Financial Data and Key Metrics Changes - Total revenue for 2025 was reported at $11.7 billion, reflecting a 28% year-over-year increase [6][17] - The SG&A expense ratio improved by approximately 160 basis points to 17.5% [7][18] - The Medical Loss Ratio (MLR) increased by 570 basis points year-over-year to 87.4% [7][17] - The loss from operations for 2025 was approximately $396 million, a change of $454 million year-over-year [18][22] - The company expects a significant improvement in earnings from operations in 2026, projecting a range of $250 million to $450 million [22] Business Line Data and Key Metrics Changes - Membership grew to approximately 2 million in Q4 2025, a 22% increase year-over-year [15] - The company served 3.4 million members as of February 1, 2026, with expectations to start Q2 with around 3 million paid members, a 58% increase year-over-year [10][43] - Market share increased from 17% in 2025 to 30% in 2026 [10] Market Data and Key Metrics Changes - The overall market membership declined by 5% year-over-year to 23 million lives [9] - The company anticipates that many passively enrolled members will exit the market when grace periods expire, leading to a potential market contraction of 20%-30% [9][40] - The average member age is now 38 years, which is approximately one year younger than the previous year [20] Company Strategy and Development Direction - The company aims to accelerate national Individual and Family Plan (IFP) and Individual Coverage Health Reimbursement Arrangement (ICHRA) expansion [13] - Oscar introduced new cost-effective Bronze and Gold plans to support consumers losing Enhanced Premium Tax Credits [11] - The company is focusing on product innovation, launching several lifestyle offerings tailored to specific conditions [11][12] - Oscar's strategy includes leveraging AI to improve operational efficiency and member experience [12][13] Management's Comments on Operating Environment and Future Outlook - Management described 2025 as a reset year for the industry due to increased market morbidity and changes in market dynamics [8] - The company is positioned for strong top-line growth and margin expansion in 2026, with a disciplined pricing strategy [8][19] - Management expressed confidence in returning to profitability in 2026, with expectations of nearly $750 million improvement in earnings from operations [7][22] Other Important Information - The company ended 2025 with approximately $5.5 billion in cash and investments [23] - Oscar's capital position remains strong, with approximately $1 billion in capital surplus across its insurance subsidiaries [23] Q&A Session Summary Question: How does the company gain comfort on new membership for 2026 and MLR projections? - Management indicated that they have significant data on renewing members and are leveraging third-party data for new members to project behaviors accurately [29][32] Question: Can you elaborate on the utilization trends and expectations for 2026? - Management noted that utilization was modestly higher than expected in Q4, driven by members seeking care before losing subsidies [36] Question: What is the expected membership cadence following the grace period? - Management expects higher churn in Q1 due to increased premiums, estimating a drop from 3.4 million to 3 million paid members by the end of Q1 [44] Question: How does the mix of metal plans affect the company? - Management confirmed a significant shift from Silver to Bronze and Gold plans, which may lead to higher churn due to increased deductibles [47][66] Question: What are the key levers for achieving EBITDA profitability without enhanced subsidies? - Management highlighted growth, AI efficiencies, and disciplined pricing as key levers for profitability [73]