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1. Company Snapshot

1.a. Company Description

Oscar Health, Inc.provides health insurance products and services in the United States.The company offers Individual & Family, Small Group, and Medicare Advantage plans, as well as +Oscar, a technology driven platform designed to help providers and payor clients to engage with members and patients.


It also provides reinsurance products.The company was formerly known as Mulberry Health Inc.and changed its name to Oscar Health, Inc.


in January 2021.Oscar Health, Inc.was incorporated in 2012 and is headquartered in New York, New York.

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1.b. Last Insights on OSCR

Breaking News: Oscar Health Inc is expected to see a turnaround in 2026 after facing pressures in 2025. The company's stock may be undervalued considering its potential return to profitability next year. As of the recent news, investors are advised to consider the stock's compelling value play ahead of the 2026 economic shift. A recent note from analyst recommend a buy on the stock citing its potential for growth. The note was authored by analyst from investment bank .

1.c. Company Highlights

2. Oscar Health's Q3 2025 Earnings: A Mixed Bag

Oscar Health reported total revenue of approximately $3 billion, a 23% increase year-over-year, driven by higher membership. The company's SG&A expense ratio improved by 150 basis points year-over-year to 17.5%. However, Oscar reported a $129 million loss from operations and an adjusted EBITDA loss of $101 million. The actual EPS came out at -$0.53, beating estimates of -$0.55. With a P/S Ratio of 0.34, the market seems to be pricing in moderate growth expectations.

Publication Date: Nov -13

📋 Highlights
  • Revenue Growth & SG&A Improvement: Total revenue reached $3 billion YoY (+23%), with SG&A expense ratio at 17.5% (improved by 150 bps YoY).
  • Operational Losses: Reported a $129M operating loss and $101M adjusted EBITDA loss, with guidance for $200M–$300M annual operating loss.
  • 2026 Pricing Strategy: Weighted average rate increase of 28%, targeting low-cost position in 30% of markets (up from 15% in 2025) amid 20–30% market contraction.
  • AI & Cost Efficiency: Deployed over 20 AI models to optimize SG&A and reduce costs, including $84M in PPD from favorable claims/reserves development.
  • Membership Expansion: 2 million members (28% YoY growth), with 90,000 sequential additions driven by lower churn and SEP member growth.

Operational Highlights

The company ended the first nine months of 2025 with more than 2 million members, a 28% increase over last year. Membership was up 90,000 members, or 4.5% sequentially, driven by lower churn and SEP member additions. The company's narrow network strategy is believed to provide a cost advantage, although they won't quantify it. As Mark Bertolini noted, "We've got well over two dozen models on the back end. We've just launched our first agentic," indicating the company's focus on leveraging AI to streamline operating costs.

Medical Loss Ratio and Pricing Strategy

The third quarter medical loss ratio was 88.5%, an increase of approximately 380 basis points year-over-year. The company expects a full year MLR in the range of 86.0% to 87.0%. For 2026, Oscar has taken a disciplined pricing strategy, with a weighted average rate increase of approximately 28%. The company believes this will enable them to capture market share profitably as other carriers retreat or price themselves out of the market.

Outlook and Valuation

Analysts estimate next year's revenue growth at -4.5%. With a P/B Ratio of 3.77 and an EV/EBITDA of -15.31, the market seems to be pricing in a challenging near-term outlook. However, the company's efforts to expand margins and return to profitability in 2026, coupled with its disciplined pricing strategy, may provide a catalyst for growth. The company's Free Cash Flow Yield of 19.07% also suggests that the stock may be undervalued.

Risk Adjustment and Program Integrity

Risk adjustment is 17% of direct premiums year-to-date. The company has factored in Wakely data on morbidity variation and risk adjustment into their pricing strategy. They believe that using the same tools to ensure people belong on the plan is key to making risk adjustment work well. The company is supportive of program integrity efforts and has been validating membership to prevent fraud.

3. NewsRoom

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This Could Be the Most Compelling Value Play Before 2026's Economic Shift

Dec -01

Source: fool.com

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Options Corner: AI Bubble Fears Deliver An Incentivized Wager On Tech Giant Microsoft

Nov -26

Source: feeds.benzinga.com

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Health Insurers Stocks Reflect Obamacare Subsidy Deal Can Be Reached

Nov -26

Source: forbes.com

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Why This Health Care Stock Has Gained 35% This Week

Nov -26

Source: investopedia.com

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Wall Street Loves Broadcom, Oscar Health, and Amazon Stocks Today

Nov -26

Source: 247wallst.com

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OSCR Stock Review: Strong Growth Meets Attractive Valuation

Nov -25

Source: forbes.com

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Biggest Stock Movers Today, Nov. 24: AVGO, NVO, & More

Nov -24

Source: fool.com

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Prediction: 2 Stocks That Will Be Worth More Than SoundHound AI 5 Years From Now

Nov -24

Source: fool.com

4. Business Breakdown

4.a. Revenues by Country

4.b. Revenues by Segment

5. Expected revenues mid-term growth (9.98%)

6. Segments

Insurance and Related Activities

Expected Growth: 9.98%

Oscar Health, Inc.'s 9.98% growth in Insurance and Related Activities is driven by increasing demand for affordable healthcare, expansion into new markets, and strategic partnerships. Additionally, the company's user-friendly technology platform and data-driven approach to healthcare have improved customer engagement and retention, contributing to its growth.

7. Detailed Products

Individual and Family Plans

Oscar Health offers individual and family health insurance plans that provide comprehensive coverage for medical expenses, including doctor visits, hospital stays, and prescriptions.

Small Group Plans

Oscar Health offers small group health insurance plans designed for businesses with 1-50 employees, providing comprehensive coverage and flexible plan options.

Medicare Advantage Plans

Oscar Health offers Medicare Advantage plans that provide comprehensive coverage for seniors and individuals with disabilities, including medical, hospital, and prescription drug coverage.

Oscar for Business

Oscar for Business is a health insurance platform designed for larger businesses, providing customizable plan options, data analytics, and personalized support.

Oscar Virtual Care

Oscar Virtual Care is a telemedicine platform that provides 24/7 access to virtual doctor visits, allowing members to receive medical care from the comfort of their own homes.

8. Oscar Health, Inc.'s Porter Forces

Forces Ranking

Threat Of Substitutes

Oscar Health, Inc. operates in a highly competitive market with many substitutes available, but its unique selling proposition and customer loyalty programs help to mitigate the threat.

Bargaining Power Of Customers

Oscar Health, Inc. customers have a high bargaining power due to the availability of alternative health insurance providers, which can lead to a loss of customers if prices are not competitive.

Bargaining Power Of Suppliers

Oscar Health, Inc. has a diversified supplier base, which reduces the bargaining power of individual suppliers, and the company's scale of operations also gives it negotiating power.

Threat Of New Entrants

While there are barriers to entry in the health insurance market, new entrants can still disrupt the market, and Oscar Health, Inc. needs to continuously innovate to stay ahead of the competition.

Intensity Of Rivalry

The health insurance market is highly competitive, with many established players, and Oscar Health, Inc. needs to differentiate itself through its products and services to gain market share.

9. SWOT Analysis

Strength

Weaknesses

Opportunities

Threats

10. Capital Structure

10.a. Balance Sheet

10.b. Weighted Average Cost of capital

Value
Debt Weight 27.09%
Debt Cost 8.13%
Equity Weight 72.91%
Equity Cost 12.19%
WACC 11.09%
Leverage 37.16%

11. Quality Control: Oscar Health, Inc. passed 3 out of 9 key points

12.a Historical Valuation

12.b Price/Earnings Ratio

12.c Margin Valuation

12.d Peers Valuation

Peers Group Analysis

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Quality: 6.8

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Oscar Health

A-Score: 4.6/10

Value: 8.2

Growth: 8.2

Quality: 4.4

Yield: 0.0

Momentum: 6.0

Volatility: 1.0

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Growth: 6.3

Quality: 5.7

Yield: 0.0

Momentum: 0.0

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Peers Metrics

12.e Scoring Insights

12.f DCF BETA

Parameters

Short Term Growth

Short term Time

Long-Term Growth

WACC

Target Price

16.77$

Current Price

16.77$

Potential

-0.00%

Expected Cash-Flows