OSCR Oscar Health Inc

• For the quarter ended June 30, 2024:
  • Total Revenue of $2.2 billion, a 46% increase YoY
  • Medical Loss Ratio of 79.0%, a 90 bps improvement YoY
  • SG&A Expense Ratio of 19.6%, a 260 bps improvement YoY
  • Net income attributable to Oscar of $56.2 million, or $0.20 of diluted earnings per share, a $71.7 million improvement YoY
  • Adjusted EBITDA of $104.1 million, a $68.6 million improvement YoY

Oscar Health, Inc. (“Oscar” or the “Company”) (NYSE: OSCR), a leading healthcare technology company, today announced its financial results for the second quarter ended June 30, 2024.

“Oscar reported strong second quarter results, closing out the best six months in the company's history," said Mark Bertolini, CEO of Oscar Health. “We continued to report robust revenue growth, improved operating margin, and strong bottom line performance. Based on our outperformance in the first half of the year, we updated our full year 2024 guidance. We are well-positioned to deliver on our target for Adjusted EBITDA profitability this year.”

Total Revenue was $2.2 billion in the quarter, up 46% year-over-year (“YoY”), driven primarily by higher membership and rate increases, partially offset by higher risk adjustment as a percentage of premiums.

The Medical Loss Ratio improved 90 bps YoY to 79.0%, primarily due to favorable prior period development. The SG&A Expense Ratio improved 260 bps YoY to 19.6%, driven by improved fixed cost leverage and variable cost efficiencies, partially offset by higher risk adjustment as a percentage of premiums.

Adjusted EBITDA of $104.1 million significantly improved by $68.6 million YoY, and Net income attributable to Oscar of $56.2 million also significantly improved by $71.7 million YoY.

Oscar is updating its full year 2024 outlook to reflect first half outperformance. The Company projects Revenue to be in the $9.0 billion to $9.1 billion range, $700 million above the prior range of $8.3 billion to $8.4 billion, and Adjusted EBITDA to be in the $160 million to $210 million range, $35 million higher than the prior range of $125 million to $175 million. Additionally, the Company now projects a lower SG&A Expense Ratio in the range of 19.75% to 20.25%, and a modestly higher Medical Loss Ratio in the range of 80.5% to 81.5%.

 

Key Metrics and Non-GAAP Financial Metrics

 

 

 

 

 

 

 

 

 

Three Months Ended June 30,

 

Six Months Ended June 30,

(in thousands, except percentages)

 

2024

 

 

 

2023

 

 

 

2024

 

 

 

2023

 

Total revenue

$

2,219,341

 

 

$

1,521,535

 

 

$

4,361,646

 

 

$

2,991,220

 

Medical Loss Ratio (MLR)

 

79.0

%

 

 

79.9

%

 

 

76.7

%

 

 

78.2

%

SG&A Expense Ratio

 

19.6

%

 

 

22.2

%

 

 

19.0

%

 

 

24.6

%

Adjusted EBITDA(1)

$

104,126

 

 

$

35,572

 

 

$

323,440

 

 

$

86,640

 

(1)

Adjusted EBITDA is a non-GAAP measure. See “Key Operating and Non-GAAP Financial Metrics - Adjusted EBITDA” in this release for a reconciliation to net loss, the most directly comparable GAAP measure, and for information regarding Oscar’s use of Adjusted EBITDA.

 

 

 

 

 

 

As of June 30,

Membership by Offering

2024

 

2023

Individual and Small Group

1,522,432

 

900,228

Medicare Advantage

—

 

1,843

Cigna+Oscar (1)

58,293

 

68,472

Total Members (2)

1,580,725

 

970,543

(1)

Represents total membership for Oscar’s co-branded partnership with Cigna.

(2)

A member covered under more than one of our health plans counts as a single member for the purposes of this metric.

 

Quarterly Conference Call Details

Oscar will host a conference call to discuss the financial results today, August 7, 2024, at 8:00 a.m. (ET). A live audio webcast will be available via the Investor Relations page of Oscar’s website at ir.hioscar.com. A replay of the webcast will be available for on-demand listening shortly after the completion of the call, at the same web link, and will remain available for approximately 90 days.

Non-GAAP Financial Information

This release presents Adjusted EBITDA, a non-GAAP financial metric, which is provided as a complement to the results provided in accordance with accounting principles generally accepted in the United States of America (“GAAP”). A reconciliation of historical non-GAAP financial information to the most directly comparable GAAP financial measure is provided in the accompanying tables found at the end of this release. For more information regarding Adjusted EBITDA, please see “Key Operating and Non-GAAP Financial Metrics” below.

Cautionary Note Regarding Forward-Looking Statements

This press release 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. These statements include, but are not limited to, statements about our financial outlook and estimates, including Total revenue, Medical Loss Ratio, SG&A Expense Ratio and Adjusted EBITDA and other financial performance metrics, and the related underlying assumptions, our business and financial prospects, and our management’s plans and objectives for future operations, expectations and business strategy. In some cases, you can identify forward-looking statements by terms such as “may,” “will,” “should,” “expects,” “plans,” “anticipates,” “could,” “intends,” “targets,” “projects,” “contemplates,” “believes,” “estimates,” “predicts,” “potential,” or “continue” or the negative of these terms or other similar expressions. Accordingly, we caution you that any such forward-looking statements are not guarantees of future performance and are subject to risks, assumptions, and uncertainties that are difficult to predict and generally beyond our control.

Although we believe that the expectations reflected in these forward-looking statements are reasonable as of the date made, there are or will be important factors that could cause our actual results to differ materially from those indicated in these forward-looking statements, including, but not limited to, the following: our ability to execute our strategy and manage our growth effectively; our ability to retain and expand our member base; heightened competition in the markets in which we participate; our ability to accurately estimate our incurred medical expenses or effectively manage our medical costs or related administrative costs; our ability to achieve or maintain profitability in the future; changes in federal or state laws or regulations, including changes with respect to the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010, as amended (collectively, the “ACA”) and any regulations enacted thereunder; our ability to comply with ongoing regulatory requirements, including capital reserve and surplus requirements and applicable performance standards; changes or developments in the health insurance markets in the United States, including passage and implementation of a law to create a single-payer or government-run health insurance program; our, or any of our vendors’, ability to comply with laws, regulations, and standards related to the handling of information about individuals or applicable consumer protection laws; our ability to arrange for the delivery of quality care and maintain good relations with the physicians, hospitals, and other providers within and outside our provider networks; unanticipated results of, or changes to, risk adjustment programs; our ability to utilize quota share reinsurance to meet our capital and surplus requirements and protect against downside risk on medical claims; unfavorable or otherwise costly outcomes of lawsuits, audits, investigations, and claims that arise from the extensive laws and regulations to which we are subject; incurrence of data security breaches of our and our partners’ information and technology systems; our ability to detect and prevent material weaknesses or significant control deficiencies in our internal controls over financial reporting or other failure to maintain an effective system of internal controls; adverse publicity or other adverse consequences related to our dual class structure or “controlled company” status; and the other factors set forth under the caption “Risk Factors” in our Annual Report on Form 10-K for the year ended December 31, 2023, filed with the Securities and Exchange Commission (“SEC”), and our other filings with the SEC, including our Quarterly Report on Form 10-Q for the quarterly period ended June 30, 2024, to be filed with the SEC.

You are cautioned not to place undue reliance on any forward-looking statements made in this press release. Any forward-looking statement speaks only as of the date as of which it is made, and, except as otherwise required by law, we do not undertake any obligation to publicly update or review any forward-looking statement, whether as a result of new information, future developments or otherwise. New factors emerge from time to time, and it is not possible for us to predict which will arise.

About Oscar Health

Oscar Health, Inc. (“Oscar”) is the first health insurance company built around a full stack technology platform and a relentless focus on serving its members. At Oscar, our mission is to make a healthier life accessible and affordable for all. Headquartered in New York City, Oscar has been challenging the healthcare system's status quo since our founding in 2012. The company’s member-first philosophy and innovative approach to care has earned us the trust of approximately 1.6 million members, as of June 30, 2024. We offer Individual & Family and Small Group plans, and +Oscar, our full stack technology platform, to others within the provider and payor space. Our vision is to refactor healthcare to make good care cost less. Refactor is a term used in software engineering that means to improve the design, structure, and implementation of the software, while preserving its functionality. At Oscar, we take this definition a step further. We improve our members’ experience by building trust through deep engagement, personalized guidance, and rapid iteration.

.

 

Oscar Health, Inc. Condensed Consolidated Statements of Operations (unaudited)

   

 

Three Months Ended June 30,

 

Six Months Ended June 30,

(in thousands, except per share amounts)

2024

 

2023

 

2024

 

2023

Revenue

 

 

 

 

 

 

 

Premium

 

2,164,116

 

 

1,474,966

 

 

$

4,257,798

 

$

2,903,592

 

Investment income

 

49,994

 

 

41,484

 

 

 

92,983

 

 

77,540

 

Services and other

 

5,231

 

 

5,085

 

 

 

10,865

 

 

10,088

 

Total revenue

 

2,219,341

 

 

1,521,535

 

 

 

4,361,646

 

 

2,991,220

 

 

 

 

 

 

 

 

 

Operating Expenses

 

 

 

 

 

 

 

Medical

 

1,708,722

 

 

1,181,999

 

 

 

3,263,496

 

 

2,273,591

 

Selling, general, and administrative

 

435,206

 

 

337,244

 

 

 

829,368

 

 

735,763

 

Depreciation and amortization

 

7,601

 

 

8,821

 

 

 

15,412

 

 

13,760

 

Total operating expenses

 

2,151,529

 

 

1,528,064

 

 

 

4,108,276

 

 

3,023,114

 

Earnings (loss) from operations

 

67,812

 

 

(6,529

)

 

 

253,370

 

 

(31,894

)

Interest expense

 

5,991

 

 

6,120

 

 

 

11,893

 

 

12,256

 

Other expenses

 

872

 

 

1,612

 

 

 

2,050

 

 

7,718

 

Earnings (loss) before income taxes

 

60,949

 

 

(14,261

)

 

 

239,427

 

 

(51,868

)

Income tax expense

 

4,637

 

 

1,164

 

 

 

5,633

 

 

3,185

 

Net income (loss)

 

56,312

 

 

(15,425

)

 

 

233,794

 

 

(55,053

)

Less: Net income attributable to noncontrolling interests

 

105

 

 

103

 

 

 

219

 

 

247

 

Net income (loss) attributable to Oscar Health, Inc.

$

56,207

 

$

(15,528

)

 

$

233,575

 

$

(55,300

)

 

 

 

 

 

 

 

 

Earnings (Loss) per Share

 

 

 

 

 

 

 

Basic

$

0.24

 

$

(0.07

)

 

$

0.99

 

$

(0.25

)

Diluted

 

0.20

 

 

(0.07

)

 

$

0.82

 

$

(0.25

)

Weighted Average Common Shares Outstanding

 

 

 

 

 

 

 

Basic

 

238,672

 

 

219,400

 

 

 

235,056

 

 

218,164

Diluted

 

303,965

 

 

219,400

 

 

 

299,186

 

218,164

 

Oscar Health, Inc. Condensed Consolidated Balance Sheets (unaudited)

   

(in thousands, except share amounts)

June 30, 2024

 

December 31, 2023

Assets

 

 

 

Current Assets:

 

 

 

Cash and cash equivalents

$

2,268,154

 

 

$

1,870,315

 

Short-term investments

 

363,639

 

 

 

689,833

 

Premiums and accounts receivable (net of allowance for credit losses of $30,400 and $31,600)

 

398,366

 

 

 

201,269

 

Risk adjustment transfer receivable

 

72,136

 

 

 

51,925

 

Reinsurance recoverable

 

241,284

 

 

 

241,194

 

Other current assets

 

15,514

 

 

 

6,564

 

Total current assets

 

3,359,093

 

 

 

3,061,100

 

Property, equipment, and capitalized software, net

 

63,953

 

 

 

61,930

 

Long-term investments

 

1,465,974

 

 

 

365,309

 

Restricted deposits

 

29,856

 

 

 

29,870

 

Other assets

 

87,273

 

 

 

83,271

 

Total assets

$

5,006,149

 

 

$

3,601,480

 

 

 

 

 

Liabilities and Stockholders' Equity

 

 

 

Current Liabilities:

 

 

 

Benefits payable

$

1,252,228

 

 

$

965,986

 

Risk adjustment transfer payable

 

1,779,039

 

 

 

1,056,941

 

Premium deficiency reserve

 

2,887

 

 

 

5,776

 

Unearned premiums

 

59,970

 

 

 

65,918

 

Accounts payable and other liabilities

 

347,523

 

 

 

273,367

 

Reinsurance payable

 

60,094

 

 

 

61,024

 

Total current liabilities

 

3,501,741

 

 

 

2,429,012

 

Long-term debt

 

299,166

 

 

 

298,777

 

Other liabilities

 

64,674

 

 

 

67,574

 

Total liabilities

 

3,865,581

 

 

 

2,795,363

 

Commitments and contingencies

 

 

 

Stockholders' Equity

 

 

 

Class A common stock ($0.00001 par value; 825,000 thousand shares authorized, 206,153 thousand and 193,875 thousand shares outstanding as of June 30, 2024 and December 31, 2023, respectively)

 

2

 

 

 

2

 

Class B common stock ($0.00001 par value; 82,500 thousand shares authorized, 35,514 thousand and 35,514 thousand shares outstanding as of June 30, 2024 and December 31, 2023, respectively)

 

—

 

 

 

—

 

Treasury stock (315 thousand shares as of June 30, 2024 and December 31, 2023)

 

(2,923

)

 

 

(2,923

)

Additional paid-in capital

 

3,786,885

 

 

 

3,682,294

 

Accumulated deficit

 

(2,643,140

)

 

 

(2,876,715

)

Accumulated other comprehensive income (loss)

 

(2,625

)

 

 

1,309

 

Total Oscar Health, Inc. stockholders' equity

 

1,138,199

 

 

 

803,967

 

Noncontrolling interests

 

2,369

 

 

 

2,150

 

Total stockholders' equity

 

1,140,568

 

 

 

806,117

 

Total liabilities and stockholders' equity

$

5,006,149

 

 

$

3,601,480

 

Oscar Health, Inc. Condensed Consolidated Statements of Cash Flows (unaudited)

   

 

Six Months Ended June 30,

(in thousands)

 

2024

 

 

 

2023

 

Cash Flows from Operating Activities:

 

 

 

Net income (loss)

$

233,794

 

 

$

(55,053

)

Adjustments to reconcile net income (loss) to net cash provided by operating activities:

 

 

 

Deferred taxes

 

51

 

 

 

26

 

Net realized loss on sale of financial instruments

 

—

 

 

 

9

 

Depreciation and amortization expense

 

15,412

 

 

 

13,761

 

Amortization of debt issuance costs

 

389

 

 

 

389

 

Stock-based compensation expense

 

54,658

 

 

 

104,773

 

Net accretion of investments

 

(12,219

)

 

 

(15,275

)

Change in provision for credit losses

 

(1,200

)

 

 

9,779

 

Changes in assets and liabilities:

 

 

 

(Increase) / decrease in:

 

 

 

Premiums and accounts receivable

 

(195,898

)

 

 

13,617

 

Risk adjustment transfer receivable

 

(20,211

)

 

 

(10,474

)

Reinsurance recoverable

 

(89

)

 

 

539,004

 

Other assets

 

(13,001

)

 

 

1,294

 

Increase / (decrease) in:

 

 

 

Benefits payable

 

286,242

 

 

 

(82,016

)

Unearned premiums

 

(5,947

)

 

 

(5,925

)

Premium deficiency reserve

 

(2,888

)

 

 

(832

)

Accounts payable and other liabilities

 

71,254

 

 

 

(38,330

)

Reinsurance payable

 

(930

)

 

 

(360,015

)

Risk adjustment transfer payable

 

722,097

 

 

 

465,507

 

Net cash provided by operating activities

 

1,131,514

 

 

 

580,239

 

Cash Flows from Investing Activities:

 

 

 

Purchase of investments

 

(1,362,993

)

 

 

(537,688

)

Sale of investments

 

—

 

 

 

19,160

 

Maturity of investments

 

596,838

 

 

 

711,453

 

Purchase of property, equipment and capitalized software

 

(13,512

)

 

 

(12,996

)

Change in restricted deposits

 

1,451

 

 

 

(522

)

Net cash (used in) provided by investing activities

 

(778,216

)

 

 

179,407

 

Cash Flows from Financing Activities:

 

 

 

Proceeds from joint venture contribution

 

—

 

 

 

471

 

Proceeds from exercise of stock options

 

46,011

 

 

 

2,586

 

Net cash provided by financing activities

 

46,011

 

 

 

3,057

 

Increase in cash, cash equivalents and restricted cash equivalents

 

399,309

 

 

 

762,703

 

Cash, cash equivalents, restricted cash and cash equivalents—beginning of period

 

1,891,971

 

 

 

1,580,497

 

Cash, cash equivalents, restricted cash and cash equivalents—end of period

 

2,291,280

 

 

 

2,343,200

 

Cash and cash equivalents

 

2,268,154

 

 

 

2,322,069

 

Restricted cash and cash equivalents included in restricted deposits

 

23,126

 

 

 

21,131

 

Total cash, cash equivalents and restricted cash and cash equivalents

$

2,291,280

 

 

$

2,343,200

 

Supplemental Disclosures:

 

 

 

Interest payments

$

11,269

 

 

$

22,636

 

Income tax payments

$

84

 

 

$

400

 

 

Key Operating and Non-GAAP Financial Metrics

We regularly review the following key operating and Non-GAAP financial metrics to evaluate our business, measure our performance, identify trends in our business, prepare financial projections, and make strategic decisions. We believe these operational and financial measures are useful in evaluating our performance, in addition to our financial results prepared in accordance with GAAP.

Members

Members are defined as any individual covered by a health plan that we offer directly or through a co-branded arrangement. We view the number of members enrolled in our health plans as an important metric to help evaluate and estimate revenue and market share. Additionally, the more members we enroll, the more data we have, which allows us to improve the functionality of our platform.

Medical Loss Ratio

Medical Loss Ratio is a metric used to calculate medical expenses as a percentage of net premiums before ceded quota share reinsurance. Medical expenses are the total expenses incurred by members in order to utilize health care services less any member cost sharing. These services include inpatient, outpatient, pharmacy, and physician costs. Medical claims also include fee-for-service claims, pharmacy benefits, capitation payments to providers, provider disputed claims, risk sharing arrangements with certain of our providers, and various other medical-related costs. The impact of the federal risk adjustment program is included in the denominator of our MLR. We believe MLR is an important metric to demonstrate the ratio of our costs to pay for healthcare of our members to the net premium before ceded reinsurance. MLR in our existing products are subject to various federal and state minimum requirements.

 

Three Months Ended June 30,

 

Six Months Ended June 30,

(in thousands, except percentages)

 

2024

 

 

 

2023

 

 

 

2024

 

 

 

2023

 

Medical

$

1,708,722

 

 

$

1,181,999

 

 

$

3,263,496

 

 

$

2,273,591

 

Less: Ceded quota share reinsurance claims (1)

 

(3,860

)

 

 

(2,786

)

 

 

(4,915

)

 

 

3,649

 

Net claims before ceded quota share reinsurance (A)

$

1,712,582

 

 

$

1,184,785

 

 

$

3,268,411

 

 

$

2,269,942

 

 

 

 

 

 

 

 

 

Premium

$

2,164,116

 

 

$

1,474,966

 

 

$

4,257,798

 

 

$

2,903,592

 

Less: Ceded quota share reinsurance premiums (2)

 

(2,820

)

 

 

(7,338

)

 

 

(4,836

)

 

 

(683

)

Net premiums before ceded quota share reinsurance (B)

$

2,166,936

 

 

$

1,482,304

 

 

$

4,262,634

 

 

$

2,904,275

 

Medical Loss Ratio (A divided by B)

 

79.0

%

 

 

79.9

%

 

 

76.7

%

 

 

78.2

%

(1)

Represents prior period development for claims ceded to reinsurers pursuant to quota share treaties accounted for under reinsurance accounting, which are in runoff.

(2)

Represents prior period development for premiums ceded to reinsurers pursuant to quota share treaties accounted for under reinsurance accounting, which are in runoff.

 

SG&A Expense Ratio

The SG&A Expense Ratio reflects the Company’s selling, general and administrative ("SG&A") expenses, as a percentage of Total revenue. Selling, general and administrative expenses primarily include wages, benefits, costs of software and hardware, and administrative costs for our corporate and technology functions, the impact of quota share reinsurance, and stock-based compensation. We believe the SG&A Expense Ratio is useful to evaluate our ability to manage our overall selling, general, and administrative cost base.

Adjusted EBITDA

Adjusted EBITDA is defined as Net income (loss) for the Company and its consolidated subsidiaries before interest expense, income tax expense (benefit), and depreciation and amortization, as further adjusted for stock-based compensation, and other items that are considered unusual or not representative of underlying trends of our business, where applicable for the period presented. We present Adjusted EBITDA because we consider it to be an important supplemental measure of our performance and believe it is frequently used by securities analysts, investors, and other interested parties in the evaluation of companies in our industry. Adjusted EBITDA is a non-GAAP measure. Management believes that investors’ understanding of our performance is enhanced by including this non-GAAP financial measure as a reasonable basis for comparing our ongoing results of operations.

We caution investors that amounts presented in accordance with our definition of Adjusted EBITDA may not be comparable to similar measures disclosed by our competitors, because not all companies and analysts calculate Adjusted EBITDA in the same manner.

By providing this non-GAAP financial measure, together with a reconciliation to the most comparable U.S. GAAP measure, Net income (loss), we believe we are enhancing investors’ understanding of our business and our results of operations, as well as assisting investors in evaluating how well we are executing our strategic initiatives. Adjusted EBITDA has limitations as an analytical tool, and

should not be considered in isolation, or as an alternative to, or a substitute for Net income (loss) or other financial statement data presented in our Condensed Consolidated Financial Statements as indicators of financial performance.

 

Three Months Ended June 30,

 

Six Months Ended June 30,

(in thousands)

2024

 

 

2023

 

 

2024

 

 

2023

 

Net income (loss)

$

56,312

 

$

(15,425

)

 

$

233,794

 

$

(55,053

)

Interest expense

 

5,991

 

 

6,120

 

 

 

11,893

 

 

12,256

 

Other expenses

 

872

 

 

1,612

 

 

 

2,050

 

 

7,718

 

Income tax expense

 

4,637

 

 

1,164

 

 

 

5,633

 

 

3,185

 

Depreciation and amortization

 

7,601

 

 

8,822

 

 

 

15,412

 

 

13,761

 

Stock-based compensation(1)

 

28,713

 

 

33,279

 

 

 

54,658

 

 

104,773

 

Adjusted EBITDA

$

104,126

 

$

35,572

 

 

$

323,440

 

$

86,640

 

(1)

Represents non-cash expenses related to equity-based compensation programs, which vary from period to period depending on various factors including the timing, number, and the valuation of awards. The six months ended June 30, 2023 includes a non-recurring charge of $46.3 million related to accelerated stock-based compensation expense recognized as a result of the cancellation of the Founders Awards previously granted to Mario Schlosser and Joshua Kushner.

   

Appendix

 

Reinsurance Impact

 

 

Three Months Ended June 30,

 

Six Months Ended June 30,

(in thousands)

 

2024

 

 

 

2023

 

 

 

2024

 

 

 

2023

 

Quota share ceded premiums

$

574

 

 

$

(5,537

)

 

$

(4,420

)

 

$

6,823

 

Quota share ceded claims

 

3,860

 

 

 

2,787

 

 

 

4,915

 

 

 

(3,648

)

Ceding commission, net of deposit accounting impact (1)

 

(13,354

)

 

 

(6,967

)

 

 

(25,526

)

 

 

(16,262

)

Experience refund

 

(3,395

)

 

 

(1,801

)

 

 

(416

)

 

 

(7,506

)

Net quota share impact

$

(12,315

)

 

$

(11,518

)

 

$

(25,447

)

 

$

(20,593

)

(1)

Includes ceding commissions received from reinsurers, net of the impact of deposit accounting of $(13,292) and $(7,557) for the three months ended June 30, 2024 and 2023, respectively, and $(25,998) and $(15,316) for the six months ended June 30, 2024 and 2023, respectively.

The Company records Premium revenue net of reinsurance. The following table reconciles total reinsurance premiums ceded and reinsurance premiums assumed, which are included as components of total Premium revenue in the condensed consolidated statement of operations.

 

Three Months Ended June 30,

 

Six Months Ended June 30,

(in thousands)

 

2024

 

 

 

2023

 

 

 

2024

 

 

 

2023

 

Direct policy premiums

$

2,544,115

 

 

$

1,584,774

 

 

$

4,854,215

 

 

$

3,248,248

 

Assumed premiums

 

60,460

 

 

 

60,395

 

 

 

118,072

 

 

 

116,330

 

Risk adjustment transfers

 

(432,895

)

 

 

(160,631

)

 

 

(702,293

)

 

 

(453,778

)

Reinsurance premiums ceded

 

(7,564

)

 

 

(9,572

)

 

 

(12,196

)

 

 

(7,208

)

Premium

$

2,164,116

 

 

$

1,474,966

 

 

$

4,257,798

 

 

$

2,903,592

 

 

The Company records Medical expenses net of reinsurance recoveries. The following table reconciles total Medical expenses to the amount presented in the condensed consolidated statement of operations:

 

Three Months Ended June 30,

 

Six Months Ended June 30,

(in thousands)

 

2024

 

 

 

2023

 

 

 

2024

 

 

 

2023

 

Direct claims incurred

$

1,680,066

 

 

$

1,136,687

 

 

$

3,203,712

 

 

$

2,184,745

 

Ceded reinsurance claims

 

(29,954

)

 

 

(14,943

)

 

 

(49,652

)

 

 

(18,567

)

Assumed reinsurance claims

 

58,610

 

 

 

60,255

 

 

 

109,436

 

 

 

107,413

 

Medical expenses

$

1,708,722

 

 

$

1,181,999

 

 

$

3,263,496

 

 

$

2,273,591

 

 

The Company records Selling, general and administrative ("SG&A") expenses net of reinsurance ceding commissions and assumed SG&A expenses. The following table reconciles total Selling, general and administrative expenses to the amount presented in the condensed consolidated statement of operations:

 

Three Months Ended June 30,

 

Six Months Ended June 30,

(in thousands)

2024

 

 

2023

 

 

 

2024

 

 

2023

Selling, general and administrative expenses, gross

$

435,144

 

$

337,833

 

 

$

829,840

 

 

$

734,817

Reinsurance ceding commissions

 

62

 

 

(589

)

 

 

(472

)

 

 

946

Selling, general and administrative expenses

$

435,206

 

$

337,244

 

 

$

829,368

 

 

$

735,763

 

The Company classifies Reinsurance recoverable within current assets on its condensed consolidated balance sheets. The composition of the Reinsurance recoverable balance is as follows:

(in thousands)

June 30, 2024

 

December 31, 2023

Reinsurance premium and claim recoverables

$

242,639

 

 

$

224,837

Reinsurance ceding commissions

 

7,017

 

 

 

7,054

Experience refunds on reinsurance agreements

 

(8,372

)

 

 

9,303

Reinsurance recoverable

$

241,284

 

 

$

241,194

 

View source version on businesswire.com: https://www.businesswire.com/news/home/20240807220528/en/

Investor Contact: Chris Potochar VP of Investor Relations ir@hioscar.com Media Contact: Kristen Prestano VP of Communications press@hioscar.com