Cover
Cover - shares | 3 Months Ended | |
Mar. 31, 2024 | Apr. 30, 2024 | |
Document Information [Line Items] | ||
Document Type | 10-Q | |
Document Quarterly Report | true | |
Document Period End Date | Mar. 31, 2024 | |
Document Transition Report | false | |
Entity File Number | 001-40154 | |
Entity Registrant Name | Oscar Health, Inc. | |
Entity Incorporation, State or Country Code | DE | |
Entity Tax Identification Number | 46-1315570 | |
Entity Address, Address Line One | 75 Varick Street, 5th Floor | |
Entity Address, City or Town | New York, | |
Entity Address, State or Province | NY | |
Entity Address, Postal Zip Code | 10013 | |
City Area Code | (646) | |
Local Phone Number | 403-3677 | |
Title of 12(b) Security | Class A Common Stock, $0.00001 par value per share | |
Trading Symbol | OSCR | |
Security Exchange Name | NYSE | |
Entity Current Reporting Status | Yes | |
Entity Interactive Data Current | Yes | |
Entity Filer Category | Large Accelerated Filer | |
Entity Small Business | false | |
Entity Emerging Growth Company | false | |
Entity Shell Company | false | |
Document Fiscal Year Focus | 2024 | |
Document Fiscal Period Focus | Q1 | |
Amendment Flag | false | |
Current Fiscal Year End Date | --12-31 | |
Entity Central Index Key | 0001568651 | |
Class A | ||
Document Information [Line Items] | ||
Entity Common Stock, Shares Outstanding | 201,709,432 | |
Class B | ||
Document Information [Line Items] | ||
Entity Common Stock, Shares Outstanding | 35,514,201 |
Condensed Consolidated Statemen
Condensed Consolidated Statements of Operations - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2024 | Mar. 31, 2023 | |
Revenue | ||
Premium | $ 2,093,682 | $ 1,428,626 |
Investment income | 42,989 | 36,056 |
Services and other | 5,634 | 5,003 |
Total revenue | 2,142,305 | 1,469,685 |
Operating Expenses | ||
Medical | 1,554,774 | 1,091,592 |
Selling, General and Administrative Expense | 394,162 | 398,519 |
Depreciation and amortization | 7,811 | 4,939 |
Total operating expenses | 1,956,747 | 1,495,050 |
Earnings (loss) from operations | 185,558 | (25,365) |
Interest expense | 5,902 | 6,136 |
Other expenses | 1,178 | 6,106 |
Earnings (loss) before income taxes | 178,478 | (37,607) |
Income tax expense | 996 | 2,021 |
Net income (loss) | 177,482 | (39,628) |
Less: Net income attributable to noncontrolling interests | 114 | 144 |
Net income (loss) attributable to Oscar Health, Inc. | $ 177,368 | $ (39,772) |
Earnings (Loss) per Share | ||
Basic (in dollars per share) | $ 0.77 | $ (0.18) |
Diluted (in dollars per share) | $ 0.62 | $ (0.18) |
Weighted average common shares outstanding, basic (in shares) | 231,443,000 | 216,913,000 |
Weighted-average common shares outstanding, diluted (in shares) | 293,796,000 | 216,913,000 |
Condensed Consolidated Statem_2
Condensed Consolidated Statements of Comprehensive Income - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2024 | Mar. 31, 2023 | |
Statement of Comprehensive Income [Abstract] | ||
Net income (loss) | $ 177,482 | $ (39,628) |
Other comprehensive income (loss), net of tax: | ||
Net unrealized gains (losses) on securities available for sale | (3,903) | 5,236 |
Comprehensive income (loss) | 173,579 | (34,392) |
Comprehensive income attributable to noncontrolling interests | 114 | 144 |
Comprehensive income (loss) attributable to Oscar Health, Inc. | $ 173,465 | $ (34,536) |
Condensed Consolidated Balance
Condensed Consolidated Balance Sheets - USD ($) $ in Thousands | Mar. 31, 2024 | Dec. 31, 2023 |
Current Assets: | ||
Cash and cash equivalents | $ 2,230,799 | $ 1,870,315 |
Short-term investments | 616,134 | 689,833 |
Premiums and accounts receivable (net of allowance for credit losses of $30,600 and $31,600) | 342,904 | 201,269 |
Risk adjustment transfer receivable | 62,037 | 51,925 |
Reinsurance recoverable | 242,935 | 241,194 |
Other current assets | 8,983 | 6,564 |
Total current assets | 3,503,792 | 3,061,100 |
Property, equipment, and capitalized software, net | 61,406 | 61,930 |
Long-term investments | 736,624 | 365,309 |
Restricted deposits | 29,814 | 29,870 |
Other assets | 87,217 | 83,271 |
Total assets | 4,418,853 | 3,601,480 |
Current Liabilities: | ||
Benefits payable | 1,248,347 | 965,986 |
Risk adjustment transfer payable | 1,336,022 | 1,056,941 |
Premium deficiency reserve | 4,332 | 5,776 |
Unearned premiums | 65,541 | 65,918 |
Accounts payable and other liabilities | 303,245 | 273,367 |
Reinsurance payable | 61,938 | 61,024 |
Total current liabilities | 3,019,425 | 2,429,012 |
Long-term debt | 298,972 | 298,777 |
Other liabilities | 66,169 | 67,574 |
Total liabilities | 3,384,566 | 2,795,363 |
Commitments and contingencies (Note 12) | ||
Stockholders' Equity | ||
Treasury stock (315 thousand shares as of March 31, 2024 and December 31, 2023) | (2,923) | (2,923) |
Additional paid-in capital | 3,736,885 | 3,682,294 |
Accumulated deficit | (2,699,347) | (2,876,715) |
Accumulated other comprehensive income (loss) | (2,594) | 1,309 |
Total Oscar Health, Inc. stockholders' equity | 1,032,023 | 803,967 |
Noncontrolling interests | 2,264 | 2,150 |
Total stockholders' equity | 1,034,287 | 806,117 |
Total liabilities and stockholders' equity | 4,418,853 | 3,601,480 |
Class A | ||
Stockholders' Equity | ||
Common stock | 2 | 2 |
Class B | ||
Stockholders' Equity | ||
Common stock | $ 0 | $ 0 |
Condensed Consolidated Balanc_2
Condensed Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Thousands | Mar. 31, 2024 | Dec. 31, 2023 |
Premiums and accounts receivable, allowance for credit losses | $ 30,600 | $ 31,600 |
Treasury stock (in shares) | 315,000 | 315,000 |
Class A | ||
Common stock, par value (in dollars per share) | $ 0.00001 | $ 0.00001 |
Common stock, shares authorized (in shares) | 825,000,000 | 825,000,000 |
Common stock, shares outstanding (in shares) | 200,497,000 | 193,875,000 |
Class B | ||
Common stock, par value (in dollars per share) | $ 0.00001 | $ 0.00001 |
Common stock, shares authorized (in shares) | 82,500,000 | 82,500,000 |
Common stock, shares outstanding (in shares) | 35,514,000 | 35,514,000 |
Condensed Consolidated Statem_3
Condensed Consolidated Statements of Stockholders' Equity - USD ($) $ in Thousands | Total | Common Stock Class A | Common Stock Class B | Treasury Stock | Additional Paid-In Capital | Accumulated Deficit | Accumulated Other Comprehensive Income (Loss) | Noncontrolling Interests |
Beginning balance (in shares) at Dec. 31, 2022 | 181,176,000 | 35,116,000 | ||||||
Beginning balance at Dec. 31, 2022 | $ 892,400 | $ 2 | $ 0 | $ (2,923) | $ 3,509,007 | $ (2,605,987) | $ (9,715) | $ 2,016 |
Increase (Decrease) in Stockholders' Equity [Roll Forward] | ||||||||
Issuance of common stock from equity incentive plans (in shares) | 2,057,000 | |||||||
Issuance of common stock from equity incentive plans | 35 | 35 | ||||||
Stock-based compensation expense | 73,248 | 73,248 | ||||||
Joint venture contributions | 471 | 471 | ||||||
Unrealized gains (losses) on investments, net | 5,236 | 5,236 | ||||||
Net income (loss) | (39,628) | (39,772) | 144 | |||||
Ending balance (in shares) at Mar. 31, 2023 | 183,234,000 | 35,116,000 | ||||||
Ending balance at Mar. 31, 2023 | 931,762 | $ 2 | $ 0 | (2,923) | 3,582,761 | (2,645,759) | (4,479) | 2,160 |
Beginning balance (in shares) at Dec. 31, 2023 | 193,875,000 | 35,514,000 | ||||||
Beginning balance at Dec. 31, 2023 | 806,117 | $ 2 | $ 0 | (2,923) | 3,682,294 | (2,876,715) | 1,309 | 2,150 |
Increase (Decrease) in Stockholders' Equity [Roll Forward] | ||||||||
Issuance of common stock from equity incentive plans (in shares) | 6,622,000 | |||||||
Issuance of common stock from equity incentive plans | 27,309 | 27,309 | ||||||
Stock-based compensation expense | 27,282 | 27,282 | ||||||
Unrealized gains (losses) on investments, net | (3,903) | (3,903) | ||||||
Net income (loss) | 177,482 | 177,368 | 114 | |||||
Ending balance (in shares) at Mar. 31, 2024 | 200,497,000 | 35,514,000 | ||||||
Ending balance at Mar. 31, 2024 | $ 1,034,287 | $ 2 | $ 0 | $ (2,923) | $ 3,736,885 | $ (2,699,347) | $ (2,594) | $ 2,264 |
Condensed Consolidated Statem_4
Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2024 | Mar. 31, 2023 | |
Cash Flows from Operating Activities: | ||
Net income (loss) | $ 177,482 | $ (39,628) |
Adjustments to reconcile net income (loss) to net cash provided by operating activities: | ||
Deferred taxes | (79) | (183) |
Net realized loss on sale of financial instruments | 0 | 43 |
Depreciation and amortization expense | 7,811 | 4,939 |
Amortization of debt issuance costs | 194 | 194 |
Stock-based compensation expense | 25,945 | 71,494 |
Net accretion of investments | (6,226) | (7,322) |
Change in provision for credit losses | (1,000) | 8,491 |
(Increase) / decrease in: | ||
Premiums and accounts receivable | (140,635) | 21,949 |
Risk adjustment transfer receivable | (10,112) | 1,740 |
Reinsurance recoverable | (1,741) | 440,652 |
Other assets | (6,285) | (4,526) |
Increase / (decrease) in: | ||
Benefits payable | 282,361 | 16,349 |
Unearned premiums | (376) | (5,648) |
Premium deficiency reserve | (1,444) | (14) |
Accounts payable and other liabilities | 28,473 | 714 |
Reinsurance payable | 914 | (387,191) |
Risk adjustment transfer payable | 279,081 | 292,662 |
Net cash provided by operating activities | 634,363 | 414,715 |
Cash Flows from Investing Activities: | ||
Purchase of investments | (556,693) | (202,650) |
Sale of investments | 0 | 15,052 |
Maturity of investments | 261,428 | 330,486 |
Purchase of property, equipment and capitalized software | (5,950) | (7,379) |
Change in restricted deposits | 626 | 0 |
Net cash (used in) provided by investing activities | (300,589) | 135,509 |
Cash Flows from Financing Activities: | ||
Proceeds from joint venture contribution | 0 | 471 |
Proceeds from exercise of stock options | 27,309 | 35 |
Net cash provided by financing activities | 27,309 | 506 |
Increase in cash, cash equivalents and restricted cash equivalents | 361,083 | 550,730 |
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 | 2,253,054 | 2,131,227 |
Cash and cash equivalents | 2,230,799 | 2,109,571 |
Restricted cash and cash equivalents included in restricted deposits | 22,255 | 21,656 |
Total cash, cash equivalents and restricted cash and cash equivalents | 2,253,054 | 2,131,227 |
Supplemental Disclosures: | ||
Interest payments | $ 11,118 | $ 11,319 |
ORGANIZATION
ORGANIZATION | 3 Months Ended |
Mar. 31, 2024 | |
Organization, Consolidation and Presentation of Financial Statements [Abstract] | |
ORGANIZATION | ORGANIZATION Oscar Health, Inc., together with its subsidiaries (either individually or collectively referred to as "Oscar" or the "Company,") is the first health insurance company built around a full stack technology platform and a relentless focus on member experience. The Company’s Class A common stock is traded on the New York Stock Exchange under the symbol “OSCR”. Powered by our own differentiated cloud-native technology platform, we have built a scaled insurance business that enables us to earn our members’ trust, leverage the power of personalized data, and help our members find quality care they can afford. In addition to supporting our insurance business, our differentiated technology platform also powers both providers and payors through +Oscar. Oscar operates as one segment to sell insurance directly to its members through the federal and state-run healthcare exchanges formed in conjunction with the Patient Protection and Affordable Care Act and leverages its technology platform to provide services via its +Oscar offering. Individual plans are offered to individuals and families through Health Insurance Marketplaces. Small Group plans are offered to employees of companies with 50 - 100 full-time workers. The Company also partners with Cigna through the Cigna +Oscar partnership to exclusively serve the small group employer market. Oscar previously offered Medicare Advantage insurance coverage, but exited the Medicare Advantage market for plan year 2024. Non-Renewal of Cigna + Oscar Partnership On March 26, 2024, the Company notified Cigna Health and Life Insurance Company that it is not renewing the Cigna+Oscar Small Group arrangement after the expiration of the initial term on December 31, 2024. The parties will continue to offer their Cigna+Oscar Small Group product through December 15, 2024. Following termination of the arrangement on December 31, 2024, the Company will continue to provide transition and run-off services through December 31, 2026 and share proportionally in all premiums and claims for any Cigna+Oscar Small Group plan sold or issued on or before December 31, 2024, in accordance with the terms of the arrangement. Basis of Presentation The accompanying interim Condensed Consolidated Financial Statements have been prepared in accordance with accounting principles generally accepted in the United States of America ("U.S. GAAP"), and the applicable rules and regulations of the Securities and Exchange Commission for interim financial information. As such, these financial statements do not include all information and footnotes required by U.S. GAAP for complete financial statements. These Condensed Consolidated Financial Statements are unaudited; however, in the opinion of management, they reflect all adjustments, consisting only of normal recurring adjustments, necessary to state fairly the information presented in conformity with U.S. GAAP applicable for the interim periods presented. The results of operations for the interim periods presented are not necessarily indicative of results for the full year or future periods. These unaudited Condensed Consolidated Financial Statements should be read in conjunction with the audited Consolidated Financial Statements and related notes thereto included in the Company’s Annual Report on Form 10-K filed with the Securities and Exchange Commission for the year ended December 31, 2023. Certain monetary amounts, percentages, and other figures included in this Quarterly Report on Form 10-Q have been subject to rounding adjustments. Percentage amounts included in this Quarterly Report on Form 10-Q have not in all cases been calculated on the basis of such rounded figures, but on the basis of such amounts prior to rounding. For this reason, percentage amounts in this Quarterly Report on Form 10-Q may vary from those obtained by performing the same calculations using the figures in the Company's Condensed Consolidated Financial Statements included elsewhere in this Quarterly Report on Form 10-Q. Certain other amounts that appear in this Quarterly Report on Form 10-Q may not sum due to rounding. Reclassification With the commencement of the current fiscal year, the Company has made certain reclassifications to the income statement to provide more transparency into the Company’s streams of revenue and to increase comparability with peers. This reclassification has been applied retrospectively, and comparative figures for prior periods have been adjusted accordingly within the accompanying Condensed Consolidated Financial Statements and notes to the Condensed Consolidated Financial Statements. The reclassification does not affect the Company’s net income. Use of Estimates The preparation of financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the amounts reported in the Condensed Consolidated Financial Statements and accompanying notes. Significant estimates inherent in the preparation of the accompanying interim Condensed Consolidated Financial Statements include healthcare costs incurred but not yet reported (“IBNR”) and risk adjustment. Estimates are based on past experience and other considerations reasonable under the circumstances. Actual results may differ materially from these estimates. Accounting Pronouncements - Not Yet Adopted In November 2023, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update No. 2023-07, Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures , which requires, for each reportable segment, disclosure of significant segment expenses categories, other segment items, enhanced interim disclosures of certain segment-related disclosures that previously were only required annually, and other disclosure requirements. This guidance is effective for fiscal years beginning after December 15, 2023, and interim periods within fiscal years beginning after December 15, 2024, with early adoption permitted. The Company is currently evaluating the impact of the adoption of this guidance on the Consolidated Financial Statements and related disclosures. In December 2023, the FASB issued Accounting Standards Update No. 2023-09, Income Taxes (Topic 740): Improvements to Income Tax Disclosures , which is intended to improve the transparency of income tax disclosures by requiring greater disaggregation of income tax disclosures related to the income tax rate reconciliation and income taxes paid and other amendments to improve the effectiveness of income tax disclosures. This guidance is effective for annual periods beginning after December 15, 2024, with early adoption permitted. The Company is currently evaluating the impact of the adoption of this guidance on the Consolidated Financial Statements and related disclosures. |
REVENUE RECOGNITION
REVENUE RECOGNITION | 3 Months Ended |
Mar. 31, 2024 | |
Insurance [Abstract] | |
REVENUE RECOGNITION | REVENUE RECOGNITION Premium Premium revenue includes direct policy premiums collected from members and from the federal government, assumed policy premiums received as part of the reinsurance arrangement under the Cigna+Oscar Small Group plan offering, and risk adjustment, and is net of ceded premium from run-off quota share reinsurance contracts accounted for under reinsurance accounting (See Note 9 - Reinsurance for additional information on the Company’s reinsurance contracts). Three Months Ended March 31, (in thousands) 2024 2023 Direct policy premiums $ 2,310,100 $ 1,663,474 Assumed premiums 57,612 55,935 Risk adjustment (269,398) (293,147) Premiums before ceded reinsurance 2,098,314 1,426,262 Reinsurance premiums ceded (4,632) 2,364 Premium $ 2,093,682 $ 1,428,626 The direct policy premiums received from Centers for Medicare & Medicaid Services ("CMS") for the three months ended March 31, 2024 and 2023 were $2.1 billion and $1.4 billion, respectively. Services and Other The Company earns revenue as part of services performed via the +Oscar platform. Services revenue is recognized in the period the contractual performance obligations are satisfied and measured in an amount that reflects the consideration the Company expects to be entitled to in exchange for performing the services. The timing of the Company's revenue recognition may differ from the timing of payment by customers. A receivable is recorded to Premiums and accounts receivable when revenue is recognized prior to payment and there is an unconditional right to payment. Alternatively, deferred revenue is recorded to Accounts payable and other liabilities when payment is received before the performance obligations are satisfied. Other revenue includes primarily sublease income. |
INVESTMENTS
INVESTMENTS | 3 Months Ended |
Mar. 31, 2024 | |
Investments, Debt and Equity Securities [Abstract] | |
INVESTMENTS | INVESTMENTS Net investment income was attributable to the following: Three Months Ended March 31, (in thousands) 2024 2023 Fixed maturity securities $ 14,277 $ 14,338 Cash equivalents 28,880 21,897 Investment income 43,157 36,235 Investment expense (168) (179) Total $ 42,989 $ 36,056 For the year ended March 31, 2024 and December 31, 2023, the Company recorded accrued investment income of $9.0 million and $6.6 million, respectively. The following tables provide summaries of the Company's investments by major security type as of March 31, 2024 and December 31, 2023: March 31, 2024 (in thousands) Amortized Cost Unrealized Gains Unrealized Losses Fair Value U.S. treasury and agency securities $ 1,034,662 $ 215 $ (2,231) $ 1,032,646 Corporate notes 281,821 210 (784) 281,247 Certificates of deposit 38,865 — — 38,865 Total $ 1,355,348 $ 425 $ (3,015) $ 1,352,758 December 31, 2023 (in thousands) Amortized Cost Unrealized Gains Unrealized Losses Fair Value U.S. treasury and agency securities $ 802,288 $ 1,689 $ (1,062) $ 802,915 Corporate notes 234,908 854 (198) 235,564 Certificates of deposit 16,663 — — 16,663 Total $ 1,053,859 $ 2,543 $ (1,260) $ 1,055,142 The following tables present the estimated fair value and gross unrealized losses of fixed maturity securities in a gross unrealized loss position, by the length of time in which the securities have continuously been in that position, as of March 31, 2024 and December 31, 2023: March 31, 2024 Less than 12 Months 12 Months or Longer (in thousands, except no. of securities) Number of Securities Fair Value Gross Number of Securities Fair Value Gross U.S. treasury and agency securities 190 $ 875,332 $ (2,231) — $ — $ — Corporate notes 112 160,333 (719) 6 16,297 (65) Total 302 $ 1,035,665 $ (2,950) $ 6 $ 16,297 $ (65) December 31, 2023 Less than 12 Months 12 Months or Longer (in thousands, except no. of securities) Number of Securities Fair Value Gross Number of Securities Fair Value Gross U.S. treasury and agency securities 69 $ 480,312 $ (995) 4 $ 24,551 $ (67) Corporate notes 64 79,024 (166) 19 5,545 (32) Total 133 $ 559,336 $ (1,161) 23 $ 30,096 $ (99) The Company monitors available-for-sale debt securities for credit losses and recognizes an allowance for credit losses when factors indicate a decline in the fair value of a security is credit-related. Certain investments may experience a decline in fair value due to changes in market interest rates, changes in general economic conditions, or a deterioration in the credit worthiness of a security's issuer. For securities in an unrealized loss position that the Company does not intend to sell, the Company has assessed the gross unrealized losses during the period and determined an allowance for credit losses is not necessary because the declines in fair value are believed to be due to market fluctuations and not due to credit-related events. The amortized cost and fair value of the Company's fixed maturity securities as of March 31, 2024 and December 31, 2023 by contractual maturity are shown below. Actual maturities of these securities could differ from their contractual maturities because issuers may have the right to call or prepay obligations, with or without penalties. March 31, 2024 December 31, 2023 (in thousands) Amortized Cost Fair Value Amortized Cost Fair Value Due in one year or less $ 617,204 $ 616,134 $ 690,694 $ 689,833 Due after one year through five years 738,144 736,624 363,165 365,309 Total $ 1,355,348 $ 1,352,758 $ 1,053,859 $ 1,055,142 |
FAIR VALUE MEASUREMENTS
FAIR VALUE MEASUREMENTS | 3 Months Ended |
Mar. 31, 2024 | |
Fair Value Disclosures [Abstract] | |
FAIR VALUE MEASUREMENTS | FAIR VALUE MEASUREMENTS Fair value represents the price that would be received to sell an asset, or paid to transfer a liability, in an orderly transaction between market participants. The Company's financial assets and liabilities measured at fair value on a recurring basis are categorized into a three-level fair value hierarchy based on the priority of the inputs used in the fair value valuation technique. The levels of the fair value hierarchy are as follows: • Level 1 : Inputs utilize quoted (unadjusted) prices in active markets for identical assets or liabilities. • Level 2 : Inputs utilize quoted prices for similar instruments in active markets; quoted prices for identical or similar instruments in markets that are not active; or model-derived valuations in which all significant inputs are observable in active markets. • Level 3 : Inputs utilized are unobservable but significant to the fair value measurement for the asset or liability. The unobservable inputs are used to measure fair value to the extent relevant observable inputs are not available. The unobservable inputs typically reflect management’s own estimates about the assumptions a market participant would use in pricing the asset or liability. The following tables summarize fair value measurements by level for assets and liabilities measured at fair value on a recurring basis: March 31, 2024 (in thousands) Level 1 Level 2 Level 3 Total Assets Cash equivalents $ 128,239 $ 360 $ — $ 128,599 Investments U.S. treasury and agency securities $ — $ 1,032,646 $ — $ 1,032,646 Corporate notes — 281,247 — 281,247 Certificates of deposit — 38,865 — 38,865 Restricted investments Certificates of deposit $ — $ 2,478 $ — $ 2,478 U.S. treasury securities — 5,081 — 5,081 Total $ 128,239 $ 1,360,677 $ — $ 1,488,916 December 31, 2023 (in thousands) Level 1 Level 2 Level 3 Total Assets Cash equivalents $ 434,330 $ — $ — $ 434,330 Investments U.S. treasury and agency securities $ — $ 802,915 $ — $ 802,915 Corporate notes — 235,564 — 235,564 Certificates of deposit — 16,663 — 16,663 Restricted investments Certificates of deposit $ — $ 2,478 $ — $ 2,478 U.S. treasury securities — 5,736 — 5,736 Total $ 434,330 $ 1,063,356 $ — $ 1,497,686 |
RESTRICTED CASH AND RESTRICTED
RESTRICTED CASH AND RESTRICTED DEPOSITS | 3 Months Ended |
Mar. 31, 2024 | |
Cash and Cash Equivalents [Abstract] | |
RESTRICTED CASH AND RESTRICTED DEPOSITS | RESTRICTED CASH AND RESTRICTED DEPOSITS The Company maintains cash, cash equivalents and investments on deposit or pledged primarily to various state agencies in connection with its insurance licensure. The restricted cash and cash equivalents and restricted investments presented below are included in Restricted deposits in the accompanying condensed consolidated balance sheets. (in thousands) March 31, 2024 December 31, 2023 Restricted cash and cash equivalents $ 22,255 $ 21,656 Restricted investments 7,559 8,214 Restricted deposits $ 29,814 $ 29,870 |
BENEFITS PAYABLE
BENEFITS PAYABLE | 3 Months Ended |
Mar. 31, 2024 | |
Insurance [Abstract] | |
BENEFITS PAYABLE | BENEFITS PAYABLE Reserves for medical claims expenses are estimated using actuarial assumptions and recorded as Benefits payable liabilities on the condensed consolidated balance sheets. The assumptions for the estimates and for establishing the resulting liability are reviewed and any adjustments to reserves are reflected in the condensed consolidated statements of operations in the period in which the estimates are updated. The following table provides a rollforward of the Company’s beginning and ending benefits payable and claims adjustment expenses ("CAE") payable balances for the three months ended March 31, 2024 and 2023: As of March 31, 2024 As of March 31, 2023 (in thousands) Benefits Payable Unallocated Claims Total Benefits Payable Unallocated Claims Total Benefits payable, beginning of the period $ 965,986 $ 13,192 $ 979,178 $ 937,727 $ 12,712 $ 950,439 Less: Reinsurance recoverable 57,111 — 57,111 277,944 — 277,944 Benefits payable, beginning of the period, net $ 908,875 $ 13,192 $ 922,067 $ 659,783 $ 12,712 $ 672,495 Claims incurred and CAE Current year $ 1,608,525 $ 23,556 $ 1,632,081 $ 1,109,952 $ 25,815 $ 1,135,767 Prior years (53,751) — (53,751) (18,360) — (18,360) Total claims incurred and CAE, net $ 1,554,774 $ 23,556 $ 1,578,330 $ 1,091,592 $ 25,815 $ 1,117,407 Claims paid and CAE Current year $ 910,988 $ 14,146 $ 925,134 $ 668,971 $ 19,692 $ 688,663 Prior years 364,043 5,722 369,765 294,591 5,728 300,319 Total claims and CAE paid, net $ 1,275,031 $ 19,868 $ 1,294,899 $ 963,562 $ 25,420 $ 988,982 Benefits and CAE payable, end of period, net $ 1,188,618 $ 16,880 $ 1,205,498 $ 787,813 $ 13,107 $ 800,920 Add: Reinsurance recoverable 59,729 — 59,729 166,263 — 166,263 Benefits and CAE payable, end of period $ 1,248,347 $ 16,880 $ 1,265,227 $ 954,076 $ 13,107 $ 967,183 Amounts incurred related to prior periods vary from previously estimated liabilities as more claim information becomes available and claims are ultimately settled. The favorable development recognized in the three months ended March 31, 2024 resulted primarily from medical claims experience developing more favorably than originally expected. |
DEBT
DEBT | 3 Months Ended |
Mar. 31, 2024 | |
Debt Disclosure [Abstract] | |
DEBT | DEBT Convertible Senior Notes As previously disclosed in in Note 15 - Long-Term Debt, in our Annual Report on Form 10-K for the year ended December 31, 2023, in February 2022, the Company issued $305.0 million in aggregate principal amount of convertible senior notes due 2031 (the “2031 Notes”) in a private placement to funds affiliated with or advised by Dragoneer Investment Group, LLC, Thrive Capital, LionTree Investment Management, LLC and Tenere Capital LLC. The 2031 Notes are the Company's senior, unsecured obligations which bear interest at a rate of 7.25% per annum, payable in cash, semi-annually in arrears on June 30 and December 31 of each year, commencing on June 30, 2022. The 2031 Notes will mature on December 31, 2031, subject to earlier repurchase, redemption, or conversion. The 2031 Notes are convertible into the Company's Class A common stock at an initial conversion rate of 120.1721 per $1,000 principal amount (equivalent to an initial conversion price of approximately $8.32 per share of Class A common stock), subject to customary adjustments upon the occurrence of certain events. During the quarterly period ended March 31, 2024, a conditional conversion feature of the 2031 Notes was satisfied when the last reported sales price per share of the Company’s common stock was greater than 130% of the conversion price of $8.32 per share for each of at least twenty (20) trading days during the period of thirty (30) consecutive trading days ending on, and including, the last trading day of the quarter. As a result, the 2031 Notes are convertible during the second quarter of 2024 at the option of the holder. Upon conversion, the 2031 Notes will be settled, at the Company's election, in shares of Class A common stock, cash, or a combination of cash and shares of Class A common stock, subject to certain exceptions. As of March 31, 2024, the net carrying amount of the 2031 Notes was $299.0 million, with unamortized debt discount and issuance costs of $6.0 million. The estimated fair value of the 2031 Notes as of March 31, 2024 was $560.3 million. The Company classified the fair value of the 2031 Notes as a level 3 measurement due to the lack of observable market data over fair value inputs such as stock price volatility over the term of the 2031 Notes and the Company's cost of debt. The following table presents the interest expense indicating an effective interest rate of 7.61% over the term of the 2031 Notes: Three Months Ended March 31, (in thousands) 2024 2023 Coupon interest expense $ 5,528 $ 5,528 Amortization of debt discount and issuance costs 194 194 Total interest expense $ 5,722 $ 5,722 Revolving Credit Facilit y As previously disclosed in Note 15 - Long-Term Debt, in our Annual Report on Form 10-K for the year ended December 31, 2023, on December 28, 2023, the Company entered into a third amendment to its senior secured credit agreement (the “Third Amendment”), with certain lenders (the “Lenders”) and Wells Fargo Bank, National Association, as administrative agent, which amended the senior secured credit agreement, dated as of February 21, 2021 (as amended by the Third Amendment, the “Amended Credit Agreement”). The Amended Credit Agreement provides for a revolving loan credit facility (the “Revolving Credit Facility”) in the aggregate principal amount of $115.0 million. The Revolving Credit Facility is guaranteed by Oscar Management Corporation, each wholly owned subsidiary of the Company, and all of the Company's future direct and indirect subsidiaries (in each case subject to certain permitted exceptions, including exceptions for certain guarantees (i) that would require material governmental consents or (ii) in respect of joint ventures)). The Revolving Credit Facility is secured by substantially all of the Company’s and the guarantors' assets (subject to certain exceptions). Proceeds are to be used solely for general corporate purposes of the Company. The Company is permitted to increase commitments under the Revolving Credit Facility by an aggregate amount not to exceed $50.0 million, subject to certain conditions. The Revolving Credit Facility is available until December 2025, provided the Company is in compliance with all covenants, including financial covenants to maintain minimum thresholds related to direct policy premiums, consolidated adjusted EBITDA and liquidity, and a maximum medical loss ratio. As of March 31, 2024, there were no outstanding borrowings under the Revolving Credit Facility. |
EARNINGS (LOSS) PER SHARE
EARNINGS (LOSS) PER SHARE | 3 Months Ended |
Mar. 31, 2024 | |
Earnings Per Share [Abstract] | |
EARNINGS (LOSS) PER SHARE | EARNINGS (LOSS) PER SHARE Basic earnings per share is computed by dividing net income (loss) for the period by the weighted-average shares of common stock outstanding during the period. In periods when the Company is in a net loss position, potentially dilutive securities are excluded from the computation of diluted earnings per share because their inclusion would have an anti-dilutive effect. Thus, basic earnings per share is the same as diluted earnings per share. During periods of net income, diluted earnings per share is calculated by adjusting net income for any interest charges and changes in the fair value of the bifurcated conversion option applicable to the convertible senior notes. This adjusted net income is then divided by the sum of the basic weighted-average shares of common stock and any dilutive potential common stock outstanding during the period, using the treasury stock method. Potential common stock includes the effect of outstanding dilutive stock options, restricted stock units, performance-based restricted stock units, as well as shares the Company could be obligated to issue from its convertible senior notes, as described in Note 7 - Debt, using the if-converted method. The calculation for Basic and Diluted earnings per share is as follows: Three Months Ended March 31, (in thousands, except per share data) 2024 2023 Numerator : Net income (loss) attributable to Oscar Health Inc. $ 177,368 $ (39,772) Effect of convertible senior notes 5,782 — Net income (loss) available to Oscar Health, Inc. 183,150 $ (39,772) Denominator : Weighted average shares of common stock outstanding 231,443 216,913 Common stock equivalents 25,701 — Effect of convertible senior notes 36,652 — Weighted average shares of common stock outstanding 293,796 216,913 Net Earnings (Loss) per Share Basic $ 0.77 $ (0.18) Diluted $ 0.62 $ (0.18) The following potential common shares were excluded from the computation of diluted net income (loss) per share attributable to Oscar Health, Inc. because including them would have had an anti-dilutive effect: Three Months Ended March 31, (in thousands) 2024 2023 Stock options to purchase common stock 3,688 28,801 Restricted stock units 5,311 31,068 Performance-based restricted stock units 64 2,033 Shares underlying convertible notes (Note 7) — 36,652 Total 9,063 98,555 |
REINSURANCE
REINSURANCE | 3 Months Ended |
Mar. 31, 2024 | |
Insurance [Abstract] | |
REINSURANCE | REINSURANCE The Company participates in quota share reinsurance to limit risk and capital requirements and excess of loss ("XOL") reinsurance to mitigate the exposure of high cost or catastrophic member risk. The quota share reinsurance arrangements are with more than one counterparty with multiple state-level treaties. A summary of the Company's reinsurance agreements and related accounting treatment is included in Note 4 - Reinsurance, in our Annual Report on Form 10-K for the year ended December 31, 2023. The Company also operates under an assumed reinsurance contract, under which the Company shares proportionally in all premiums and claims underwritten for the Cigna+Oscar Small Group offering. Reinsurance Contracts Accounted for under Deposit Accounting As of March 31, 2024 and December 31, 2023, a deposit liability balance of $12.7 million and $7.0 million, respectively, was recorded for the Company's quota share arrangements accounted for under deposit accounting and represent fees paid to the reinsurer, which are recognized within Selling, general, and administrative expenses on the statement of operations. For the three months ended March 31, 2024 and 2023, the Company ceded 54% and 48% of its premium under reinsurance contracts accounted for under deposit accounting. Reinsurance Contracts Accounted for under Reinsurance Accounting Reinsurance accounting applies to quota share reinsurance contracts that are in runoff. Under reinsurance accounting, the Company records premium paid to the reinsurer are recorded as reinsurance premium ceded (a reduction to premium revenue) and a corresponding reinsurance payable. Expected reimbursement from the reinsurer for claims incurred are recorded as a reduction to claims incurred and a corresponding reinsurance recoverable asset. The tables below present information for the Company's reinsurance arrangements accounted for under reinsurance accounting. Please see Note 2 - Revenue Recognition for total reinsurance premiums ceded and reinsurance premiums assumed, which are included as components of total Premium revenue in the condensed consolidated statement of operations. The following table reconciles total Medical expenses to the amount presented in the condensed consolidated statement of operations: Three Months Ended March 31, (in thousands) 2024 2023 Direct claims incurred $ 1,523,646 $ 1,048,058 Ceded reinsurance claims (19,698) (3,624) Assumed reinsurance claims 50,826 47,158 Medical expenses $ 1,554,774 $ 1,091,592 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 statement of operations: Three Months Ended March 31, (in thousands) 2024 2023 Selling, general and administrative expenses, gross $ 394,696 $ 396,984 Reinsurance ceding commissions (534) 1,535 Selling, general and administrative expenses $ 394,162 $ 398,519 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) March 31, 2024 December 31, 2023 Reinsurance premium and claim recoverables $ 235,216 $ 224,837 Reinsurance ceding commissions 7,613 7,054 Experience refunds on reinsurance agreements 106 9,303 Reinsurance recoverable $ 242,935 $ 241,194 Credit Ratings The financial condition of the Company's reinsurers is regularly evaluated to minimize exposure to significant losses. A key credit quality indicator for reinsurance is the financial strength ratings issued by the credit rating agencies, which provide an independent opinion of a reinsurer’s ability to meet ongoing obligations to policyholders. The Company's reinsurers have most recently been issued financial strength ratings of A+ (A.M. Best and Fitch). The creditworthiness of each reinsurer is evaluated in order to assess counterparty credit risk and estimate an allowance for expected credit losses on the Company's reinsurance recoverable balances. |
BUSINESS ARRANGEMENTS
BUSINESS ARRANGEMENTS | 3 Months Ended |
Mar. 31, 2024 | |
Organization, Consolidation and Presentation of Financial Statements [Abstract] | |
BUSINESS ARRANGEMENTS | BUSINESS ARRANGEMENTS Variable Interest Entities In the normal course of business, the Company entered into business arrangements with integrated health systems, as well as medical professional corporations that employ health care providers to deliver telemedical healthcare services to its covered member population in various states. The financial results of these entities are consolidated into the Company's financial statements. The following table presents the collective assets and liabilities of the Company's variable interest entities: (in thousands) March 31, 2024 December 31, 2023 Assets $ 131,179 $ 125,709 Liabilities $ 76,426 $ 74,568 |
RELATED PARTY TRANSACTIONS
RELATED PARTY TRANSACTIONS | 3 Months Ended |
Mar. 31, 2024 | |
Related Party Transactions [Abstract] | |
RELATED PARTY TRANSACTIONS | RELATED PARTY TRANSACTIONS In February 2022, the Company issued the 2031 Notes to funds affiliated with or advised by Dragoneer Investment Group, LLC, Thrive Capital Management, LLC, LionTree Investment Management, LLC and Tenere Capital LLC (collectively, the “Purchasers”). See Note 7 - Debt for additional information. |
COMMITMENTS AND CONTINGENCIES
COMMITMENTS AND CONTINGENCIES | 3 Months Ended |
Mar. 31, 2024 | |
Commitments and Contingencies Disclosure [Abstract] | |
COMMITMENTS AND CONTINGENCIES | COMMITMENTS AND CONTINGENCIES The Company’s current and past business practices are subject to review or other investigations by various state insurance and healthcare regulatory authorities and other state and federal regulatory authorities. These reviews focus on numerous facets of the Company’s business, including claims payment practices, statutory capital requirements, provider contracting, risk adjustment, competitive practices, commission payments, privacy issues, utilization management practices, pharmacy benefits, access to care, and sales practices, among others. Some of these reviews have historically resulted in fines imposed on the Company and some have required changes to certain of the Company’s practices. The Company continues to be subject to these reviews, which could result in additional fines or other sanctions being imposed on the Company or additional changes to certain of its practices. The Company is also currently involved in, and may in the future from time to time become involved in, legal proceedings and other claims in the ordinary course of its business, including class actions and suits brought by the Company’s members, providers, commercial counterparties, employees, and other parties relating to the Company’s business, including management and administration of health benefit plans and other services. Such matters can include various employment claims, disputes regarding reinsurance arrangements, disputes relating to intellectual property and the Telephone Consumer Protection Act and class action lawsuits, or other claims relating to the performance of contractual and non-contractual obligations to providers, members, employer groups, and others, including, but not limited to, the alleged failure to properly pay in-network and out-of-network claims and challenges to the manner in which the Company processes claims, and claims alleging that the Company has engaged in unfair business practices. In addition, on May 12, 2022, a securities class action lawsuit against the Company, certain of its directors and officers, and the underwriters that participated in the Company’s initial public offering ("IPO") was commenced in the United States District Court for the Southern District of New York, captioned Carpenter v. Oscar Health, Inc., et al., Case No. 1:22-CV-03885 (S.D.N.Y.) (the “Securities Action”). The initial complaint in the Securities Action asserted violations of Sections 11 and 15 of the Securities Act based on the Company’s purported failure to disclose in its IPO registration statement growing COVID-19 testing and treatment costs, the impact of significant Special Enrollment Period membership, and risk adjustment data validation results for 2019 and 2020. By Court orders dated September 27, 2022 and December 13, 2022, the Court appointed a lead plaintiff and lead counsel on behalf of the putative class. An amended complaint filed on December 6, 2022 asserts the same violations of Sections 11 and 15 of the Securities Act, but this time based on the Company’s alleged failure to disclose in its IPO registration statement purportedly inadequate controls and systems in connection with the risk adjustment data validation audit for 2019, alleging that this purported omission caused losses and damages for members of the putative class. The amended complaint seeks unspecified compensatory damages as well as interest, fees, and costs. On April 4, 2023, the Company moved to dismiss the amended complaint. Briefing on the motion was completed on July 7, 2023. The Company believes it has meritorious defenses to these claims. At this time, the Company cannot predict the outcome, or provide a reasonable estimate or range of estimates of the possible outcome or loss, if any, in this matter. The Company records liabilities for its reasonable estimates of probable losses resulting from these matters where appropriate. Estimates of losses resulting from legal and regulatory matters involving the Company are inherently difficult to predict, particularly where the matters: involve indeterminate claims for monetary damages or may involve fines, penalties or punitive damages; present novel legal theories or represent a shift in regulatory policy; involve a large number of claimants or regulatory bodies; are in the early stages of the proceedings; or could result in a change in business practices. Accordingly, the Company is often unable to estimate the losses or ranges of losses for those matters where there is a reasonable possibility or it is probable that a loss may be incurred, the ultimate settlement of which could be material. Given that such proceedings are subject to uncertainty, there can be no assurance that such legal proceedings, either individually or in the aggregate, will not have a material adverse effect on Oscar's business, results of operations, financial condition or cash flows. |
CANCELLATION OF FOUNDERS AWARDS
CANCELLATION OF FOUNDERS AWARDS | 3 Months Ended |
Mar. 31, 2024 | |
Share-Based Compensation Arrangement by Share-Based Payment Award, Non-Option Equity Instruments, Forfeitures and Expirations [Abstract] | |
CANCELLATION OF FOUNDERS AWARDS | CANCELLATION OF FOUNDERS AWARDS On March 28, 2023, the Company’s Co-Founders, Mario Schlosser (the Company’s President of Technology and Chief Technology Officer and former Chief Executive Officer) and Joshua Kushner (the Company’s Vice Chairman), recommended to the Company’s Board of Directors that they should cancel and terminate the applicable awards that were granted to them in connection with the Company’s Initial Public Offering (the “Founders Awards”). This recommendation was made in support of reducing the dilutive effects of equity awards granted on April 3, 2023, to Mark T. Bertolini in connection with his appointment as the Company’s Chief Executive Officer, effective April 3, 2023, and the Company’s annual employee equity awards granted in 2023. On March 28, 2023, Mr. Schlosser and Mr. Kushner each entered into an agreement to cancel and terminate his Founders Award, which consisted of performance-based restricted stock units covering 4,229,853 shares (for Mr. Schlosser) and 2,114,926 shares (for Mr. Kushner) of the Company’s Class A common stock. As a result of this cancellation, during the three months ended March 31, 2023, the Company recognized approximately $46.3 million of accelerated stock-based compensation expense that would have otherwise been recognized over the remaining vesting period of the awards. Stock-based compensation expense is included in the Selling, general and administrative line item on the condensed consolidated statement of operations. |
Pay vs Performance Disclosure
Pay vs Performance Disclosure - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2024 | Mar. 31, 2023 | |
Pay vs Performance Disclosure | ||
Net Income (Loss) | $ 177,368 | $ (39,772) |
Insider Trading Arrangements
Insider Trading Arrangements | 3 Months Ended |
Mar. 31, 2024 shares | |
Trading Arrangements, by Individual | |
Material Terms of Trading Arrangement | On February 28, 2024, R. Scott Blackley, the Company’s Chief Financial Officer, adopted a Rule 10b5-1 trading arrangement that is intended to satisfy the affirmative defense of Rule 10b5-1(c) for the sale of up to 250,000 shares of the Company’s Class A common stock by February 27, 2025. On April 2, 2024, Mark T. Bertolini, the Company’s Chief Executive Officer, terminated his sell-to-cover instruction providing for sales of Class A common stock as necessary to cover tax withholding obligations incurred in connection with the vesting or settlement of restricted stock units, as Mr. Bertolini has elected to pay such amounts in cash. The instruction was originally adopted on August 13, 2023 and was intended to satisfy the affirmative defense of Rule 10b5-1(c). |
Non-Rule 10b5-1 Arrangement Adopted | false |
Non-Rule 10b5-1 Arrangement Terminated | false |
R. Scott Blackley [Member] | |
Trading Arrangements, by Individual | |
Name | R. Scott Blackley |
Title | Chief Financial Officer |
Rule 10b5-1 Arrangement Adopted | true |
Adoption Date | February 28, 2024 |
Arrangement Duration | 365 days |
Aggregate Available | 250,000 |
Mark T. Bertolini [Member] | |
Trading Arrangements, by Individual | |
Name | Mark T. Bertolini |
Title | Chief Executive Officer |
Adoption Date | August 13, 2023 |
Rule 10b5-1 Arrangement Terminated | true |
Termination Date | April 2, 2024 |
ORGANIZATION (Policies)
ORGANIZATION (Policies) | 3 Months Ended |
Mar. 31, 2024 | |
Organization, Consolidation and Presentation of Financial Statements [Abstract] | |
Basis of Presentation | Basis of Presentation The accompanying interim Condensed Consolidated Financial Statements have been prepared in accordance with accounting principles generally accepted in the United States of America ("U.S. GAAP"), and the applicable rules and regulations of the Securities and Exchange Commission for interim financial information. As such, these financial statements do not include all information and footnotes required by U.S. GAAP for complete financial statements. These Condensed Consolidated Financial Statements are unaudited; however, in the opinion of management, they reflect all adjustments, consisting only of normal recurring adjustments, necessary to state fairly the information presented in conformity with U.S. GAAP applicable for the interim periods presented. The results of operations for the interim periods presented are not necessarily indicative of results for the full year or future periods. These unaudited Condensed Consolidated Financial Statements should be read in conjunction with the audited Consolidated Financial Statements and related notes thereto included in the Company’s Annual Report on Form 10-K filed with the Securities and Exchange Commission for the year ended December 31, 2023. Certain monetary amounts, percentages, and other figures included in this Quarterly Report on Form 10-Q have been subject to rounding adjustments. Percentage amounts included in this Quarterly Report on Form 10-Q have not in all cases been calculated on the basis of such rounded figures, but on the basis of such amounts prior to rounding. For this reason, percentage amounts in this Quarterly Report on Form 10-Q may vary from those obtained by performing the same calculations using the figures in the Company's Condensed Consolidated Financial Statements included elsewhere in this Quarterly Report on Form 10-Q. Certain other amounts that appear in this Quarterly Report on Form 10-Q may not sum due to rounding. |
Use of Estimates | Use of Estimates The preparation of financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the amounts reported in the Condensed Consolidated Financial Statements and accompanying notes. Significant estimates inherent in the preparation of the accompanying interim Condensed Consolidated Financial Statements include healthcare costs incurred but not yet reported (“IBNR”) and risk adjustment. Estimates are based on past experience and other considerations reasonable under the circumstances. Actual results may differ materially from these estimates. |
Accounting Pronouncements - Not Yet Adopted | Accounting Pronouncements - Not Yet Adopted In November 2023, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update No. 2023-07, Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures , which requires, for each reportable segment, disclosure of significant segment expenses categories, other segment items, enhanced interim disclosures of certain segment-related disclosures that previously were only required annually, and other disclosure requirements. This guidance is effective for fiscal years beginning after December 15, 2023, and interim periods within fiscal years beginning after December 15, 2024, with early adoption permitted. The Company is currently evaluating the impact of the adoption of this guidance on the Consolidated Financial Statements and related disclosures. In December 2023, the FASB issued Accounting Standards Update No. 2023-09, Income Taxes (Topic 740): Improvements to Income Tax Disclosures , which is intended to improve the transparency of income tax disclosures by requiring greater disaggregation of income tax disclosures related to the income tax rate reconciliation and income taxes paid and other amendments to improve the effectiveness of income tax disclosures. This guidance is effective for annual periods beginning after December 15, 2024, with early adoption permitted. The Company is currently evaluating the impact of the adoption of this guidance on the Consolidated Financial Statements and related disclosures. |
REVENUE RECOGNITION (Tables)
REVENUE RECOGNITION (Tables) | 3 Months Ended |
Mar. 31, 2024 | |
Insurance [Abstract] | |
Effects of Reinsurance | Three Months Ended March 31, (in thousands) 2024 2023 Direct policy premiums $ 2,310,100 $ 1,663,474 Assumed premiums 57,612 55,935 Risk adjustment (269,398) (293,147) Premiums before ceded reinsurance 2,098,314 1,426,262 Reinsurance premiums ceded (4,632) 2,364 Premium $ 2,093,682 $ 1,428,626 The following table reconciles total Medical expenses to the amount presented in the condensed consolidated statement of operations: Three Months Ended March 31, (in thousands) 2024 2023 Direct claims incurred $ 1,523,646 $ 1,048,058 Ceded reinsurance claims (19,698) (3,624) Assumed reinsurance claims 50,826 47,158 Medical expenses $ 1,554,774 $ 1,091,592 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 statement of operations: Three Months Ended March 31, (in thousands) 2024 2023 Selling, general and administrative expenses, gross $ 394,696 $ 396,984 Reinsurance ceding commissions (534) 1,535 Selling, general and administrative expenses $ 394,162 $ 398,519 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) March 31, 2024 December 31, 2023 Reinsurance premium and claim recoverables $ 235,216 $ 224,837 Reinsurance ceding commissions 7,613 7,054 Experience refunds on reinsurance agreements 106 9,303 Reinsurance recoverable $ 242,935 $ 241,194 |
INVESTMENTS (Tables)
INVESTMENTS (Tables) | 3 Months Ended |
Mar. 31, 2024 | |
Investments, Debt and Equity Securities [Abstract] | |
Summary of investment income | Net investment income was attributable to the following: Three Months Ended March 31, (in thousands) 2024 2023 Fixed maturity securities $ 14,277 $ 14,338 Cash equivalents 28,880 21,897 Investment income 43,157 36,235 Investment expense (168) (179) Total $ 42,989 $ 36,056 |
Summary of investments | The following tables provide summaries of the Company's investments by major security type as of March 31, 2024 and December 31, 2023: March 31, 2024 (in thousands) Amortized Cost Unrealized Gains Unrealized Losses Fair Value U.S. treasury and agency securities $ 1,034,662 $ 215 $ (2,231) $ 1,032,646 Corporate notes 281,821 210 (784) 281,247 Certificates of deposit 38,865 — — 38,865 Total $ 1,355,348 $ 425 $ (3,015) $ 1,352,758 December 31, 2023 (in thousands) Amortized Cost Unrealized Gains Unrealized Losses Fair Value U.S. treasury and agency securities $ 802,288 $ 1,689 $ (1,062) $ 802,915 Corporate notes 234,908 854 (198) 235,564 Certificates of deposit 16,663 — — 16,663 Total $ 1,053,859 $ 2,543 $ (1,260) $ 1,055,142 |
Summary of investments in a gross unrealized loss position | The following tables present the estimated fair value and gross unrealized losses of fixed maturity securities in a gross unrealized loss position, by the length of time in which the securities have continuously been in that position, as of March 31, 2024 and December 31, 2023: March 31, 2024 Less than 12 Months 12 Months or Longer (in thousands, except no. of securities) Number of Securities Fair Value Gross Number of Securities Fair Value Gross U.S. treasury and agency securities 190 $ 875,332 $ (2,231) — $ — $ — Corporate notes 112 160,333 (719) 6 16,297 (65) Total 302 $ 1,035,665 $ (2,950) $ 6 $ 16,297 $ (65) December 31, 2023 Less than 12 Months 12 Months or Longer (in thousands, except no. of securities) Number of Securities Fair Value Gross Number of Securities Fair Value Gross U.S. treasury and agency securities 69 $ 480,312 $ (995) 4 $ 24,551 $ (67) Corporate notes 64 79,024 (166) 19 5,545 (32) Total 133 $ 559,336 $ (1,161) 23 $ 30,096 $ (99) |
Summary of contractual maturities of available-for-sale securities | The amortized cost and fair value of the Company's fixed maturity securities as of March 31, 2024 and December 31, 2023 by contractual maturity are shown below. Actual maturities of these securities could differ from their contractual maturities because issuers may have the right to call or prepay obligations, with or without penalties. March 31, 2024 December 31, 2023 (in thousands) Amortized Cost Fair Value Amortized Cost Fair Value Due in one year or less $ 617,204 $ 616,134 $ 690,694 $ 689,833 Due after one year through five years 738,144 736,624 363,165 365,309 Total $ 1,355,348 $ 1,352,758 $ 1,053,859 $ 1,055,142 |
FAIR VALUE MEASUREMENTS (Tables
FAIR VALUE MEASUREMENTS (Tables) | 3 Months Ended |
Mar. 31, 2024 | |
Fair Value Disclosures [Abstract] | |
Schedule of assets and liabilities measured on recurring basis | The following tables summarize fair value measurements by level for assets and liabilities measured at fair value on a recurring basis: March 31, 2024 (in thousands) Level 1 Level 2 Level 3 Total Assets Cash equivalents $ 128,239 $ 360 $ — $ 128,599 Investments U.S. treasury and agency securities $ — $ 1,032,646 $ — $ 1,032,646 Corporate notes — 281,247 — 281,247 Certificates of deposit — 38,865 — 38,865 Restricted investments Certificates of deposit $ — $ 2,478 $ — $ 2,478 U.S. treasury securities — 5,081 — 5,081 Total $ 128,239 $ 1,360,677 $ — $ 1,488,916 December 31, 2023 (in thousands) Level 1 Level 2 Level 3 Total Assets Cash equivalents $ 434,330 $ — $ — $ 434,330 Investments U.S. treasury and agency securities $ — $ 802,915 $ — $ 802,915 Corporate notes — 235,564 — 235,564 Certificates of deposit — 16,663 — 16,663 Restricted investments Certificates of deposit $ — $ 2,478 $ — $ 2,478 U.S. treasury securities — 5,736 — 5,736 Total $ 434,330 $ 1,063,356 $ — $ 1,497,686 |
RESTRICTED CASH AND RESTRICTE_2
RESTRICTED CASH AND RESTRICTED DEPOSITS (Tables) | 3 Months Ended |
Mar. 31, 2024 | |
Cash and Cash Equivalents [Abstract] | |
Schedule of restricted deposits | The restricted cash and cash equivalents and restricted investments presented below are included in Restricted deposits in the accompanying condensed consolidated balance sheets. (in thousands) March 31, 2024 December 31, 2023 Restricted cash and cash equivalents $ 22,255 $ 21,656 Restricted investments 7,559 8,214 Restricted deposits $ 29,814 $ 29,870 |
BENEFITS PAYABLE (Tables)
BENEFITS PAYABLE (Tables) | 3 Months Ended |
Mar. 31, 2024 | |
Insurance [Abstract] | |
Schedule of Liability for Unpaid Claims and Claims Adjustment Expense | The following table provides a rollforward of the Company’s beginning and ending benefits payable and claims adjustment expenses ("CAE") payable balances for the three months ended March 31, 2024 and 2023: As of March 31, 2024 As of March 31, 2023 (in thousands) Benefits Payable Unallocated Claims Total Benefits Payable Unallocated Claims Total Benefits payable, beginning of the period $ 965,986 $ 13,192 $ 979,178 $ 937,727 $ 12,712 $ 950,439 Less: Reinsurance recoverable 57,111 — 57,111 277,944 — 277,944 Benefits payable, beginning of the period, net $ 908,875 $ 13,192 $ 922,067 $ 659,783 $ 12,712 $ 672,495 Claims incurred and CAE Current year $ 1,608,525 $ 23,556 $ 1,632,081 $ 1,109,952 $ 25,815 $ 1,135,767 Prior years (53,751) — (53,751) (18,360) — (18,360) Total claims incurred and CAE, net $ 1,554,774 $ 23,556 $ 1,578,330 $ 1,091,592 $ 25,815 $ 1,117,407 Claims paid and CAE Current year $ 910,988 $ 14,146 $ 925,134 $ 668,971 $ 19,692 $ 688,663 Prior years 364,043 5,722 369,765 294,591 5,728 300,319 Total claims and CAE paid, net $ 1,275,031 $ 19,868 $ 1,294,899 $ 963,562 $ 25,420 $ 988,982 Benefits and CAE payable, end of period, net $ 1,188,618 $ 16,880 $ 1,205,498 $ 787,813 $ 13,107 $ 800,920 Add: Reinsurance recoverable 59,729 — 59,729 166,263 — 166,263 Benefits and CAE payable, end of period $ 1,248,347 $ 16,880 $ 1,265,227 $ 954,076 $ 13,107 $ 967,183 |
DEBT (Tables)
DEBT (Tables) | 3 Months Ended |
Mar. 31, 2024 | |
Debt Disclosure [Abstract] | |
Schedule of debt interest expense | The following table presents the interest expense indicating an effective interest rate of 7.61% over the term of the 2031 Notes: Three Months Ended March 31, (in thousands) 2024 2023 Coupon interest expense $ 5,528 $ 5,528 Amortization of debt discount and issuance costs 194 194 Total interest expense $ 5,722 $ 5,722 |
EARNINGS (LOSS) PER SHARE (Tabl
EARNINGS (LOSS) PER SHARE (Tables) | 3 Months Ended |
Mar. 31, 2024 | |
Earnings Per Share [Abstract] | |
Schedule of basic and diluted earnings per share | Three Months Ended March 31, (in thousands, except per share data) 2024 2023 Numerator : Net income (loss) attributable to Oscar Health Inc. $ 177,368 $ (39,772) Effect of convertible senior notes 5,782 — Net income (loss) available to Oscar Health, Inc. 183,150 $ (39,772) Denominator : Weighted average shares of common stock outstanding 231,443 216,913 Common stock equivalents 25,701 — Effect of convertible senior notes 36,652 — Weighted average shares of common stock outstanding 293,796 216,913 Net Earnings (Loss) per Share Basic $ 0.77 $ (0.18) Diluted $ 0.62 $ (0.18) |
Schedule of antidilutive securities excluded from computation | The following potential common shares were excluded from the computation of diluted net income (loss) per share attributable to Oscar Health, Inc. because including them would have had an anti-dilutive effect: Three Months Ended March 31, (in thousands) 2024 2023 Stock options to purchase common stock 3,688 28,801 Restricted stock units 5,311 31,068 Performance-based restricted stock units 64 2,033 Shares underlying convertible notes (Note 7) — 36,652 Total 9,063 98,555 |
REINSURANCE (Tables)
REINSURANCE (Tables) | 3 Months Ended |
Mar. 31, 2024 | |
Insurance [Abstract] | |
Effects of Reinsurance | Three Months Ended March 31, (in thousands) 2024 2023 Direct policy premiums $ 2,310,100 $ 1,663,474 Assumed premiums 57,612 55,935 Risk adjustment (269,398) (293,147) Premiums before ceded reinsurance 2,098,314 1,426,262 Reinsurance premiums ceded (4,632) 2,364 Premium $ 2,093,682 $ 1,428,626 The following table reconciles total Medical expenses to the amount presented in the condensed consolidated statement of operations: Three Months Ended March 31, (in thousands) 2024 2023 Direct claims incurred $ 1,523,646 $ 1,048,058 Ceded reinsurance claims (19,698) (3,624) Assumed reinsurance claims 50,826 47,158 Medical expenses $ 1,554,774 $ 1,091,592 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 statement of operations: Three Months Ended March 31, (in thousands) 2024 2023 Selling, general and administrative expenses, gross $ 394,696 $ 396,984 Reinsurance ceding commissions (534) 1,535 Selling, general and administrative expenses $ 394,162 $ 398,519 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) March 31, 2024 December 31, 2023 Reinsurance premium and claim recoverables $ 235,216 $ 224,837 Reinsurance ceding commissions 7,613 7,054 Experience refunds on reinsurance agreements 106 9,303 Reinsurance recoverable $ 242,935 $ 241,194 |
BUSINESS ARRANGEMENTS (Tables)
BUSINESS ARRANGEMENTS (Tables) | 3 Months Ended |
Mar. 31, 2024 | |
Organization, Consolidation and Presentation of Financial Statements [Abstract] | |
Schedule of variable interest entities | The following table presents the collective assets and liabilities of the Company's variable interest entities: (in thousands) March 31, 2024 December 31, 2023 Assets $ 131,179 $ 125,709 Liabilities $ 76,426 $ 74,568 |
ORGANIZATION (Details)
ORGANIZATION (Details) | 3 Months Ended |
Mar. 31, 2024 segment | |
Organization, Consolidation and Presentation of Financial Statements [Abstract] | |
Number of operating segments | 1 |
REVENUE RECOGNITION (Details)
REVENUE RECOGNITION (Details) - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2024 | Mar. 31, 2023 | |
Insurance [Abstract] | ||
Direct policy premiums | $ 2,310,100 | $ 1,663,474 |
Assumed premiums | 57,612 | 55,935 |
Risk adjustment | (269,398) | (293,147) |
Premiums before ceded reinsurance | 2,098,314 | 1,426,262 |
Reinsurance premiums ceded | (4,632) | 2,364 |
Premium | $ 2,093,682 | $ 1,428,626 |
REVENUE RECOGNITION - Narrative
REVENUE RECOGNITION - Narrative (Details) - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2024 | Mar. 31, 2023 | |
Effects of Reinsurance [Line Items] | ||
Direct policy premiums | $ 2,310,100 | $ 1,663,474 |
CMS | ||
Effects of Reinsurance [Line Items] | ||
Direct policy premiums | $ 2,100,000 | $ 1,400,000 |
INVESTMENTS - Summary of invest
INVESTMENTS - Summary of investment income (Details) - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2024 | Mar. 31, 2023 | |
Debt Securities, Available-for-sale [Line Items] | ||
Investment income | $ 43,157 | $ 36,235 |
Investment expense | (168) | (179) |
Total | 42,989 | 36,056 |
Fixed maturity securities | ||
Debt Securities, Available-for-sale [Line Items] | ||
Investment income | 14,277 | 14,338 |
Cash equivalents | ||
Debt Securities, Available-for-sale [Line Items] | ||
Investment income | $ 28,880 | $ 21,897 |
INVESTMENTS - Narrative (Detail
INVESTMENTS - Narrative (Details) - USD ($) $ in Thousands | Mar. 31, 2024 | Dec. 31, 2023 |
Investments, Debt and Equity Securities [Abstract] | ||
Accrued investment income | $ 9,000 | $ 6,600 |
INVESTMENTS - Summary of inve_2
INVESTMENTS - Summary of investments (Details) - USD ($) $ in Thousands | Mar. 31, 2024 | Dec. 31, 2023 |
Debt Securities, Available-for-sale [Line Items] | ||
Amortized Cost | $ 1,355,348 | $ 1,053,859 |
Unrealized Gains | 425 | 2,543 |
Unrealized Losses | (3,015) | (1,260) |
Fair Value | 1,352,758 | 1,055,142 |
U.S. treasury and agency securities | ||
Debt Securities, Available-for-sale [Line Items] | ||
Amortized Cost | 1,034,662 | 802,288 |
Unrealized Gains | 215 | 1,689 |
Unrealized Losses | (2,231) | (1,062) |
Fair Value | 1,032,646 | 802,915 |
Corporate notes | ||
Debt Securities, Available-for-sale [Line Items] | ||
Amortized Cost | 281,821 | 234,908 |
Unrealized Gains | 210 | 854 |
Unrealized Losses | (784) | (198) |
Fair Value | 281,247 | 235,564 |
Certificates of deposit | ||
Debt Securities, Available-for-sale [Line Items] | ||
Amortized Cost | 38,865 | 16,663 |
Unrealized Gains | 0 | 0 |
Unrealized Losses | 0 | 0 |
Fair Value | $ 38,865 | $ 16,663 |
INVESTMENTS - Summary of inve_3
INVESTMENTS - Summary of investments in a gross unrealized loss position by length of time (Details) $ in Thousands | Mar. 31, 2024 USD ($) security | Dec. 31, 2023 USD ($) security |
Debt Securities, Available-for-sale [Line Items] | ||
Less than 12 months, number of securities | security | 302 | 133 |
Less than 12 months, fair value | $ 1,035,665 | $ 559,336 |
Less than 12 months, gross unrealized losses | $ (2,950) | $ (1,161) |
12 months or longer, number of securities | security | 6 | 23 |
12 months or longer, fair value | $ 16,297 | $ 30,096 |
12 months or longer, gross unrealized losses | $ (65) | $ (99) |
U.S. treasury and agency securities | ||
Debt Securities, Available-for-sale [Line Items] | ||
Less than 12 months, number of securities | security | 190 | 69 |
Less than 12 months, fair value | $ 875,332 | $ 480,312 |
Less than 12 months, gross unrealized losses | $ (2,231) | $ (995) |
12 months or longer, number of securities | security | 0 | 4 |
12 months or longer, fair value | $ 0 | $ 24,551 |
12 months or longer, gross unrealized losses | $ 0 | $ (67) |
Corporate notes | ||
Debt Securities, Available-for-sale [Line Items] | ||
Less than 12 months, number of securities | security | 112 | 64 |
Less than 12 months, fair value | $ 160,333 | $ 79,024 |
Less than 12 months, gross unrealized losses | $ (719) | $ (166) |
12 months or longer, number of securities | security | 6 | 19 |
12 months or longer, fair value | $ 16,297 | $ 5,545 |
12 months or longer, gross unrealized losses | $ (65) | $ (32) |
INVESTMENTS - Summary of contra
INVESTMENTS - Summary of contractual maturities of available-for-sale securities (Details) - USD ($) $ in Thousands | Mar. 31, 2024 | Dec. 31, 2023 |
Amortized Cost | ||
Due in one year or less | $ 617,204 | $ 690,694 |
Due after one year through five years | 738,144 | 363,165 |
Amortized Cost | 1,355,348 | 1,053,859 |
Fair Value | ||
Due in one year or less | 616,134 | 689,833 |
Due after one year through five years | 736,624 | 365,309 |
Fair Value | $ 1,352,758 | $ 1,055,142 |
FAIR VALUE MEASUREMENTS - Sched
FAIR VALUE MEASUREMENTS - Schedule of assets and liabilities measured on recurring basis (Details) - USD ($) $ in Thousands | Mar. 31, 2024 | Dec. 31, 2023 |
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Investments | $ 1,352,758 | $ 1,055,142 |
U.S. treasury and agency securities | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Investments | 1,032,646 | 802,915 |
Corporate notes | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Investments | 281,247 | 235,564 |
Certificates of deposit | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Investments | 38,865 | 16,663 |
Recurring | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Cash equivalents | 128,599 | 434,330 |
Total | 1,488,916 | 1,497,686 |
Recurring | U.S. treasury and agency securities | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Investments | 1,032,646 | 802,915 |
Recurring | Corporate notes | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Investments | 281,247 | 235,564 |
Recurring | Certificates of deposit | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Investments | 38,865 | 16,663 |
Restricted investments | 2,478 | 2,478 |
Recurring | U.S. treasury securities | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Restricted investments | 5,081 | 5,736 |
Level 1 | Recurring | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Cash equivalents | 128,239 | 434,330 |
Total | 128,239 | 434,330 |
Level 1 | Recurring | U.S. treasury and agency securities | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Investments | 0 | 0 |
Level 1 | Recurring | Corporate notes | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Investments | 0 | 0 |
Level 1 | Recurring | Certificates of deposit | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Investments | 0 | 0 |
Restricted investments | 0 | 0 |
Level 1 | Recurring | U.S. treasury securities | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Restricted investments | 0 | 0 |
Level 2 | Recurring | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Cash equivalents | 360 | 0 |
Total | 1,360,677 | 1,063,356 |
Level 2 | Recurring | U.S. treasury and agency securities | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Investments | 1,032,646 | 802,915 |
Level 2 | Recurring | Corporate notes | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Investments | 281,247 | 235,564 |
Level 2 | Recurring | Certificates of deposit | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Investments | 38,865 | 16,663 |
Restricted investments | 2,478 | 2,478 |
Level 2 | Recurring | U.S. treasury securities | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Restricted investments | 5,081 | 5,736 |
Level 3 | Recurring | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Cash equivalents | 0 | 0 |
Total | 0 | 0 |
Level 3 | Recurring | U.S. treasury and agency securities | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Investments | 0 | 0 |
Level 3 | Recurring | Corporate notes | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Investments | 0 | 0 |
Level 3 | Recurring | Certificates of deposit | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Investments | 0 | 0 |
Restricted investments | 0 | 0 |
Level 3 | Recurring | U.S. treasury securities | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Restricted investments | $ 0 | $ 0 |
RESTRICTED CASH AND RESTRICTE_3
RESTRICTED CASH AND RESTRICTED DEPOSITS (Details) - USD ($) $ in Thousands | Mar. 31, 2024 | Dec. 31, 2023 |
Cash and Cash Equivalents [Abstract] | ||
Restricted cash and cash equivalents | $ 22,255 | $ 21,656 |
Restricted investments | 7,559 | 8,214 |
Restricted deposits | $ 29,814 | $ 29,870 |
BENEFITS PAYABLE (Details)
BENEFITS PAYABLE (Details) - USD ($) $ in Thousands | 3 Months Ended | |||
Mar. 31, 2024 | Mar. 31, 2023 | Dec. 31, 2023 | Dec. 31, 2022 | |
Liability for Unpaid Claims and Claims Adjustment Expense [Roll Forward] | ||||
Benefits payable, beginning of period | $ 965,986 | $ 937,727 | ||
CAE payable, beginning of the period | 13,192 | 12,712 | ||
Benefits and CAE payable, beginning of period | 1,265,227 | 967,183 | $ 979,178 | $ 950,439 |
Less: Reinsurance recoverable | 57,111 | 277,944 | ||
Benefits payable, net reinsurance recoverable, beginning of period | 908,875 | 659,783 | ||
Benefits and CAE payable, net, beginning of period | 922,067 | 672,495 | ||
Benefits Payable | ||||
Current year | 1,608,525 | 1,109,952 | ||
Prior years | (53,751) | (18,360) | ||
Claims incurred | 1,554,774 | 1,091,592 | ||
Unallocated Claims Adjustment Expense | ||||
Current year | 23,556 | 25,815 | ||
Prior years | 0 | 0 | ||
Claims adjustment expense | 23,556 | 25,815 | ||
Total | ||||
Current year | 1,632,081 | 1,135,767 | ||
Prior years | (53,751) | (18,360) | ||
Total claims incurred and CAE, net | 1,578,330 | 1,117,407 | ||
Benefits Payable | ||||
Current year | 910,988 | 668,971 | ||
Prior years | 364,043 | 294,591 | ||
Claims paid | 1,275,031 | 963,562 | ||
Unallocated Claims Adjustment Expense | ||||
Current year | 14,146 | 19,692 | ||
Prior years | 5,722 | 5,728 | ||
CAE paid | 19,868 | 25,420 | ||
Total | ||||
Current year | 925,134 | 688,663 | ||
Prior years | 369,765 | 300,319 | ||
Total claims and CAE paid, net | 1,294,899 | 988,982 | ||
Benefits payable, net reinsurance recoverable, end of period | 1,188,618 | 787,813 | ||
CAE payable, end of the period | 16,880 | 13,107 | ||
Benefits and CAE payable, net, end of period | 1,205,498 | 800,920 | ||
Add: Reinsurance recoverable | 59,729 | 166,263 | ||
Benefits payable, end of period | 1,248,347 | 954,076 | ||
Benefits and CAE payable, end of period | $ 1,265,227 | $ 967,183 |
DEBT - Narrative (Details)
DEBT - Narrative (Details) | 1 Months Ended | |||
Feb. 28, 2022 USD ($) tradingDay $ / shares | Mar. 31, 2024 USD ($) | Dec. 28, 2023 USD ($) | Feb. 21, 2021 USD ($) | |
Convertible debt | 7.25% Convertible Senior Notes Due 2031 | ||||
Debt Instrument [Line Items] | ||||
Aggregate principal amount | $ 305,000,000 | |||
Stated interest rate | 7.25% | |||
Conversion ratio | 0.1201721 | |||
Conversion price (in dollars per share) | $ / shares | $ 8.32 | |||
Threshold percentage of stock price trigger | 130% | |||
Threshold trading days | tradingDay | 20 | |||
Threshold consecutive trading days | tradingDay | 30 | |||
Long-term debt, net | $ 299,000,000 | |||
Unamortized debt discount and debt issuance costs | 6,000,000 | |||
Long-term debt, fair value | $ 560,300,000 | |||
Effective interest rate | 7.61% | |||
Line of credit | Revolving credit facility | Revolving Credit Agreement | ||||
Debt Instrument [Line Items] | ||||
Maximum borrowing capacity | $ 115,000,000 | |||
Borrowing capacity, increase limit | $ 50,000,000 | |||
Line of credit outstanding | $ 0 |
DEBT - Schedule of debt interes
DEBT - Schedule of debt interest expense (Details) - 7.25% Convertible Senior Notes Due 2031 - Convertible debt - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2024 | Mar. 31, 2023 | |
Debt Instrument [Line Items] | ||
Coupon interest expense | $ 5,528 | $ 5,528 |
Amortization of debt discount and issuance costs | 194 | 194 |
Total interest expense | $ 5,722 | $ 5,722 |
EARNINGS (LOSS) PER SHARE - Sch
EARNINGS (LOSS) PER SHARE - Schedule of basic and diluted earnings per share (Details) - USD ($) $ / shares in Units, $ in Thousands | 3 Months Ended | |
Mar. 31, 2024 | Mar. 31, 2023 | |
Numerator: | ||
Net income (loss) attributable to Oscar Health Inc. | $ 177,368 | $ (39,772) |
Effect of convertible senior notes | 5,782 | 0 |
Net income (loss) available to Oscar Health, Inc. common shareholders | $ 183,150 | $ (39,772) |
Denominator: | ||
Weighted average common shares outstanding, basic (in shares) | 231,443,000 | 216,913,000 |
Common stock equivalents (in shares) | 25,701,000 | 0 |
Effect of convertible senior notes (in shares) | 36,652,000 | 0 |
Weighted-average shares of common stock outstanding and potential dilutive common shares outstanding (in shares) | 293,796,000 | 216,913,000 |
Net Earnings (Loss) per Share | ||
Basic (in dollars per share) | $ 0.77 | $ (0.18) |
Diluted (in dollars per share) | $ 0.62 | $ (0.18) |
EARNINGS (LOSS) PER SHARE - S_2
EARNINGS (LOSS) PER SHARE - Schedule of antidilutive securities excluded from computation (Details) - shares | 3 Months Ended | |
Mar. 31, 2024 | Mar. 31, 2023 | |
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items] | ||
Antidilutive securities excluded from computation (in shares) | 9,063,000 | 98,555,000 |
Stock options to purchase common stock | ||
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items] | ||
Antidilutive securities excluded from computation (in shares) | 3,688,000 | 28,801,000 |
Restricted stock units | ||
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items] | ||
Antidilutive securities excluded from computation (in shares) | 5,311,000 | 31,068,000 |
Performance-based restricted stock units | ||
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items] | ||
Antidilutive securities excluded from computation (in shares) | 64,000 | 2,033,000 |
Shares underlying convertible notes | ||
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items] | ||
Antidilutive securities excluded from computation (in shares) | 0 | 36,652,000 |
REINSURANCE - Narrative (Detail
REINSURANCE - Narrative (Details) - USD ($) $ in Millions | 3 Months Ended | ||
Mar. 31, 2024 | Mar. 31, 2023 | Dec. 31, 2023 | |
Insurance [Abstract] | |||
Reinsurance, deposit liability | $ 12.7 | $ 7 | |
Reinsurance premiums ceded, percentage | 54% | 48% |
REINSURANCE - Reinsurance Arran
REINSURANCE - Reinsurance Arrangements (Details) - USD ($) $ in Thousands | 3 Months Ended | ||
Mar. 31, 2024 | Mar. 31, 2023 | Dec. 31, 2023 | |
Policyholder Benefits and Claims Incurred, Net [Abstract] | |||
Direct claims incurred | $ 1,523,646 | $ 1,048,058 | |
Ceded reinsurance claims | (19,698) | (3,624) | |
Assumed reinsurance claims | 50,826 | 47,158 | |
Medical expenses | 1,554,774 | 1,091,592 | |
Other Insurance Cost, Net [Abstract] | |||
Selling, general and administrative expenses, gross | 394,696 | 396,984 | |
Reinsurance ceding commissions | (534) | 1,535 | |
Selling, general and administrative expenses | 394,162 | $ 398,519 | |
Reinsurance Recoverables, Including Reinsurance Premium Paid [Abstract] | |||
Reinsurance premium and claim recoverables | 235,216 | $ 224,837 | |
Reinsurance ceding commissions | 7,613 | 7,054 | |
Experience refunds on reinsurance agreements | 106 | 9,303 | |
Reinsurance recoverable | $ 242,935 | $ 241,194 |
BUSINESS ARRANGEMENTS - Variabl
BUSINESS ARRANGEMENTS - Variable interest entities (Details) - USD ($) $ in Thousands | Mar. 31, 2024 | Dec. 31, 2023 |
Variable Interest Entity [Line Items] | ||
Assets | $ 4,418,853 | $ 3,601,480 |
Liabilities | 3,384,566 | 2,795,363 |
Primary Beneficiary | ||
Variable Interest Entity [Line Items] | ||
Assets | 131,179 | 125,709 |
Liabilities | $ 76,426 | $ 74,568 |
CANCELLATION OF FOUNDERS AWAR_2
CANCELLATION OF FOUNDERS AWARDS (Details) - USD ($) $ in Millions | 3 Months Ended | |
Mar. 28, 2023 | Mar. 31, 2023 | |
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | ||
Accelerated stock-based compensation expense | $ 46.3 | |
PSUs | Founder, Mario Schlosser | ||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | ||
Shares canceled (in shares) | 4,229,853 | |
PSUs | Founder, Joshua Kushner | ||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | ||
Shares canceled (in shares) | 2,114,926 |