 

82.4%

 

83.4%

 

SG&A Expense Ratio (3)

 

15.8%

 

16.3%

 

Earnings from Operations (4)

 

$250 million

 

$450 million

 

(1) Total revenue includes premium revenue (net of risk adjustment transfers), investment income, and other revenues. 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.

(2) Medical loss ratio (MLR) is a metric used to calculate medical expenses as a percentage of net premiums before ceded quota share reinsurance. We believe MLR is an important metric to demonstrate the ratio of our costs to pay for healthcare of our members to the net premiums before ceded quota share reinsurance.

(3) The Selling, general, and administrative (SG&A) expense ratio is calculated as selling, general and administrative expenses as a percentage of total revenue (net of risk adjustment transfers). We believe the SG&A expense ratio is useful to evaluate our ability to manage our overall selling, general, and administrative cost base.

(4) Earnings from operations is the Company's total revenue less total operating expenses. We believe earnings (loss) from operations is an important primary metric for assessing operating performance.

Full Year 2025 Key Metrics and Non-GAAP Financial Metrics

  • Total revenue was approximately $11.7 billion for the full year 2025 compared to $9.2 billion for the full year 2024. The increase was driven by higher membership, partially offset by an increase in the net risk adjustment transfer accrual.
  • The medical loss ratio was 87.4% for the full year 2025 compared to 81.7% for the full year 2024. The increase was primarily driven by higher average market morbidity that resulted in an increase in the net risk adjustment transfer accrual, as well as higher utilization that was not fully offset by risk adjustment.
  • The SG&A expense ratio was 17.5% for the full year 2025 compared to 19.1% for the full year 2024. The decrease was primarily due to greater fixed cost leverage, lower exchange fee rates, and disciplined cost management, partially offset by the impact of higher risk adjustment as a percentage of premium.
  • Loss from operations was $396.4 million for the full year 2025 compared to earnings from operations of $57.3 million for the full year 2024. The decrease was primarily driven by higher average market morbidity that resulted in an increase in the net risk adjustment transfer accrual, as well as higher utilization that was not fully offset by risk adjustment.
  • Net loss attributable to Oscar Health, Inc. was $443.2 million, or $(1.69) of diluted earnings per share, for the full year 2025 compared to net income attributable to Oscar Health, Inc. of $25.4 million, or $0.10 of diluted earnings per share, for the full year 2024.
  • Adjusted EBITDA loss was $279.8 million for the full year 2025 compared to Adjusted EBITDA of $199.2 million for the full year 2024.

Revolving Credit Facility

On February 6, 2026, the Company entered into a $475 million secured three-year revolving credit facility.

“We took opportunistic steps to strengthen our balance sheet and optimize our capital structure,” said Scott Blackley, CFO of Oscar Health. “The transaction was well supported by a strong syndicate of top-tier banks and completed on favorable terms, further enhancing our balance sheet and providing additional flexibility to fuel long-term growth and accelerate consumer and employer adoption of the individual market.”

Quarterly Conference Call Details

Oscar will host a conference call to discuss its financial results today, February 10, 2026, at 8:00 a.m. (ET). Investors and other interested parties are invited to listen to the conference call by dialing 1-855-761-5600 and entering the following conference ID: 7768132. A live audio webcast will also 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 the United States of America (“GAAP”). A reconciliation of historical non-GAAP financial information to the most directly comparable GAAP financial measure is provided in the accompanying tables found at the end of this release. For more information regarding Adjusted EBITDA, please see “Key Operating and Non-GAAP Financial Metrics” below.

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, Earnings (loss) from operations, and other financial performance metrics, and the related underlying assumptions, our business and financial prospects, including management’s plans and objectives for future operations, expectations and business strategy, such as our 2026 margins and profitability, and industry and market dynamics and expected trends. 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,” “forecasts,” “predicts,” “potential,” or “continues” 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 (including our ability to successfully integrate strategic acquisitions); our ability to retain and expand our member base; our ability to accurately estimate our incurred medical expenses or overall market morbidity, or effectively manage our medical costs or related administrative costs; unanticipated results of, or changes to, risk adjustment programs or our estimates thereof; our ability to achieve or maintain profitability in the future; evolving federal or state laws or regulations (including any changes in the interpretation or enforcement of existing laws and regulations), including changes with respect to the Patient Protection and Affordable Care Act and any regulations enacted thereunder, the expiration or potential renewal of the enhanced Advanced Premium Tax Credits, the implementation of new program integrity rules, the potential funding of a cost-sharing reduction program, or other government actions, such as the imposition of tariffs; our ability to arrange for the delivery of quality care and maintain good relations with brokers and the physicians, hospitals, and other providers within and outside our provider networks; our ability to comply with ongoing, complex and evolving regulatory requirements, including capital reserve and surplus requirements and applicable performance standards; changes or developments in the regulation of health insurance markets in the United States; our, or any of our vendors’, ability to comply with laws, regulations, and standards related to the handling of information about individuals or applicable consumer protection laws, including as a result of our participation in government-sponsored programs; the ability of our health insurance and Health Maintenance Organization subsidiaries to make payments of dividends or distributions to us, including to fund our business strategy; our ability to utilize quota share reinsurance to meet our capital and surplus requirements and protect against downside risk on medical claims; adverse market conditions resulting in our investment portfolio suffering losses or reducing our ability to meet our financing needs; unfavorable or otherwise costly outcomes of lawsuits, audits, investigations, and other third party claims that may arise from the extensive laws and regulations to which we are subject; incurrence of data security breaches of our or our partners’ information and technology systems; heightened competition in the markets in which we participate; our ability to attract and retain qualified personnel; our ability to detect and prevent material weaknesses or significant control deficiencies in our internal controls over financial reporting or other failure to maintain an effective system of internal controls; uncertainties associated with our utilization of certain artificial intelligence and machine learning models; and adverse publicity or other adverse consequences related to our dual class structure or “controlled company” status; and the other factors set forth under the caption “Risk Factors” in our Annual Report on Form 10-K for the year ended December 31, 2024, filed with the Securities and Exchange Commission (“SEC”), and our other filings with the SEC, including our Quarterly Report on Form 10-Q for the quarterly period ended September 30, 2025 filed with the SEC, and our Annual Report on Form 10-K for the annual period ended December 31, 2025, to be filed 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.

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 2.0 million members, as of December 31, 2025.

Oscar Health, Inc.

Consolidated Statements of Operations

(unaudited)

 

 

Three Months Ended December 31,

 

Year Ended December 31,

(in thousands, except per share amounts)

2025

 

2024

 

2025

 

2024

Revenue

 

 

 

 

 

 

 

Premium

$

2,746,660

 

 

$

2,345,204

 

 

$

11,469,893

 

 

$

8,971,259

Investment income

 

49,610

 

 

 

42,420

 

 

 

202,941

 

 

 

185,729

Other revenues

 

8,965

 

 

 

4,812

 

 

 

28,593

 

 

 

20,576

Total revenue

 

2,805,235

 

 

 

2,392,436

 

 

 

11,701,427

 

 

 

9,177,564

Operating Expenses

 

 

 

 

 

 

 

Medical

 

2,620,071

 

 

 

2,065,114

 

 

 

10,019,025

 

 

 

7,332,589

Selling, general, and administrative

 

511,031

 

 

 

465,820

 

 

 

2,049,867

 

 

 

1,755,565

Depreciation and amortization

 

7,880

 

 

 

9,233

 

 

 

28,892

 

 

 

32,145

Total operating expenses

 

3,138,982

 

 

 

2,540,167

 

 

 

12,097,784

 

 

 

9,120,299

Earnings (loss) from operations

 

(333,747

)

 

 

(147,731

)

 

 

(396,357

)

 

 

57,265

Interest expense (income)

 

(1,097

)

 

 

6,026

 

 

 

17,601

 

 

 

23,734

Other expenses (income)

 

20,031

 

 

 

(68

)

 

 

23,339

 

 

 

105

Earnings (loss) before income taxes

 

(352,681

)

 

 

(153,689

)

 

 

(437,297

)

 

 

33,426

Income tax expense (benefit)

 

(247

)

 

 

(404

)

 

 

5,606

 

 

 

7,305

Net income (loss)

 

(352,434

)

 

 

(153,285

)

 

 

(442,903

)

 

 

26,121

Less: Net income attributable to noncontrolling interests

 

177

 

 

 

262

 

 

 

248

 

 

 

689

Net income (loss) attributable to Oscar Health, Inc.

$

(352,611

)

 

$

(153,547

)

 

$

(443,151

)

 

$

25,432

 

 

 

 

 

 

 

 

Earnings (Loss) per Share

 

 

 

 

 

 

 

Basic

$

(1.24

)

 

$

(0.62

)

 

$

(1.69

)

 

$

0.11

Diluted

$

(1.24

)

 

$

(0.62

)

 

$

(1.69

)

 

$

0.10

Weighted Average Common Shares Outstanding

 

 

 

 

 

 

 

Basic

 

283,247

 

 

 

248,210

 

 

 

262,388

 

 

 

240,386

Diluted

 

283,247

 

 

 

248,210

 

 

 

262,388

 

 

 

265,853

Oscar Health, Inc.

Consolidated Balance Sheets

(unaudited)

 

(in thousands, except per share amounts)

December 31, 2025

 

December 31, 2024

Assets

 

 

 

Current Assets:

 

 

 

Cash and cash equivalents

$

2,774,151

 

 

$

1,527,186

 

Short-term investments

 

1,216,461

 

 

 

624,461

 

Premiums and accounts receivable (net of allowance for credit losses of $7,226 and $31,300)

 

442,645

 

 

 

315,891

 

Risk adjustment transfer receivable

 

56,066

 

 

 

64,779

 

Reinsurance recoverable

 

99,750

 

 

 

291,537

 

Other current assets

 

24,331

 

 

 

21,320

 

Total current assets

 

4,613,404

 

 

 

2,845,174

 

Property, equipment, and capitalized software, net

 

88,350

 

 

 

66,793

 

Long-term investments

 

1,470,987

 

 

 

1,815,254

 

Restricted deposits

 

32,951

 

 

 

30,878

 

Other assets

 

119,719

 

 

 

82,397

 

Total assets

$

6,325,411

 

 

$

4,840,496

 

 

 

 

 

Liabilities and Stockholders' Equity

 

 

Current Liabilities:

 

 

 

Benefits payable

$

1,455,385

 

 

$

1,356,730

 

Risk adjustment transfer payable

 

2,587,700

 

 

 

1,558,341

 

Unearned premiums

 

166,203

 

 

 

74,389

 

Accounts payable and other liabilities

 

649,720

 

 

 

432,428

 

Reinsurance payable

 

3,579

 

 

 

41,346

 

Total current liabilities

 

4,862,587

 

 

 

3,463,234

 

Long-term debt

 

430,095

 

 

 

299,555

 

Other liabilities

 

51,994

 

 

 

61,282

 

Total liabilities

 

5,344,676

 

 

 

3,824,071

 

Commitments and contingencies

 

 

 

Stockholders' Equity

 

 

 

Class A common stock ($0.00001 par value; 825,000 thousand shares authorized, 261,851 thousand and 214,974 thousand shares outstanding as of December 31, 2025 and 2024, respectively)

 

3

 

 

 

2

 

Class B common stock ($0.00001 par value; 82,500 thousand shares authorized, 35,838 thousand and 35,514 thousand shares outstanding as of December 31, 2025 and 2024, respectively)

 

 

 

 

 

Treasury stock (315 thousand shares as of December 31, 2025 and 2024)

 

(2,923

)

 

 

(2,923

)

Additional paid-in capital

 

4,256,972

 

 

 

3,869,617

 

Accumulated deficit

 

(3,294,434

)

 

 

(2,851,283

)

Accumulated other comprehensive income (loss)

 

18,030

 

 

 

(1,827

)

Total Oscar Health, Inc. stockholders’ equity

 

977,648

 

 

 

1,013,586

 

Noncontrolling interests

 

3,087

 

 

 

2,839

 

Total stockholders’ equity

 

980,735

 

 

 

1,016,425

 

Total liabilities and stockholders' equity

$

6,325,411

 

 

$

4,840,496

 

Oscar Health, Inc.

Consolidated Statements of Cash Flows

(unaudited)

 

 

Year Ended December 31,

(in thousands)

2025

 

2024

Cash Flows from Operating Activities:

 

 

 

Net income (loss)

$

(442,903

)

 

$

26,121

 

Adjustments to reconcile net income (loss) to net cash (used in) provided by operating activities:

 

 

 

Deferred taxes

 

2,449

 

 

 

(2,338

)

Net realized gain on sale of financial instruments

 

(1,339

)

 

 

(23

)

Depreciation and amortization expense

 

28,892

 

 

 

32,145

 

Amortization of debt issuance costs

 

1,630

 

 

 

778

 

Stock-based compensation expense

 

87,654

 

 

 

109,824

 

Net accretion of investments

 

(29,793

)

 

 

(26,877

)

Non-cash inducement payment for convertible note conversion

 

13,336

 

 

 

 

Change in provision for credit losses

 

(24,074

)

 

 

(300

)

Changes in assets and liabilities:

 

 

 

(Increase) / decrease in:

 

 

 

Premiums and accounts receivable

 

(101,932

)

 

 

(114,323

)

Risk adjustment transfer receivable

 

8,714

 

 

 

(12,854

)

Reinsurance recoverable

 

191,787

 

 

 

(50,343

)

Other assets

 

(27,116

)

 

 

(11,547

)

Increase / (decrease) in:

 

 

 

Benefits payable

 

98,655

 

 

 

390,744

 

Unearned premiums

 

91,814

 

 

 

8,472

 

Premium deficiency reserve

 

 

 

 

(5,776

)

Accounts payable and other liabilities

 

205,488

 

 

 

152,768

 

Reinsurance payable

 

(37,767

)

 

 

(19,678

)

Risk adjustment transfer payable

 

1,029,359

 

 

 

501,400

 

Net cash provided by operating activities

 

1,094,854

 

 

 

978,193

 

Cash Flows from Investing Activities:

 

 

 

Purchase of investments

 

(1,013,918

)

 

 

(2,133,510

)

Sale of investments

 

134,231

 

 

 

25,250

 

Maturity and paydowns of investments

 

670,724

 

 

 

744,794

 

Purchase of property, equipment and capitalized software

 

(36,372

)

 

 

(27,897

)

Change in restricted deposits

 

4,275

 

 

 

3,929

 

Net cash used in investing activities

 

(241,060

)

 

 

(1,387,434

)

Cash Flows from Financing Activities:

 

 

 

Proceeds from long-term debt

 

410,000

 

 

 

 

Payments of debt issuance costs

 

(22,902

)

 

 

 

Inducement payment for convertible note conversion

 

(4,445

)

 

 

 

Purchase of capped calls related to convertible notes

 

(34,440

)

 

 

 

Tax payments related to net settlement of share-based awards

 

(4,035

)

 

 

 

Proceeds from exercise of stock options

 

55,033

 

 

 

68,388

 

Net cash provided by financing activities

 

399,211

 

 

 

68,388

 

Increase (decrease) in cash, cash equivalents and restricted cash equivalents

 

1,253,005

 

 

 

(340,853

)

Cash, cash equivalents, restricted cash and cash equivalents—beginning of period

 

1,551,118

 

 

 

1,891,971

 

Cash, cash equivalents, restricted cash and cash equivalents—end of period

 

2,804,123

 

 

 

1,551,118

 

Cash and cash equivalents

 

2,774,151

 

 

 

1,527,186

 

Restricted cash and cash equivalents included in restricted deposits

 

29,972

 

 

 

23,932

 

Total cash, cash equivalents and restricted cash and cash equivalents

$

2,804,123

 

 

$

1,551,118

 

Supplemental Disclosures:

 

 

 

Interest payments

$

12,783

 

 

$

33,691

 

Income tax payments

$

17,516

 

 

$

674

 

Non-Cash Investing and Financing Activities:

 

 

 

Conversion of convertible notes into common stock

$

283,336

 

 

$

 

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.

Total Revenue

Total revenue includes premium revenue (net of risk adjustment transfers), investment income, and other revenues. 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 (MLR) is a metric used to calculate medical expenses as a percentage of net premiums before ceded quota share reinsurance. 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 quota share reinsurance.

 

Three Months Ended December 31,

 

Year Ended December 31,

(in thousands, except percentages)

2025

 

2024

 

2025

 

2024

Medical

$

2,620,071

 

 

$

2,065,114

 

 

$

10,019,025

 

 

$

7,332,589

 

Less: Ceded quota share reinsurance claims (1)

 

 

 

 

849

 

 

 

 

 

 

(2,029

)

Net claims before ceded quota share reinsurance (A)

$

2,620,071

 

 

$

2,064,265

 

 

$

10,019,025

 

 

$

7,334,618

 

 

 

 

 

 

 

 

 

Premium

$

2,746,660

 

 

$

2,345,204

 

 

$

11,469,893

 

 

$

8,971,259

 

Less: Ceded quota share reinsurance premiums (1)

 

 

 

 

984

 

 

 

 

 

 

(881

)

Net premiums before ceded quota share reinsurance (B)

$

2,746,660

 

 

$

2,344,220

 

 

$

11,469,893

 

 

$

8,972,140

 

Medical Loss Ratio (A divided by B)

 

95.4

%

 

 

88.1

%

 

 

87.4

%

 

 

81.7

%

(1) Represents prior period development for claims and premiums, respectively, 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 expenses, as a percentage of total revenue (net of risk adjustment transfers). We believe the SG&A expense ratio is useful to evaluate our ability to manage our overall selling, general, and administrative cost base.

Earnings (Loss) from Operations

Earnings (loss) from operations is the Company's total revenue less total operating expenses. We believe earnings (loss) from operations is an important primary metric for assessing operating performance.

Net Income (Loss) Attributable to Oscar Health, Inc.

Net income (loss) attributable to Oscar Health, Inc. is net earnings (loss) allocated to the Company after net income (loss) attributable to noncontrolling interests. It is a key indicator of the Company’s profitability and operational efficiency, allowing management to evaluate performance and make informed decisions on strategic planning, cost management, and resource allocation.

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 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 U.S. GAAP measure, Net income (loss), we believe we are enhancing investors’ understanding of our business and our results of operations, as well as assisting investors in evaluating how well we are executing our strategic initiatives. Adjusted EBITDA has limitations as an analytical tool, and should not be considered in isolation, or as an alternative to, or a substitute for, net income (loss) or other financial statement data presented in our Condensed Consolidated Financial Statements as indicators of financial performance.

 

Three Months Ended December 31,

 

Year Ended December 31,

(in thousands)

2025

 

2024

 

2025

 

2024

Net income (loss)

$

(352,434

)

 

$

(153,285

)

 

$

(442,903

)

 

$

26,121

Interest expense (income)

 

(1,097

)

 

 

6,026

 

 

 

17,601

 

 

 

23,734

Other expenses (income)

 

20,031

 

 

 

(68

)

 

 

23,339

 

 

 

105

Income tax expense (benefit)

 

(247

)

 

 

(404

)

 

 

5,606

 

 

 

7,305

Earnings (loss) from operations

 

(333,747

)

 

 

(147,731

)

 

 

(396,357

)

 

 

57,265

Depreciation and amortization

 

7,880

 

 

 

9,233

 

 

 

28,892

 

 

 

32,145

Stock-based compensation (1)

 

18,085

 

 

 

25,855

 

 

 

87,654

 

 

 

109,824

Adjusted EBITDA

$

(307,782

)

 

$

(112,643

)

 

$

(279,811

)

 

$

199,234

(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. Additionally, these expenses are reported net of any stock-based compensation that has been capitalized for software development costs.

Appendix

Reinsurance Impact

 

Three Months Ended December 31,

 

Year Ended December 31,

(in thousands)

2025

 

2024

 

2025

 

2024

Quota share ceded premiums

$

 

 

$

50

 

 

$

 

 

$

(3,070

)

Quota share ceded claims

 

 

 

 

(850

)

 

 

 

 

 

2,029

 

Deposit Accounting impact, net of ceding commission

 

(12,842

)

 

 

(14,103

)

 

 

(48,053

)

 

 

(53,376

)

Experience refund

 

 

 

 

933

 

 

 

 

 

 

2,188

 

Net quota share impact

$

(12,842

)

 

$

(13,970

)

 

$

(48,053

)

 

$

(52,229

)

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 Consolidated Statements of Operations:

 

Three Months Ended December 31,

 

Year Ended December 31,

(in thousands)

2025

 

2024

 

2025

 

2024

Direct policy premiums

$

3,552,565

 

 

$

2,750,027

 

 

$

14,031,308

 

 

$

10,292,125

 

Assumed premiums

 

266

 

 

 

46,438

 

 

 

46,568

 

 

 

219,572

 

Risk adjustment transfers

 

(803,301

)

 

 

(449,327

)

 

 

(2,596,833

)

 

 

(1,526,448

)

Reinsurance premiums ceded

 

(2,870

)

 

 

(1,934

)

 

 

(11,150

)

 

 

(13,990

)

Premium

$

2,746,660

 

 

$

2,345,204

 

 

$

11,469,893

 

 

$

8,971,259

 

The Company records medical expenses net of reinsurance recoveries. The following table reconciles total medical expenses to the amount presented in the Consolidated Statement of Operations:

 

Three Months Ended December 31,

 

Year Ended December 31,

(in thousands)

 

2025

 

 

 

2024

 

 

 

2025

 

 

 

2024

 

Direct claims incurred

$

2,661,203

 

 

$

2,088,366

 

 

$

10,118,434

 

 

$

7,278,267

 

Ceded reinsurance claims

 

(43,186

)

 

 

(68,309

)

 

 

(144,151

)

 

 

(159,132

)

Assumed reinsurance claims

 

2,054

 

 

 

45,057

 

 

 

44,742

 

 

 

213,454

 

Medical expenses

$

2,620,071

 

 

$

2,065,114

 

 

$

10,019,025

 

 

$

7,332,589

 

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 Consolidated Statement of Operations:

 

Three Months Ended December 31,

 

Year Ended December 31,

(in thousands)

2025

 

2024

 

2025

 

2024

Selling, general and administrative expenses, gross

$

            511,031

 

$

            466,580

 

 

$

          2,049,867

 

$

          1,755,942

 

Reinsurance ceding commissions

 

                      —

 

 

                   (760

)

 

 

                      —

 

 

                   (377

)

Selling, general, and administrative expenses

$

            511,031

 

$

            465,820

 

 

$

          2,049,867

 

$

          1,755,565

 

The Company classifies reinsurance recoverable within current assets on its Consolidated Balance Sheets. The composition of the reinsurance recoverable balance is as follows:

 

 

As of December 31,

(in thousands)

 

2025

 

2024

Reinsurance premium and claim recoverables

 

$

98,014

 

 

$

288,878

 

Reinsurance ceding commissions

 

 

7,002

 

 

 

6,996

 

Experience refunds on reinsurance agreements

 

 

(5,266

)

 

 

(4,337

)

Reinsurance recoverable

 

$

99,750

 

 

$

291,537

 

 

Contacts:

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.

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