Group 1 - U.S. stock futures are higher, with Nasdaq futures gaining approximately 1.5% [1] - Monday.Com Ltd is expected to report quarterly earnings of 88 cents per share, an increase from 85 cents per share year-over-year [2] - The consensus estimate for monday.com's quarterly revenue is $312.26 million, up from $251 million a year earlier [2] Group 2 - Monday.Com shares fell 2.6% to $184.70 in pre-market trading [2] - Metsera Inc shares dipped 15% to $70.68 in pre-market trading following Pfizer's $10 billion acquisition deal [4] - Ionis Pharmaceuticals Inc declined 11.5% to $65.00 after disclosing results from pivotal Phase 3 studies [4] - Other companies such as UniQure NV, Oscar Health Inc, Centene Corp, and Immunovant Inc also experienced declines in pre-market trading [4]

Group 1 - U.S. stock futures are higher, with Nasdaq futures gaining approximately 1.5% on Monday [1] - Monday.Com Ltd is expected to report quarterly earnings of 88 cents per share, an increase from 85 cents per share in the previous year [2] - The consensus estimate for monday.com's quarterly revenue is $312.26 million, up from $251 million a year earlier [2] Group 2 - Monday.Com shares fell 2.6% to $184.70 in pre-market trading [2] - Metsera Inc shares dipped 15% to $70.68 after Pfizer secured a $10 billion deal to acquire the company [4] - Ionis Pharmaceuticals Inc declined 11.5% to $65.00 following the disclosure of pivotal Phase 3 study results [4] - Other companies such as UniQure NV, Oscar Health Inc, Centene Corp, and Immunovant Inc also experienced declines in pre-market trading [4]

Group 1 - President Trump proposed redirecting "hundreds of billions of dollars" in federal funding from health insurers under the Affordable Care Act to the public, impacting health insurance stocks [2] - Health insurance companies such as UnitedHealth Group, Elevance Health, Centene, Cigna, Oscar Health, and Molina Healthcare are facing scrutiny due to Trump's comments [2] - The stock market indexes rose ahead of the Federal Reserve's rate decision, with Nvidia achieving a record close [2][3] Group 2 - UnitedHealth's recovery contributed positively to the Dow Jones, while Oscar Health's stock saw a significant increase in its relative strength rating [5] - CVS Health achieved an 80-plus relative strength rating benchmark, indicating strong performance in the market [5] - The overall stock market experienced weekly gains despite ongoing government shutdown discussions, with attention on Fed minutes and other economic indicators [5]

Core Insights - Oscar Health's Q3 CY2025 revenue of $2.99 billion fell short of market expectations of $3.09 billion, despite a year-on-year growth of 23.2% [1][6] - The company's full-year revenue guidance of $12.1 billion is 0.5% above analysts' estimates [1] - GAAP loss per share was $0.53, which is 6.8% below analysts' consensus estimates of -$0.50 [1][6] Market Challenges - Management attributed the underperformance to increased market morbidity, with a higher proportion of sicker individuals entering the risk pool, influenced by Medicaid redeterminations and program integrity efforts [3] - CEO Mark Bertolini described 2025 as a "reset moment" for the market, highlighting ongoing challenges [3] Future Strategy - Oscar Health's guidance for the next year focuses on disciplined pricing and margin expansion, with a strategic aim for profitability in 2026 [4] - A weighted average rate increase of approximately 28% for 2026 is planned to address elevated market morbidity and potential expiration of enhanced premium tax credits [4] - The company is implementing ongoing cost reduction initiatives and utilizing artificial intelligence to streamline operations [4] Management Insights - Management linked Q3 performance to membership growth, higher morbidity in the insured population, and ongoing product and technology initiatives [5] - Cost management efforts and product innovation were emphasized as responses to evolving market conditions [5] Financial Metrics - Adjusted EBITDA was -$101.5 million, beating analyst estimates of -$119.5 million, with a margin of -3.4% [6] - Operating margin was -4.3%, down from -2% in the same quarter last year [6] - Market capitalization stands at $4.32 billion [6]

Core Viewpoint - The article emphasizes the importance of enabling Javascript and cookies in browsers to prevent access issues, particularly when ad-blockers are enabled [1] Group 1 - The article suggests that users may face restrictions if they have ad-blockers enabled, indicating a need for adjustments in browser settings to ensure smooth access [1]

Membership and Growth - As of September 30, 2025, Oscar Health, Inc. has approximately 2.1 million effectuated members actively enrolled in its plans[104] - The company experienced increased membership due to Medicaid redeterminations, although future growth from this source is expected to be less significant[116] - Membership increased by 0.5 million or 28% as of September 2025 compared to September 2024, primarily due to above-market growth during the 2025 Open Enrollment period[136] Financial Performance - Total revenue includes premium revenue, investment income, and other revenues, which are critical for assessing business growth and investment potential[106] - Premium revenue increased by $555.7 million or 23% for the three months ended September 30, 2025, and by $2,097.2 million or 32% for the nine months ended September 30, 2025, compared to the same periods in 2024, driven by higher membership[136] - Medical expenses rose by $582.4 million or 29% for the three months ended September 30, 2025, and by $2,131.5 million or 40% for the nine months ended September 30, 2025, compared to the same periods in 2024, attributed to increased membership and medical cost trends[140] - Net income attributable to Oscar Health, Inc. was a loss of $137,450 thousand for the three months ended September 30, 2025, compared to a loss of $54,596 thousand for the same period in 2024[134] Medical Loss Ratio and Expenses - The medical loss ratio (MLR) is a key metric, reflecting medical expenses as a percentage of net premiums, and is subject to federal and state minimum requirements[107] - Medical loss ratio (MLR) increased to 88.5% for the three months ended September 30, 2025, compared to 84.6% for the same period in 2024, and to 84.8% for the nine months ended September 30, 2025, compared to 79.5% for the same period in 2024[134] - Selling, general, and administrative expenses increased by $61.2 million or 13% for the three months ended September 30, 2025, and by $249.1 million or 19% for the nine months ended September 30, 2025, compared to the same periods in 2024[143] - The SG&A expense ratio decreased by 153 basis points to 17.5% for the three months ended September 30, 2025, and by 170 basis points to 17.3% for the nine months ended September 30, 2025, compared to the same periods in 2024[144] Cash and Investments - Total cash and cash equivalents and investments held by the holding company were $540.9 million as of September 30, 2025, compared to $189.8 million as of December 31, 2024[146] - Total cash and cash equivalents and investments held by health insurance subsidiaries were $4.3 billion as of September 30, 2025, compared to $3.8 billion as of December 31, 2024[147] - Net cash provided by operating activities for the nine months ended September 30, 2025, was $423.0 million, a decrease from $631.4 million in the same period of 2024[174] - Net cash used in investing activities for the nine months ended September 30, 2025, was $192.4 million, significantly lower than $1,356.0 million for the same period in 2024[175] - Net cash provided by financing activities for the nine months ended September 30, 2025, was $391.0 million, compared to $64.6 million for the same period in 2024, due to proceeds from newly issued convertible notes[176] Regulatory and Market Factors - Regulatory changes, including the implementation of the Program Integrity Rules and the One Big Beautiful Bill Act, may impact enrollment processes and APTC eligibility[115] - Seasonal patterns affect medical expenses and claims incurred, with higher costs typically observed in the second half of the policy year[121] - SEP enrollment volumes across the ACA market in 2025 have returned to historical baselines, impacting MLR risks[123] Risk Management - The risk adjustment transfer estimates were significantly increased based on updated market risk scores, indicating higher expected medical costs[119] - The company is subject to interest rate risk related to its investment portfolio, which includes U.S. Treasury and agency securities, corporate notes, and certificates of deposit[178] - A hypothetical 1% increase in interest rates would lead to a decrease in the fair value of investments by approximately $43.6 million[178] - The primary market risk exposure is driven by changes to Federal fund effective rates[178] - Interest rate risk is influenced by U.S. monetary and tax policies, as well as international economic factors[178] - Declines in interest rates over time would reduce the company's investment income[178] Capital and Contributions - The combined statutory capital and surplus of the health insurance subsidiaries was approximately $1.3 billion as of September 30, 2025, exceeding minimum capital requirements[148] - Health insurance subsidiaries exceeded the minimum statutory RBC requirement by approximately $734 million as of December 31, 2024, and are estimated to have approximately $564.1 million of excess capital as of September 30, 2025[148] - During the nine months ended September 30, 2025, health insurance subsidiaries made loan repayments of $15.0 million, compared to $133.0 million in dividends and loan repayments in the same period of 2024[149] - Parent made capital contributions of $65.8 million and $99.8 million to health insurance subsidiaries for the nine months ended September 30, 2025, and 2024, respectively[150] Investment Income - Investment income increased by $2.9 million or 6% for the three months ended September 30, 2025, and by $10.0 million or 7% for the nine months ended September 30, 2025, compared to the same periods in 2024[139] - Net investment income for the three months ended September 30, 2025, was $53.2 million, compared to $50.3 million for the same period in 2024[170] Debt Issuance - The company issued $305.0 million in convertible senior notes due 2031, with an interest rate of 7.25% per annum[153][154] - The company issued $410.0 million in convertible senior subordinated notes due 2030, with an interest rate of 2.25% per annum[161][162]

Core Insights - Oscar Health Inc. reported third-quarter revenue of approximately $2.99 billion, missing the consensus estimate of $3.08 billion, compared to $2.4 billion a year ago [1][2] - The company experienced a loss of 53 cents per share, which also fell short of the consensus estimate of 61 cents [2] Financial Performance - The medical loss ratio increased to 88.5% from 84.6% a year ago, primarily due to a $130 million increase in net risk adjustment transfer accrual [3] - SG&A expense ratio improved to 17.5% from 19.0%, attributed to greater fixed cost leverage and disciplined cost management [4] - Loss from operations was $129.3 million, compared to a loss of $48.4 million a year ago, driven by increased average market morbidity [5] - Adjusted EBITDA loss was $101.5 million for Q3 2025, compared to a loss of $11.6 million for Q3 2024 [5] Membership Growth - Total membership increased significantly from 1.65 million to 2.12 million during the quarter [6] Future Guidance - Oscar Health reaffirmed its fiscal 2025 sales guidance of $12 billion to $12.2 billion, compared to the Wall Street estimate of $12.04 billion [7] - The company expects a medical loss ratio of 86%-87% and an SG&A expense ratio of 17.1%-17.6% for 2025 [7] - Projected operating loss for 2025 is estimated to be between $200 million to $300 million [7]

Financial Data and Key Metrics Changes - Total revenue for Q3 2025 was approximately $3 billion, representing a 23% year-over-year increase [5][14] - Medical Loss Ratio (MLR) increased by approximately 380 basis points to 88.5% due to higher market morbidity [5][15] - SG&A expense ratio improved by approximately 150 basis points year-over-year to 17.5% [5][16] - Loss from operations was $129 million, a change of $81 million year-over-year, while net loss was $137 million, an $83 million change year-over-year [5][16] - Adjusted EBITDA loss was $101 million in the quarter, a change of $90 million year-over-year [5][16] Business Line Data and Key Metrics Changes - Membership grew to over 2 million, a 28% increase year-over-year [8] - The company continues to diversify its product mix, introducing new plans like Hello Meno for women experiencing menopause [9] Market Data and Key Metrics Changes - The total addressable market for plan year 2026 is approximately $12 million, up $500,000 year-over-year [9] - The weighted average rate increase for 2026 is approximately 28%, reflecting elevated market morbidity and the expiration of enhanced premium tax credits [8][20] Company Strategy and Development Direction - The company aims to expand margins and return to profitability in 2026, focusing on disciplined pricing strategies [12][20] - Oscar is positioned to capture market share as other carriers retreat or price themselves out of the market [8][20] - The introduction of an AI health agent, Oswell, is part of the strategy to enhance member experience and operational efficiency [11] Management's Comments on Operating Environment and Future Outlook - Management noted that 2025 is a reset moment for the individual market, with expectations of rational pricing in the 2026 open enrollment period [7][20] - The company remains optimistic about Congress reaching a compromise on tax credits to address affordability issues [7] - Management expressed confidence in the ability to navigate market dynamics and improve profitability [20][39] Other Important Information - The company completed a $410 million convertible notes offering, strengthening its capital position [17] - Oscar's innovative plans and AI integration are expected to redefine the healthcare experience [11] Q&A Session Summary Question: Regarding the September weekly report and market morbidity shifts - Management indicated that market morbidity increased by about 1.5 to 2 points across several markets, with no significant changes expected through the end of the year [24] Question: On G&A targets for 2027 - Management believes there is room for improvement in SG&A, leveraging AI to streamline operating costs [27] Question: On underlying cost trends in the quarter - Favorable development of $84 million was noted, primarily related to risk adjustment and claims [30] Question: On enrollment trends and member retention - Stronger than expected membership growth was driven by lower churn, positively impacting MLR dynamics [70] Question: On competitive dynamics and pricing strategy - Management noted that they are positioned competitively, with a focus on taking market share from higher-priced competitors [51][66]

Core Insights - Oscar Health, Inc. reported a quarterly loss of $0.53 per share, which was better than the Zacks Consensus Estimate of a loss of $0.55, but worse than a loss of $0.22 per share a year ago, indicating an earnings surprise of +3.64% [1] - The company generated revenues of $2.99 billion for the quarter ended September 2025, missing the Zacks Consensus Estimate by 3.37%, compared to $2.42 billion in the same quarter last year [2] - Oscar Health shares have increased by approximately 26.7% year-to-date, outperforming the S&P 500's gain of 15.6% [3] Earnings Outlook - The current consensus EPS estimate for the upcoming quarter is -$0.87 on revenues of $3.06 billion, and for the current fiscal year, it is -$1.42 on revenues of $12.06 billion [7] - The estimate revisions trend for Oscar Health was unfavorable prior to the earnings release, resulting in a Zacks Rank 4 (Sell), indicating expected underperformance in the near future [6] Industry Context - The Insurance - Multi line industry, to which Oscar Health belongs, is currently ranked in the top 27% of over 250 Zacks industries, suggesting a favorable outlook compared to lower-ranked industries [8] - Empirical research indicates a strong correlation between near-term stock movements and trends in earnings estimate revisions, which can be tracked by investors [5]

Core Insights - Oscar Health reported a third quarter loss of $137 million but anticipates a return to profitability as the health insurance industry navigates rising costs and policy uncertainties in Washington [2][3][5] Financial Performance - Oscar's total membership increased by 28% to over 2.1 million compared to the same quarter last year, contributing to a 23% rise in total revenue to nearly $2.9 billion [4] - The company reported a loss of $137.5 million, or 53 cents per share, compared to a loss of $54.6 million, or 22 cents per share in the previous year [4] Industry Context - Oscar is part of a group of health insurers providing government-subsidized insurance that have faced significant challenges due to rising costs, leading to lowered profit forecasts and plans to increase rates next year [5] - The company aims to achieve positive net income next year by balancing membership growth with profitability [5] Future Outlook - Oscar has resubmitted rate filings in states covering nearly 99% of its current membership for 2026, reflecting elevated cost trends and higher market morbidity [6] - The company sees an opportunity to gain market share as competitors like CVS Health's Aetna withdraw from the market, while Oscar's CEO believes the individual market will continue to expand due to macroeconomic trends [6][8]