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 - The company generated consolidated revenue of $329 million, representing a 13% growth year-over-year, primarily driven by strong growth in healthcare services [4][17] - Senior revenues declined to $59 million from $93 million a year ago, a decrease of 37%, attributed to lower policy production due to new eligibility requirements [4][18] - The company reported a quarterly EBITDA loss of $32 million, which was below the guided loss range of $25-$30 million [8][17] Business Line Data and Key Metrics Changes - The senior business segment experienced a 32% reduction in policy production compared to the previous year, leading to a negative EBITDA of $21 million [5][18] - Healthcare services EBITDA was impacted by changes in drug reimbursement rates, with an expected second-quarter adjusted EBITDA of approximately break-even [6][20] - The life insurance business saw nearly 20% revenue growth, driven by balanced growth in term life and final expense policies [22] Market Data and Key Metrics Changes - The company noted an elevated level of policyholder volatility due to shifts in planned benefits and structures from carriers, which is expected to continue in the upcoming AEP season [9][10] - The Medicare Advantage (MA) market is experiencing a high level of consumer engagement as beneficiaries evaluate options, with a focus on simplifying benefits [34][36] Company Strategy and Development Direction - The company aims to leverage its data-enabled agent-led model as a competitive advantage in the dynamic Medicare Advantage market [9][10] - There is a strategic focus on improving policyholder retention and understanding their plans better, which is seen as critical in the current environment [10][27] - The company is negotiating a longer-term reimbursement agreement with its PBM partner to enhance visibility and predictability for its healthcare services business [6][20] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in the long-term economics of healthcare services despite short-term reimbursement challenges [7][20] - The company remains optimistic about the upcoming AEP and OEP seasons, supported by strong agent retention and successful preseason hiring [10][23] - The fiscal 2026 financial outlook remains unchanged at $1.65 billion to $1.75 billion in revenue and $120 million to $150 million in adjusted EBITDA [23] Other Important Information - The company is actively working on improving medication adherence through its SelectRx program, which has shown positive results in reducing hospital days and improving health outcomes [16][12] - The company is expanding its healthcare services offerings to address social determinants of health, enhancing its value proposition to members [31] Q&A Session Summary Question: Concerns about SelectRx reimbursement headwinds - Management reassured that they are in constructive discussions with their PBM partner to solidify a longer-term agreement, emphasizing the clinical value of their solution [24][25] Question: Impact of SelectRx on LTV - Management noted that while they observe improved persistency among SelectRx members, this is not currently factored into the lifetime value calculations [25][26] Question: Strategies for helping policyholders understand their plans - Management highlighted their proactive approach to assist beneficiaries in navigating plan changes, utilizing AI and data to enhance customer engagement [27][29] Question: Market dynamics in the AEP season - Management indicated that the current AEP season is dynamic, with high consumer engagement and a focus on profitability among carriers [34][36] Question: Managing growth in SelectRx - Management emphasized a measured approach to member growth, focusing on profitability and partnerships with payers that value their services [38][40]

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 - The Cigna Group has appointed Dr. Amy Flaster as Chief Medical Officer, effective November 1, 2025, expanding her role across both Cigna Healthcare and Evernorth [1][2] - Dr. Flaster aims to enhance clinical excellence, innovate care models, and leverage technology for whole-person health [1][2] - Katya Andresen has taken over leadership of the Excellence and Transformation (XT) initiatives, focusing on improving customer engagement and driving innovation [4][5] Leadership Changes - Dr. Flaster's promotion follows the departure of Dr. David Brailer, who served as Executive Vice President and Chief Health Officer since 2022 [6] - Chris DeRosa, Head of Business Improvement and Innovation, is retiring after over two decades of service, contributing to expanding access to affordable care [7] Company Overview - The Cigna Group is a global health company with a commitment to improving health outcomes and creating innovative solutions [8] - The company operates in over 30 countries and has more than 186 million customer relationships worldwide [8]

Oscar Health Thursday reported a $137 million third quarter loss but predicts “a return to profitability” as the health insurance industry works its way through a period of rising costs and an uncertain policy environment in Washington.Oscar Health Oscar Health Thursday reported a $137 million third quarter loss but predicts “a return to profitability” as the health insurance industry works its way through a period of rising costs and Washington gridlock. Oscar has more than 2 million health plan members as ...

NEW YORK, Nov. 05, 2025 (GLOBE NEWSWIRE) -- WHY: Rosen Law Firm, a global investor rights law firm, reminds purchasers of securities of Molina Healthcare, Inc. (NYSE: MOH) between February 5, 2025 and July 23, 2025, both dates inclusive (the “Class Period”), of the important December 2, 2025 lead plaintiff deadline. SO WHAT: If you purchased Molina securities during the Class Period you may be entitled to compensation without payment of any out of pocket fees or costs through a contingency fee arrangement. ...

Core Viewpoint - Rosen Law Firm is reminding investors who purchased Molina Healthcare, Inc. securities between February 5, 2025, and July 23, 2025, of the December 2, 2025, lead plaintiff deadline for a class action lawsuit [1]. Group 1: Class Action Details - Investors who purchased Molina securities during the specified Class Period may be entitled to compensation without any out-of-pocket fees through a contingency fee arrangement [2]. - A class action lawsuit has already been filed, and those wishing to serve as lead plaintiff must act by December 2, 2025 [3]. - Investors can join the class action by visiting the provided link or contacting the law firm directly for more information [6]. Group 2: Law Firm Credentials - Rosen Law Firm emphasizes the importance of selecting qualified counsel with a successful track record in securities class actions, highlighting its own achievements in this area [4]. - The firm has secured significant settlements for investors, including over $438 million in 2019 alone, and has been consistently ranked among the top firms for securities class action settlements [4]. Group 3: Case Allegations - The lawsuit alleges that Molina's management failed to disclose critical adverse information regarding its medical cost trend assumptions and the dislocation between premium rates and medical costs [5]. - It is claimed that Molina's near-term growth relied on a lack of utilization of various health services, and as a result, the company's financial guidance for fiscal year 2025 was likely to be cut [5]. - The lawsuit asserts that the positive statements made by Molina's management about the company's business and prospects were materially misleading [5].

Core Insights - Humana Inc. expects a smaller decline in full-year individual Medicare Advantage membership than previously projected, but has reduced its unadjusted profit forecast due to high medical costs [1][2] Membership Projections - The company projects a decline of approximately 425,000 members in its Medicare Advantage business for the fiscal year, an improvement from the prior estimate of up to 500,000, attributed to stronger retention and robust sales [2] Quality Ratings and Financial Impact - About 20% of Humana's members, or roughly 1.2 million, are enrolled in Medicare Advantage plans rated four stars or higher for 2026, with 14% in 4.5-star plans, a significant increase from 3% the previous year [3] - A U.S. court ruling rejected Humana's challenge to 2025 plan ratings from the Centers for Medicare & Medicaid Services (CMS), which may negatively impact future government bonus payments [4] - The company anticipates a "significant decline" in higher-rated plans in 2025, warning that failure to overturn the ruling could reduce its 2026 CMS quality bonus payments, affecting revenue, operating results, and cash flow [5] Financial Performance - Humana reported a third-quarter medical cost ratio of 91.1%, an increase from 89.9% a year ago, but within expectations, facing ongoing cost pressures from higher utilization in government-backed programs [5] - Adjusted earnings were $3.24 per share, exceeding estimates, while revenue reached $32.65 billion. The company now expects unadjusted earnings of about $12.26 per share, down from $13.77 previously, while reaffirming adjusted EPS guidance of around $17.00 [6]

Core Insights - Cigna Group is a global health services company offering a variety of insurance products and services, operating through segments like Evernorth and Cigna Healthcare, and competes with major health insurers such as UnitedHealth Group and Anthem [1] Stock Performance - Wells Fargo set a price target of $300 for Cigna's stock (CI), indicating a potential upside of approximately 13.35% from its trading price of $264.66 [2] - Cigna's stock has faced challenges, particularly after reporting expected margin pressure in its pharmacy benefit services segment during the third-quarter 2025 earnings call [2] - Currently, Cigna's stock is trading at $264.14, down by 0.20% from the previous day, with fluctuations between $257.70 and $266.15 [3] - Over the past year, Cigna's stock has experienced significant volatility, with a high of $350 and a low of $239.51 [3] Strategic Initiatives - In response to cost and transparency concerns, Evernorth introduced a rebate-free pharmacy benefit model aimed at reducing costs and improving transparency, with plans for full implementation by 2028 [4] - Cigna is focusing on enhancing the economic terms of contracts for long-term strategic clients, particularly those involved in government programs [5] Market Position - Cigna's current market capitalization is approximately $70.56 billion, with a trading volume of 690,780 shares on the NYSE [5]

Core Insights - Humana Inc. reported third-quarter 2025 adjusted earnings of $3.24 per share, exceeding the Zacks Consensus Estimate by 11.3%, but down 22.1% year over year [1] - Adjusted revenues reached $32.65 billion, an 11.4% increase year over year, surpassing the consensus mark by 2.1% [1] - The quarterly results were driven by increased premiums, although offset by higher expenses and a decline in medical memberships [1] Q3 Operational Update - Premiums improved by 9.9% year over year to $30.7 billion, beating the Zacks Consensus Estimate by 1.2% [2] - Services revenues climbed 45.1% year over year to $1.6 billion, exceeding the consensus mark by 15.5% [2] - Investment income was $338 million, a decrease of 1.5% year over year, but above the model estimate of $312.6 million [2] Financial Performance - The benefit ratio deteriorated by 120 basis points year over year to 91.1% in Q3 [3] - Total operating expenses rose 12.5% year over year to $32.2 billion, exceeding the estimate of $31.2 billion [3] - Net income for the quarter was $194 million, down 59.6% year over year [3] Segmental Update - The Insurance segment recorded adjusted revenues of $31.2 billion, a 9.9% year-over-year increase, driven by improved Medicare premiums and an expanding customer base [4] - Adjusted operating income in the Insurance segment fell 17.9% year over year to $270 million [5] - Total medical membership in the segment was 15 million, an 8.3% decline year over year, below the Zacks Consensus Estimate of 15.2 million [5] CenterWell Performance - CenterWell revenues increased 16.6% year over year to $5.9 billion, surpassing the Zacks Consensus Estimate by 7.1% [6] - Adjusted operating income for CenterWell was $358 million, down 18.5% year over year [6] - The operating cost ratio deteriorated by 260 basis points year over year to 93.9% [6] Financial Position - As of September 30, 2025, Humana had cash and cash equivalents of $5.4 billion, up from $2.2 billion at the end of 2024 [9] - Total assets increased to $49.7 billion from $46.5 billion at the end of 2024 [9] - Long-term debt rose to $12.6 billion from $11.1 billion as of December 31, 2024 [9] Guidance and Outlook - Humana reaffirmed 2025 EPS guidance of about $17, expecting an 8.7% revenue growth for the year [8] - The company anticipates a decline of around 425,000 in Individual Medicare Advantage membership for 2025 [14] - The benefit ratio for the Insurance unit is projected between 90.1% and 90.5% for 2025 [15]