Oscar Health, Inc. · NYSE:OSCR
Oscar Health — Q1 2026 Earnings Presentation
64 slides from Oscar Health's earnings presentation, May 6, 2026
Slide 1: Oscar Health, June 7, 2024
June 7, 2024 oscar health
Slide 2: Cautionary Note Regarding Forward-Looking Statements
Disclaimer Cautionary Note Regarding Forward-Looking Statements This presentation contains forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. All statements other than statements of historical fact contained herein are forward-looking statements. T
Slide 3: Industry Information and Non-GAAP Financial Measures
Disclaimer Industry Information Unless otherwise indicated, information concerning the Company’s industry and the markets in which the Company operates, including the Company’s general expectations, market position, market opportunity, and market size, are based on management’s knowledge and experie
Slide 4: Agenda
Agenda 01 Vision & Strategy Mark Bertolini 02 Financial Outlook Scott Blackley 03 Insurance Alessa Quane 04 Technology Mario Schlosser
Slide 5: Oscar Health Vision & Strategy
Oscar Health Vision & Strategy Mark Bertolini Chief Executive Officer
Slide 6: Make a healthier life accessible and affordable for all
OUR MISSION Make a healthier life accessible and affordable for all 6
Slide 7: Our management team has deep healthcare and technology experience
Our management team has deep healthcare and technology experience Mark Bertolini Mario Schlosser Scott Blackley Alessa Quane Ranmali Bopitiya Chief Executive Officer Co-Founder & Chief Chief Financial Officer Chief Insurance Officer Chief Legal Officer Technology Officer Rebecca Krouse Dr. Sean Martin Steve K
Slide 8: We are delivering on our commitments
We are delivering on our commitments 2022 Investor Day Commitments 2021 – 2023 1Q24 Total Company Position Oscar for $219M Adjusted EBITDA 1 Near-Term Profitability $169M Insurance Company Adjusted EBITDA in 2023 $177M Net Income 37% Membership CAGR 42% Membership Growth YoY 2 Grow Our ACA Footprint
Slide 9: The U.S. healthcare system is failing individuals & families
The U.S. healthcare system is failing individuals & families, accelerating trends that are shaping the future of the market Consumer Expectations Stable Individual New Disruptive Healthcare for Affordable Healthcare Market Risk Pool Technologies Median household income U.S. healthcare spend Total AC
Slide 10: Our model is uniquely positioned to address these trends
Our model is uniquely positioned to address these trends and reorient healthcare around individuals and families 1 Leverage Deep ACA ~21M Oscar Marketplace Expertise Individual ACA TAM in 20242 Insurance 2 Build the Individual Market ~75M to Work for More Consumers SMB Employer TAM in 20243 3 Focus
Slide 11: Oscar delivers an unparalleled individual healthcare experience
Oscar delivers an unparalleled individual healthcare experience Exceptional Superior Tech-Enabled Consumer Member Growth & Engagement Experiences Affordability Members with a medical visit used Membership CAGR 68% our tools to search 66 NPS as of 1Q24 37% 2021 - 2023 for a provider in 4Q23 MLR impro
Slide 12: Our long-term strategy is guided by four strategic objectives
Our long-term strategy is guided by four strategic objectives Market-Leading, Build on Our Harness Our Innovate Market Sustainable, Scalable Superior Member Technology to Offerings to Expand Operations Experience Power Others the Individual Market Grow at ~20% revenue CAGR Focus on improving the Ext
Slide 13: Individual market growth is sustainable with additional upside
Individual market growth is sustainable with additional upside if enhanced subsidies extend beyond 2025 Individual Market Size1 (Millions) Key Growth Drivers ~31 Total Enrolled Lives ~22 ~24 Medicaid Redeterminations ~1/3 of those who lose Medicaid eligibility are estimated to be eligible ~12 for AC
Slide 14: We have a clear path to expand our individual market opportunity
We have a clear path to expand our individual market opportunity 2027 Oscar In-Market Opportunity1 20M Mature Current Oscar 3 4M 1 2024 ACA Footprint 15M 2 6M 6M Total Lives 4M Drive 2025 – 2027 10M 2 16M Oscar Market Expansion 1 10M 5M 3 2026 – 2027 Enhanced 0M Subsidies Upside 2024 Oscar New Marke
Slide 15: Enhanced subsidies lower health insurance costs and improve equitable access
Enhanced subsidies lower health insurance costs and improve equitable access to health coverage for our most vulnerable populations Income Monthly Enrollee Premium Monthly Enrollee Premium Level1 Costs with Subsidies2 Costs without Subsidies2 Potential enhanced subsidy expiration could increase cost
Slide 16: Grow at ~20% revenue CAGR and achieve ~5% operating margin in 2027
STRATEGIC OBJECTIVE 01 Market-Leading, Sustainable, Scalable Operations Grow at ~20% revenue CAGR and achieve ~5% operating margin in 2027 16
Slide 17: Oscar has a clear path to sustainable long-term growth & profitability
Oscar has a clear path to sustainable long-term growth & profitability Our Strategic Focus Deliver Total Company Expand our current market footprint, targeting entry into an additional Adjusted EBITDA profitability 150+ MSAs by 2027 and driving continued ACA market growth in 2024 and beyond Build a l
Slide 18: Focus on improving the member experience in everything we do
STRATEGIC OBJECTIVE 02 Build on Our Superior Member Experience Focus on improving the member experience in everything we do 18
Slide 19: We are investing in and delivering superior member experiences
We are investing in and delivering Our Strategic Focus superior member experiences Launch and Evolve Oscar Member-Provider Experience Flywheel Personalized Plans 66 NPS ~90% Oscar Provider visits members rated positively Enhance Digital Tools in 1Q24 by members1 and Automate Processes 82% 75+ NPS Me
Slide 20: Externalize our technology platform to power the industry as a whole
STRATEGIC OBJECTIVE 03 Harness Our Technology to Power Others Externalize our technology platform to power the industry as a whole 20
Slide 21: We are early in building and delivering health technology solutions
We are early in building and delivering health technology solutions that meet the needs of the modern healthcare system Externalize Our Technology Our Strategic Focus Platform to Power Health Scale our +Oscar Campaign Builder product that harnesses the Plans and Providers power of our omnichannel co
Slide 22: Expand the individual insurance market with disruptive products like ICHRA
STRATEGIC OBJECTIVE 04 Innovate Market Offerings to Expand the Individual Market Expand the individual insurance market with disruptive products like ICHRA 22
Slide 23: ICHRA has the power to expand individual insurance beyond the traditional ACA market
ICHRA has the power to expand individual Key ICHRA Adoption Drivers insurance beyond the traditional ACA market Rising ~9% 2024 Individual Market TAM1,2,3 Employer Expected increase Costs in employer medical Total Addressable Lives & Revenue 100M costs in 20244 ~$300B ~$720B 75M ~40M Growing ~24% ~$
Slide 24: This innovative benefits solution will disrupt traditional employer group coverage
This innovative benefits solution will disrupt traditional employer group coverage and unlock the growth of a new market Individual Coverage Value Proposition of ICHRA Benefits Solution2 Health Reimbursement Benefit ICHRA Traditional Group Arrangement (ICHRA)1 Budget Control ✔ Defined Contribution Prem
Slide 25: ICHRA is capable of transforming the health benefits experiences
ICHRA is capable of transforming the health benefits experiences of both employers and employees Employer: Eric Walker Employee: Rebecca Jones 30-employee small business owner Employee with Type 1 diabetes Challenges: High renewal rates and Challenges: Limited plan options and insulin budgetary cons
Slide 26: Strategic partnerships will position Oscar to be the leading ICHRA carrier
Strategic partnerships will position Oscar to be Value of the leading carrier of the ICHRA ecosystem ICHRA Platforms Partnerships With a Diverse Platform Landscape Employees Deliver more plan choice, better Platform experiences, and lower costs Ecosystem1 Employer Medium: <1000 Employees Targets Sma
Slide 27: Achieving our strategic objectives will drive long-term shareholder and consumer value
Achieving our strategic objectives will drive long-term shareholder and consumer value Grow at ~20% revenue CAGR and achieve ~5% operating margin in 2027 Focus on improving the member experience in everything we do Externalize our technology platform to power the industry as a whole Expand the indiv
Slide 28: Financial Outlook
Financial Outlook Scott Blackley Chief Financial Officer 28
Slide 29: We are re-affirming 2024 guidance
We are re-affirming 2024 guidance Financial Outlook Strong YTD Results Adj. EBITDA ~$40M Total Revenue MLR above plan through April $8.3B – $8.4B 80.2% – 81.2% Growing Member Base SEP adds through April have been robust SG&A Expense Ratio Adjusted EBITDA Higher SEP Membership 20.5% – 21.0% $125M – $
Slide 30: We have delivered strong growth and improved profitability
We have delivered strong growth and improved profitability Membership Adjusted EBITDA Sustained Growth ~40% 3-year membership CAGR Profitability Targets ~40% $125M – +$580M1 $175M Insurance Company: Achieved in 2023 CAGR ~1.5M Total Company: Adjusted EBITDA profitability in 2024 Meaningful Margin Impr
Slide 31: We are targeting at least 20% revenue CAGR and 5% operating margin by 2027
We are targeting at least 20% revenue CAGR and 5% operating margin by 2027 with upside if enhanced subsidies are extended Total Revenue Operating Margin EPS ~20% ~5% $2.25+ CAGR Margin $8.3B – $8.4B 2024E 2027E 2027E 2027E 31
Slide 32: Multiple levers to drive sustained top-line growth
Multiple levers to drive sustained top-line growth Key Strategic Levers to Drive ~20% Top-Line CAGR 0 Subsidy Loss 0% – 1% & Enrollment Shift Market shrinkage and metal shift 12%– from enhanced subsidy expiration 14% 1 Expand Existing 12% – ~20% Market Presence 14% CAGR Balance rates with growth to
Slide 33: ~5% operating margin target driven by pricing discipline and administrative cost efficiencies
~5% operating margin target driven by pricing Key Strategic Levers to Drive 2024 – 2027 discipline and administrative cost efficiencies Margin Improvement 1 Strategic Pricing Approach 1% – 2% Price and Total Cost of Care ~5% initiatives to offset trend 2% – 4% Margin 2 Drive Continued Admin Leverage
Slide 34: We are driving a sustainable MLR as we continue to grow
We are driving a sustainable MLR as we continue to grow Medical Loss Ratio Disciplined Pricing Approach Strategically balance rate actions with growth and retention targets as we mature markets and expand Medical Cost Savings Execute technology-enabled affordability initiatives 81.6% 80.2% – spannin
Slide 35: Growth drives meaningful operating leverage and technology enables variable cost savings
Growth drives meaningful operating leverage and technology enables variable cost savings SG&A Expense Ratio Fixed Cost Leverage Fixed Fixed cost infrastructure significant enough to support Variable enhanced scale coupled with robust cost management 24.3% 20.5%–21.0% ~40% Tech-Enabled Expense Efficienc
Slide 36: We are positioned for strong cash flow and capital generation
We are positioned for strong Reinvest in the Business cash flow and capital generation Leverage capital generation in insurance subsidiaries to fund organic growth Dividends to the Parent1 Enterprise Capital* Fund needs at the parent level and create capital flexibility Optimize Capital Structure ~37
Slide 37: Project strong financial performance through 2027
Project strong financial performance through 2027 with expected upside if enhanced subsidies are extended Grow at ~20% revenue CAGR Achieve ~5% operating margin Drive strong positive cash flow and capital generation in 2024, expanding thereafter 37
Slide 38: Oscar Insurance Update
Oscar Insurance Update Alessa Quane Chief Insurance Officer 38
Slide 39: Oscar Insurance in 2024
Oscar Insurance in 2024 ~1.5M Members as of April 2024 ~7% Total ACA market share $8.3B – $8.4B Revenue estimated for 2024 18 ACA states 39
Slide 40: Oscar Insurance is well-positioned to deliver sustainable long-term growth and profitability
Oscar Insurance is well-positioned to deliver sustainable long-term growth and profitability Oscar Insurance Strategic Disciplined Innovative Robust Imperatives Footprint Products & Total Cost of Care Expansion Experiences Management 40
Slide 41: Leveraging a proven, repeatable approach to mature our markets as we expand
Leveraging a proven, repeatable approach to mature our markets as we expand How We Drive Growth Revenue Growth YoY (% of Total) Build strong networks with strategic partners Establish key local partnerships Introduce personalized products that address individual needs Miami Iowa Atlanta Execute disc
Slide 42: We are positioned to expand our opportunity in the individual market
We are positioned to expand our opportunity in the individual market 2027 Oscar In-Market Opportunity1 1 Mature Current 2024 ACA Footprint 20M Makes up ~50% of the total ~21M market 3 4M 15M 2 6M6M 2 Drive 2025 – 2027 Market Expansion Total Lives 4M Market footprint growth and extending our ICHRA 10
Slide 43: Driving sustained growth by maturing our markets, expanding our footprint
Driving sustained growth by maturing our markets, expanding our footprint, and driving new product innovation Key Sources of Growth1 Existing Market Maturity Grow from ~13% market share in our 2024 footprint to ~18% by 2027 6M Total Lives 4M New Market & Product Innovation Increase our total in-mark
Slide 44: Evolving our innovative and affordable product portfolio
Evolving our innovative and affordable product portfolio to better address individual member needs Challenges Oscar Product Solutions Cultural Deliver Personalized Culturally-Authentic Experiences barriers to care HolaOscar Bring our suite of solutions to more people with new products that Under-add
Slide 45: Our robust, balanced Total Cost of Care approach creates optionality
Our robust, balanced Total Cost of Care approach creates optionality to support top-line growth and margin improvement Cumulative Total Cost of Care Value Network and Portfolio Management Executing network curation, contract value negotiations, and portfolio sculpting efforts Payment Integrity Lever
Slide 46: Executing on our Total Cost of Care initiatives has enabled annual trend rates well below average
Executing on our Total Cost of Care initiatives has enabled us to realize annual trend rates well below average Our robust efforts have driven lower claim trends, supported by our technology stack Oscar’s annual trend rate has been materially below the +3.0% annual inflationary pressure indicated by
Slide 47: Oscar Insurance is well-positioned to deliver sustainable long-term growth and profitability
Oscar Insurance is well-positioned to deliver sustainable long-term growth and profitability Execute Disciplined Footprint Expansion Scale Innovative Products & Experiences Deliver Robust Total Cost of Care Management 47
Slide 48: Technology Update
Technology Update Mario Schlosser Co-Founder & Chief Technology Officer 48
Slide 49: Our aspiration is to build the most-automated health plan
Our aspiration is to build the most-automated health plan, with zero manual intervention, zero errors, and zero friction Oscar Technology Platform Improve real-time information flow to create frictionless experiences Integrated ecosystem of modules powered by a single source of truth Empower individ
Slide 50: Leveraging our unique technology stack to deliver on our long-term objectives
Leveraging our unique technology stack to deliver on our long-term growth and profitability objectives Oscar Technology Strategic Power the Externalize Our Innovate and Imperatives Growth & Technology to Strengthen Our Profitability of the Broader Technology Oscar Insurance Market With AI 50
Slide 51: Our integrated technology platform is driving meaningful outcomes & value
Our integrated technology platform is driving meaningful outcomes & value Improving Operational 98%+ Claims auto-adjudication 1 Efficiencies Key Value Levers Understanding Members using care ✔ Reduced Admin Costs Harnessing & Engaging 54% router visit one of the top 5 providers recommended2 Members Ou
Slide 52: We are bringing our innovative technology to the healthcare system through +Oscar
We are bringing our innovative technology to the healthcare system and addressing diverse client needs through +Oscar Delivers personalized health engagement and Delivers personalized health engagement and recommendation tools enabling +Oscar recommendation tools enabling healthcare systems and heal
Slide 53: +Oscar is driving strong outcomes for our health plan and provider clients
+Oscar is driving strong Actual Client Outcomes outcomes for our health plan and provider clients Annual Wellness Medication Adherence Visit Outreach & Savings Solutions ~118% ~6x ROI YoY increase in Annual By switching from 30- Wellness Visits1 to 90-day Rx refills2 Automated Follow Ups Member & Pat
Slide 54: Key Oscar AI Use Cases in Pipeline
We are unlocking long-term value across all levels of our technology stack through new AI opportunities ● Automated answers to common benefits questions Key Oscar AI Use Cases in Pipeline Member Experience (Mobile & Web) ● Dynamic patient intake ● Automated note-taking in call center Member Service &
Slide 55: Our proprietary technology platform enables faster integration of new AI features
Our proprietary technology platform enables Oscar to integrate new AI features into our operations faster than others in the market Case Study: Oscar Medical Group Virtual Care Automation Lab Results Messaging Patient Instructions for Dynamic Summarization Documentation Automation Phone & Video Visi
Slide 56: Leveraging our unique technology stack to deliver on our long-term objectives
Leveraging our unique technology stack to deliver on our long-term growth and profitability objectives Power the Growth & Profitability of Oscar Insurance Externalize Our Technology to the Broader Market Innovate & Strengthen Our Technology with AI 56
Slide 57: Oscar Health is well-positioned to drive sustainable growth and margin expansion
Oscar Health is well-positioned to drive sustainable growth and margin expansion Prominent player in the fastest-growing market in health insurance with room to expand our addressable opportunity Clear path to long-term sustainable top-line growth and profitability Significant runway to continue drivi
Slide 58: Q&A
oscar health &A 58
Slide 59: June 7, 2024 oscar health
June 7, 2024 oscar health
Slide 60: Appendix
Appendix 60
Slide 61: Use of Non-GAAP Financial Information
Use of Non-GAAP Financial Information These materials present Adjusted EBITDA and Insurance Company Adjusted EBITDA, non-GAAP financial metrics, which are provided to supplement financial information presented in accordance with GAAP. There are limitations to the use of non-GAAP financial measures, and
Slide 62: 1Q24 Adjusted EBITDA GAAP Reconciliation
1Q24 Adjusted EBITDA GAAP Reconciliation Three Months Ended (in thousands) March 31, 2024 March 31, 2023 Net Income $ 177,482 $ (39,628) Interest expense 5,902 6,136 Other expense 1,178 6,106 Income tax expense 996 2,021 Depreciation and amortization 7,811 4,939 Stock-based compensation (1) 25,945 7
Slide 63: 2023 Adjusted EBITDA GAAP Reconciliation
2023 Adjusted EBITDA GAAP Reconciliation Twelve Months Ended December 31, (in thousands) 2023 2021 Net Income $ (270,594) $ (571,426) Interest expense 24,603 4,720 Other expense 7,082 1,201 Income tax expense 3,294 846 Depreciation and amortization 30,694 14,605 Stock-based compensation (1) 159,683
Slide 64: Insurance Company Adjusted EBITDA GAAP Reconciliation
Insurance Company Adjusted EBITDA GAAP Reconciliation Year Ended (in thousands) December 31, 2023 Net Income $ (270,594) Interest expense 24,603 Other expense 7,082 Income tax expense 3,294 Depreciation and amortization (“D&A”) 30,694 Stock-based compensation (“SBC”) (1) 159,683 Adjusted EBITDA $ (4