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 adjusted EBITDA loss for the full year was approximately $280 million, a change of $479 million year-over-year [18] 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][42] - Market share increased from 17% in 2025 to 30% in 2026 [10] Market Data and Key Metrics Changes - Overall market membership was reported at 23 million lives, a better-than-expected decline of 5% year-over-year [9] - The individual market is expected to experience a contraction of 20%-30% due to the expiration of enhanced premium tax credits [9][19] - The average member age is 38 years, approximately one year younger year-over-year [20] Company Strategy and Development Direction - The company aims to accelerate national Individual and Family Plans (IFP) and Individual Coverage Health Reimbursement Arrangements (ICHRA) expansion [13] - Oscar is focusing on creating lifestyle products with exceptional consumer experiences and driving operational excellence through AI [13][14] - The company has introduced new cost-effective Bronze and Gold plans to support consumers losing Enhanced Premium Tax Credits [11] Management's Comments on Operating Environment and Future Outlook - Management indicated that 2025 was a reset year for the industry, with higher market morbidity impacting dynamics [8] - The company expects a significant year-over-year improvement of nearly $750 million in earnings from operations in 2026 [7] - Management expressed confidence in returning to profitability in 2026, driven by disciplined pricing and innovative product offerings [22][26] Other Important Information - Oscar's investments in AI have led to a reduction in administrative costs by 160 basis points year-over-year while increasing membership [12] - The company ended 2025 with approximately $5.5 billion in cash and investments, including $414 million at the parent level [23] Q&A Session Summary Question: How does the company get comfort on new membership for 2026 and MLR projections? - Management indicated that they have significant information on renewing members and are leveraging third-party data for new members to project behaviors accurately [29][32] Question: Can you elaborate on 4Q utilization and its relation to 2026 expectations? - Utilization was modestly higher than expected, driven by members seeking care before losing subsidies [36] Question: What is the expected membership cadence following the 1Q grace period? - Higher churn is expected in the first quarter due to increased premiums, with a return to pre-ARPA churn patterns thereafter [44] Question: How does the mix of metal plans affect membership and profitability? - The company has seen a significant shift from Silver to Bronze and Gold plans, which may impact churn rates due to higher deductibles [47] Question: What are the key levers to achieving EBITDA profitability without enhanced subsidies? - Growth, AI efficiencies, and disciplined management of medical costs are key levers for profitability [73]

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]

Financial Data and Key Metrics Changes - Total revenue for 2025 was reported at $11.7 billion, reflecting a 28% year-over-year increase [5][15] - The SG&A expense ratio improved by approximately 160 basis points to 17.5% due to efficiency gains and disciplined expense management [5][15] - The Medical Loss Ratio (MLR) increased by 570 basis points year-over-year to 87.4% [5][15] - The loss from operations for 2025 was approximately $396 million, a change of $454 million year-over-year [15][16] - The company expects a significant improvement in earnings from operations in 2026, projecting a range of $250 million to $450 million [21][24] Business Line Data and Key Metrics Changes - Membership grew to approximately 2 million in Q4 2025, a 22% increase year-over-year [13] - 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 [8][40] - Market share increased from 17% in 2025 to 30% in 2026 [8] - New product offerings, including lifestyle plans, contributed to member retention and growth [9][10] Market Data and Key Metrics Changes - Overall market membership declined by 5% year-over-year, with expectations of further contraction as passively enrolled members exit [7][38] - The individual market is expected to stabilize, with more small business owners and gig workers entering due to affordability issues in group insurance [7] - The company anticipates a market contraction tracking toward the lower end of the original projection of 20%-30% [7] Company Strategy and Development Direction - The company aims to accelerate national Individual and Family Plans (IFP) and Individual Coverage Health Reimbursement Arrangements (ICHRA) expansion [11] - Focus on creating lifestyle products with exceptional consumer experiences and driving operational excellence through AI [11][12] - The strategic approach includes disciplined pricing and product innovation to capture profitable growth as competitors exit the market [6][9] Management's Comments on Operating Environment and Future Outlook - Management described 2025 as a reset year for the industry, with higher market morbidity impacting financial performance [6][13] - The company is positioned for strong top-line growth and margin expansion in 2026, with a focus on profitability [5][11] - Management expressed confidence in the ability to manage new membership and projected MLR improvements [30][31] Other Important Information - The company has strengthened its capital position with a $410 million convertible notes offering and a new $475 million revolving credit facility [22] - As of December 31, 2025, the company had approximately $5.5 billion in cash and investments [22] Q&A Session Summary Question: How does the company get 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 [27][30] Question: Can you elaborate on the utilization trends and expectations for 2026? - Utilization was modestly higher than expected in Q4, driven by members seeking care before losing subsidies [33][34] Question: What is the expected market size post-effectuation and pricing adequacy? - The market has shrunk by 5%, with significant shifts in plan designs leading to changes in membership mix [37][38] Question: What percentage of members work with brokers versus passive renewals? - Approximately 90%-95% of members come through brokers, with some direct enrollments for specific products [55] Question: How does the company plan to achieve EBITDA profitability without enhanced subsidies? - Key levers include growth, AI efficiencies, and disciplined management of medical costs [70][72]