OSCR

Earlier in 2026, Oscar Health reported record first-half financial results and lifted its full-year guidance, prompting analysts to raise their earnings estimates and highlight a low PEG ratio of 0.6 as evidence of relatively modest valuation expectations. This combination of upgraded guidance and analyst estimate revisions underscores how improving profitability expectations are reshaping perceptions of Oscar Health’s earnings power and growth profile. We’ll now examine how Oscar Health’s upgraded full-year guidance and stronger first-half performance may influence the company’s broader investment narrative. The future of work is here. Discover the 38 top robotics and automation stocks leading the charge in AI-driven automation and industrial transformation. To own Oscar Health, you need to believe its tech-enabled model can keep turning membership growth and cost control into durable profitability, despite policy and morbidity uncertainty. The recent record first half and raised 2026 guidance sharpen the near term catalyst around margin improvement, but they do not remove the biggest risk that shifting regulation, subsidies and risk pools could still pressure medical loss ratios and earnings resilience. Among recent announcements, the upgraded 2026 guidance to US$18.7 billion to US$19.0 billion in revenue and US$500 million to US$700 million in earnings from operations ties most directly to this news. It connects stronger first half execution with management’s confidence in operating performance, which feeds into the core catalyst of improving profitability while investors continue to watch how claims trends, rate filings and regulatory decisions affect that outlook. Yet even with stronger results, investors should still be aware of how fast rising morbidity or an adverse policy change could... Read the full narrative on Oscar Health (it's free!) Oscar Health’s narrative projects $23.8 billion revenue and $998.5 million earnings by 2029. This requires 21.4% yearly revenue growth and an earnings increase of about $1.0 billion from -$39.4 million today. Uncover how Oscar Health's forecasts yield a $24.20 fair value, a 21% downside to its current price. Some of the most optimistic analysts were already projecting revenue near US$25.9 billion and earnings around US$973 million by 2029, so this earnings beat and guidance raise may either reinforce that bullish view of AI driven margin lift or prompt you to question whether such expectations underplay risks like rising medical costs and regulatory shifts. Explore 9 other fair value estimates on Oscar Health - why the stock might be a potential multi-bagger! Disagree with existing narratives? Extraordinary investment returns rarely come from following the herd, so go with your instincts. A great starting point for your Oscar Health research is our analysis highlighting 3 key rewards and 2 important warning signs that could impact your investment decision. Our free Oscar Health research report provides a comprehensive fundamental analysis summarized in a single visual - the Snowflake - making it easy to evaluate Oscar Health's overall financial health at a glance. Our top stock finds are flying under the radar-for now. Get in early: Outshine the giants: these 18 early-stage AI stocks could fund your retirement. Rare earth metals are the new gold rush. Find out which 30 stocks are leading the charge. Find 44 companies with promising cash flow potential yet trading below their fair value. This article by Simply Wall St is general in nature. We provide commentary based on historical data and analyst forecasts only using an unbiased methodology and our articles are not intended to be financial advice. It does not constitute a recommendation to buy or sell any stock, and does not take account of your objectives, or your financial situation. We aim to bring you long-term focused analysis driven by fundamental data. Note that our analysis may not factor in the latest price-sensitive company announcements or qualitative material. Simply Wall St has no position in any stocks mentioned. Companies discussed in this article include OSCR. Have feedback on this article? Concerned about the content? Get in touch with us directly. Alternatively, email [email protected]

Oscar Health’s second quarter saw results well above Wall Street’s expectations, yet the market response was notably negative. Management credited disciplined pricing, technology-driven cost efficiencies, and strong execution in the individual health insurance market for driving year-over-year revenue and margin improvement. CEO Mark Bertolini highlighted that “disciplined pricing, differentiated consumer products and a scalable technology platform” fueled growth, with membership up 46% and administrative cost ratios reaching historic lows. The company cited favorable medical utilization and risk adjustment dynamics as further contributors to the positive results. Is now the time to buy OSCR? Find out in our full research report (it’s free). Revenue: $4.88 billion vs analyst estimates of $4.74 billion (70.4% year-on-year growth, 2.9% beat) Adjusted EPS: $1.10 vs analyst estimates of $0.38 (significant beat) Adjusted EBITDA: $415.3 million vs analyst estimates of $170.9 million (8.5% margin, significant beat) Operating Margin: 8%, up from -8% in the same quarter last year Market Capitalization: $9.13 billion While we enjoy listening to the management’s commentary, our favorite part of earnings calls is the analyst questions. Those are unscripted and can often highlight topics that management teams would rather avoid or topics where the answer is complicated. Here is what has caught our attention. Andrew Mok (Barclays) asked about outpatient utilization trends and the pace for the rest of the year. CEO Mark Bertolini explained that while outpatient was slightly elevated, overall trends were stable and utilization remained in line with expectations. Jessica Tassan (Piper Sandler) questioned Oscar’s visibility into utilization and MLR guidance despite higher deductibles. Bertolini responded that stable risk profiles and real-time data tracking gave management confidence in their projections. Parker Snure (Raymond James) inquired about rate positioning and ACA market enrollment for 2027. Bertolini said the market remains rational, with Oscar prepared to adjust pricing and product offerings if regulations change. Raj Kumar (Stephens Inc.) asked about the recent ICHRAx partnership and capabilities. Bertolini described ICHRAx as enabling lower-cost administration and broader network access, with all major competitors participating on the platform. Justin Lake (Wolfe Research) pressed for details about the financial impact of CMS eligibility reviews on member disenrollment. Bertolini said the company has established reserves for at-risk members, and CFO Richard Blackley confirmed this risk is factored into guidance. In the coming quarters, the StockStory team will closely watch (1) the impact of CMS eligibility reviews on churn and membership stability, (2) the scaling of AI-powered tools for claims and care navigation, and (3) the adoption and profitability of the ICHRAx platform targeting small businesses and gig workers. Execution on product innovation and operational efficiency will also be key for sustained margin improvement. Oscar Health currently trades at $29.44, down from $30.11 just before the earnings. Is the company at an inflection point that warrants a buy or sell? The answer lies in our full research report (it’s free for active Edge members). ALSO WORTH WATCHING: Top 5 Momentum Stocks. The best time to own a great stock is when the market is finally noticing it. These aren’t just high-quality businesses. Something is happening with them right now. Elite fundamentals meet near-term momentum — both boxes checked at the same time. Find out which stocks our AI platform is flagging this week. See this week’s Strong Momentum stocks — FREE. Get Our Strong Momentum Stocks for Free HERE. Stocks that have made our list include now familiar names such as Nvidia (+1,460% between June 2020 and June 2025) as well as under-the-radar businesses like the once-micro-cap company Tecnoglass (+1,552% between June 2020 and June 2025). Find your next big winner with StockStory today.

Find your next quality investment with Simply Wall St's easy and powerful screener, trusted by over 7 million individual investors worldwide. Oscar Health (OSCR) is back in focus after reporting second quarter 2026 results that swung from a loss to net income of $361.81 million and raising full year earnings guidance. See our latest analysis for Oscar Health. Oscar Health shares have been volatile around the earnings release, with an 11.9% drop reported after the outlook update. The stock still shows a 118.84% year to date share price return and a 109.46% 1 year total shareholder return, suggesting momentum remains strong despite concerns over second half utilization, risk adjustment and churn. If Oscar Health’s move has you rethinking your watchlist, this could be a good moment to scan for other healthcare technology opportunities through our curated 44 healthcare AI stocks The swing in Oscar Health’s results and guidance points to real business progress, yet the sharp pullback hints at a reset in sentiment. How does that mix of fundamentals and mood show up in today’s valuation? At a last close of $32.76 versus a narrative fair value of $583.34, Oscar Health screens as heavily undervalued on one widely followed valuation framework. That gap raises clear questions about the assumptions behind such an aggressive target. Suspicious of a value trap, I started digging into the operational engine to find the catch. Instead, the deeper I dug, the more the moat began to show: Capital Efficiency: The business generates a powerful 27.9% return on invested capital (ROIC), even while operating on a razor-thin 4.1% operating margin. Cash: Out of USD $15.32 billion in trailing revenue, an estimated 28.6% converts into cash flow. Balance Sheet: Total debt sits at a microscopic 0.21 times equity. In absolute terms, they are holding a USD $3.64 billion net cash position. If the market turns hostile, this cash could extend their survival time relative to more heavily levered competitors. Read the complete narrative. This narrative on Oscar Health centers its fair value on cash conversion, capital efficiency and a balance sheet cushion. It raises the question of which growth and margin paths would need to align to support that level of upside. Result: Fair Value of $583.34 (UNDERVALUED) Have a read of the narrative in full and understand what's behind the forecasts. However, Oscar Health’s story could change quickly if medical cost trends, churn, or regulatory shifts weaken those cash conversion and capital efficiency assumptions. Find out about the key risks to this Oscar Health narrative. With sentiment on Oscar Health pulled between strong recent numbers and clear uncertainties, it makes sense to move quickly and test the story against your own tolerance for risk and reward. To weigh both sides in one place, start by checking the 3 key rewards and 2 important warning signs If Oscar Health has sharpened your focus on where to put fresh capital next, do not sit on the sidelines while other opportunities pass by. Target resilient income by reviewing companies we flag as income standouts through the 10 dividend fortresses. Spot potential mispricings early by scanning the 50 high quality undervalued stocks before attention rushes in. Prioritize balance sheet strength by using the solid balance sheet and fundamentals stocks screener (50 results) to see which stocks keep financial risk in check. This article by Simply Wall St is general in nature. We provide commentary based on historical data and analyst forecasts only using an unbiased methodology and our articles are not intended to be financial advice. It does not constitute a recommendation to buy or sell any stock, and does not take account of your objectives, or your financial situation. We aim to bring you long-term focused analysis driven by fundamental data. Note that our analysis may not factor in the latest price-sensitive company announcements or qualitative material. Simply Wall St has no position in any stocks mentioned. Companies discussed in this article include OSCR. Have feedback on this article? Concerned about the content? Get in touch with us directly. Alternatively, email [email protected]

Wrapping up Q2 earnings, we look at the numbers and key takeaways for the health insurance providers stocks, including Oscar Health (NYSE:OSCR) and its peers. Upfront premiums collected by health insurers lead to reliable revenue, but profitability ultimately depends on accurate risk assessments and the ability to control medical costs. Health insurers are also highly sensitive to regulatory changes and economic conditions such as unemployment. Going forward, the industry faces tailwinds from an aging population, increasing demand for personalized healthcare services, and advancements in data analytics to improve cost management. However, continued regulatory scrutiny on pricing practices, the potential for government-led reforms such as expanded public healthcare options, and inflation in medical costs could add volatility to margins. One big debate among investors is the long-term impact of AI and whether it will help underwriting, fraud detection, and claims processing or whether it may wade into ethical grey areas like reinforcing biases and widening disparities in medical care. The 12 health insurance providers stocks we track reported a strong Q2. As a group, revenues beat analysts’ consensus estimates by 2.8% while next quarter’s revenue guidance was 1.7% below. While some health insurance providers stocks have fared somewhat better than others, they have collectively declined. On average, share prices are down 4.7% since the latest earnings results. Founded in 2012 to simplify the notoriously complex American healthcare system, Oscar Health (NYSE:OSCR) is a technology-focused health insurance company that offers individual and small group health plans through its cloud-native platform. Oscar Health reported revenues of $4.88 billion, up 70.4% year on year. This print exceeded analysts’ expectations by 2.9%. Overall, it was an exceptional quarter for the company with a beat of analysts’ EPS estimates. Oscar Health pulled off the fastest revenue growth of the whole group. Investor expectations, however, were likely higher than Wall Street’s published projections, leaving some wishing for even better results (analysts’ consensus estimates are those published by big banks and advisory firms, not the investors who make buy and sell decisions). The stock is down 8.1% since reporting and currently trades at $27.66. Read why we think that Oscar Health is one of the best health insurance providers stocks, our full report is free. With over 9,000 retail pharmacy locations serving as neighborhood health destinations across America, CVS Health (NYSE:CVS) operates retail pharmacies, provides pharmacy benefit management services, and offers health insurance through its Aetna subsidiary. CVS Health reported revenues of $106.1 billion, up 7.3% year on year, outperforming analysts’ expectations by 6.7%. The business had an incredible quarter with a beat of analysts’ EPS estimates and an impressive beat of analysts’ full-year EPS guidance estimates. Although it had a fine quarter compared to its peers, the market seems unhappy with the results as the stock is down 8.4% since reporting. It currently trades at $95.66. Is now the time to buy CVS Health? Access our full analysis of the earnings results here, it’s free. Pioneering a data-driven approach to family building that has achieved an industry-leading patient satisfaction score of +80, Progyny (NASDAQ:PGNY) provides comprehensive fertility and family building benefits solutions to employers, helping employees access quality fertility treatments and support services. Progyny reported revenues of $350.5 million, up 5.3% year on year, exceeding analysts’ expectations by 0.6%. Still, it was a slower quarter as it posted EBITDA guidance for next quarter missing analysts’ expectations significantly and full-year revenue guidance slightly missing analysts’ expectations. Progyny delivered the weakest guidance update in the group. As expected, the stock is down 7.8% since the results and currently trades at $27.87. Read our full analysis of Progyny’s results here. With over 80% of its revenue derived from federal government contracts, Humana (NYSE:HUM) provides health insurance plans and healthcare services to approximately 17 million members, with a strong focus on Medicare Advantage plans for seniors. Humana reported revenues of $40.87 billion, up 26.2% year on year. This number surpassed analysts’ expectations by 0.6%. It was a satisfactory quarter as it also logged a beat of analysts’ EPS estimates. The company added 200,800 customers to reach a total of 17.91 million. The stock is flat since reporting and currently trades at $390.00. Read our full, actionable report on Humana here, it’s free. Founded in 2014 to improve healthcare for America's seniors through technology, Clover Health (NASDAQ:CLOV) provides Medicare Advantage plans for seniors with a focus on affordable care and uses its proprietary Clover Assistant software to help physicians manage patient care. Clover Health reported revenues of $743.2 million, up 55.6% year on year. This print beat analysts’ expectations by 2%. It was an exceptional quarter as it also put up a beat of analysts’ EPS estimates and full-year EBITDA guidance exceeding analysts’ expectations. The company added 1,536 customers to reach a total of 157,309. The stock is up 9.9% since reporting and currently trades at $4.55. Read our full, actionable report on Clover Health here, it’s free. Over the past year, investors have been forced to repeatedly answer the same question: what is the market’s biggest risk? The answer has changed several times, and each shift has reshaped market leadership. Late in 2025 and early 2026, artificial intelligence became the market’s primary uncertainty. Investors questioned whether AI would erode software pricing power and weaken competitive moats as AI made it easier to replicate once-differentiated products. By the spring, technology took a back seat to geopolitics. The U.S. conflict with Iran briefly became the market’s dominant narrative, raising concerns about oil prices, inflation, and global growth. But as energy markets remained orderly and fears of a prolonged supply disruption faded, investors quickly turned their focus back to fundamentals. Want to invest in winners with rock-solid fundamentals? Check out our 9 Best Market-Beating Stocks and add them to your watchlist. These companies are poised for growth regardless of the political or macroeconomic climate.

Interested in Oscar Health, Inc.? Here are five stocks we like better. Oscar Health reported record first-half profitability, including $1.1 billion in operating earnings and $1 billion in net income. Second-quarter revenue climbed 70% year over year to $4.9 billion, while membership increased 46% to 2.96 million and the medical loss ratio improved to 79.2%. The company raised its 2026 operating-earnings forecast by $250 million to $500 million–$700 million, while maintaining revenue guidance of $18.7 billion–$19 billion. Improved medical loss and SG&A ratio expectations reflect favorable utilization, pricing discipline, fixed-cost leverage and technology-related savings. Membership churn is expected to increase in the second half as CMS eligibility and program-integrity reviews lead to delayed disenrollments, though management characterized the change as timing-related and said it does not affect the full-year revenue outlook. 5 Small Cap Stocks With Explosive Upside Potential Oscar Health (NYSE:OSCR) reported record profitability for the first half of 2026 and raised its full-year operating outlook, citing membership growth, disciplined pricing, favorable utilization trends and lower administrative expense ratios. Chief Executive Officer Mark Bertolini said the company generated $1.1 billion in earnings from operations and $1 billion in net income during the first six months of the year. In the second quarter, revenue rose 70% year over year to $4.9 billion, while the medical loss ratio, or MLR, improved by nearly 12 percentage points to 79.2%. → Sandisk Just Delivered a Blowout Quarter—Here's Why the Stock Is Falling Second-quarter earnings from operations totaled $389 million, compared with a loss in the prior-year period, while net income was $362 million. Adjusted EBITDA was $415 million. The company ended the quarter with 2.96 million effectuated members, up 46% from a year earlier, driven by above-market open enrollment growth and retention. Chief Financial Officer Scott Blackley said Oscar raised its full-year 2026 earnings-from-operations forecast to between $500 million and $700 million, representing a $250 million increase from its prior outlook. The company maintained its revenue outlook of $18.7 billion to $19 billion. Full-year MLR is now expected to be 81.5% to 82.5%, a 90-basis-point improvement at the midpoint from prior guidance. The SG&A expense ratio is expected to be 15.6% to 16.1%, an improvement of 20 basis points at the midpoint. Adjusted EBITDA is still expected to be roughly $115 million above earnings from operations. → 4 Oil and Gas ETF Plays as Prices Stay Sky-High The company’s SG&A expense ratio reached a record low of 14.2% in the second quarter, improving 450 basis points year over year. Blackley attributed the improvement to expense discipline, fixed-cost leverage and technology and artificial intelligence initiatives that reduced variable costs, partly offsetting higher taxes and exchange fees. Oscar expects its SG&A ratio to remain relatively stable in the third quarter before increasing in the fourth quarter, when it typically invests in preparation for the following year’s enrollment cycle. → No Hangover: Revisiting Microsoft One Week After Earnings Oscar received its final 2025 CMS risk-adjustment report during the quarter, which was approximately $160 million favorable to its first-quarter accruals and was fully recognized in the second quarter. The company also received an initial 2026 risk-adjustment report based on claims through April that showed market morbidity tracking favorably to pricing assumptions. However, management said it recognized only a small portion of that favorability because the available claims data covered only four months. Risk adjustment represented about 20% of direct premiums during the first half, consistent with Oscar’s expectation for the full year. Utilization through the first six months was moderately favorable to expectations. Inpatient, professional and pharmacy utilization were favorable, while outpatient utilization was elevated. Bertolini said the outpatient trends were stable and not concentrated in any particularly outsized category. Management expects MLR to rise seasonally during the second half as members use more healthcare services after working through deductibles. The company said its membership has shifted across metal tiers, with some members moving from silver plans to bronze or gold offerings, but performance in those products has been consistent with or favorable to internal expectations. Bertolini said Oscar is using AI across benefits, billing, claims, clinical care and member support. The company’s claims platform has a 98.7% first-pass accuracy rate and processes most claims in less than 48 hours, according to management. During the quarter, Oscar piloted a radiology program using its Oswell agent, which uses members’ claims history and clinical interactions to recommend next steps and care sites based on coverage, cost, location and availability. Bertolini said one in four members selected Oswell’s recommended site of care, saving an average of $75 per appointment. The company also said it is using AI and medical-economics programs to identify pharmacy and utilization outliers. Management expects these capabilities to generate tens of millions of dollars in annual savings. Oscar highlighted growing interest in individual coverage health reimbursement arrangements, or ICHRA, particularly from small businesses in healthcare and professional services. Blackley discussed the company’s ICHRAx platform, built on an electronic data exchange acquired last year. He said the platform includes competing insurers and is intended to help employers move from defined-benefit coverage toward defined-contribution arrangements. Oscar expects membership churn to rise in the second half as CMS continues program-integrity and eligibility-verification efforts. Blackley said the company’s membership was essentially flat in the second quarter because lapses were lower than expected, with some anticipated disenrollments delayed into the latter half of the year. Management now expects monthly churn to be closer to twice its prior estimate of 1% to 2%. Blackley characterized the change as primarily a timing issue and said it does not affect the company’s full-year revenue outlook. Oscar said it does not recognize revenue for members it expects to be disenrolled and has incorporated the effects of payment-integrity actions into its guidance. Looking toward 2027, Bertolini said Oscar sees a rational pricing environment and believes the ACA market can remain stable or grow, absent major regulatory changes. The company plans to provide further details on its growth strategy at its Investor Day on Sept. 16. Oscar Health, trading on the New York Stock Exchange under the ticker OSCR, is a technology-driven health insurance company headquartered in New York, New York. Founded in 2012 by Mario Schlosser, Joshua Kushner and Kevin Nazemi, the company was built with the goal of simplifying healthcare coverage and enhancing member experience. Oscar leverages a proprietary digital platform to streamline plan enrollment, claims administration and member support, distinguishing itself in the individual, family and small group insurance markets. The company's primary products include on-exchange individual and family medical plans under the Affordable Care Act, off-exchange plans, as well as Medicare Advantage offerings. This instant news alert was generated by narrative science technology and financial data from MarketBeat in order to provide readers with the fastest reporting and unbiased coverage. Please send any questions or comments about this story to [email protected]. The article "Oscar Health Q2 Earnings Call Highlights" was originally published by MarketBeat. View MarketBeat's top stocks for August 2026.

Image source: The Motley Fool. Thursday, Aug. 6, 2026 at 8:00 a.m. ET Vice President of Treasury and Investor Relations - Chris Potochar Chief Executive Officer - Mark Bertolini Chief Financial Officer - Scott Blackley Operator: Good morning. My name is Jeannie, and I will be your conference operator today. At this time, I would like to welcome everyone to Oscar Health's Second Quarter 2026 Earnings Conference Call. [Operator Instructions] I will now turn the call over to Chris Potochar, Vice President of Treasury and Investor Relations. Chris Potochar: Good morning, everyone. Thank you for joining us for our second quarter 2026 earnings call. Mark Bertolini, Oscar Health's Chief Executive Officer; and Scott Blackley, Oscar Health's Chief Financial Officer, will host this morning's call. This call can also be accessed through our Investor Relations website at ir.hioscar.com. Full details of our results and additional management commentary are available in our earnings release, which can be found on our Investor Relations website at ir.hioscar.com. Any remarks that Oscar makes about the future constitute forward-looking statements within the meaning of safe harbor provisions under the Private Securities Litigation Reform Act of 1995. Actual results may differ materially from those indicated by those forward-looking statements as a result of various important factors, including those discussed in our Annual Report on Form 10-K for the period ended December 31, 2025, and the quarterly report on Form 10-Q for the period ended March 31, 2026, each as filed with the Securities and Exchange Commission and other filings with the SEC, including our quarterly report on Form 10-Q for the period ended June 30, 2026, to be filed with the SEC. Such forward-looking statements are based on our current expectations as of today. Oscar anticipates that subsequent events and developments may cause estimates to change. While the company may elect to update these forward-looking statements at some point in the future, we specifically disclaim any obligation to do so. The call will also refer to certain non-GAAP measures. A reconciliation of these measures to the most directly comparable GAAP measures can be found in the second quarter earnings press release available on the company's Investor Relations website at ir.hioscar.com. We have not provided a quantitative reconciliation of estimated full year 2026 adjusted EBITDA as described on this call to GAAP net income because Oscar is unable without making unreasonable efforts to calculate certain reconciling items with confidence. With that, I will turn the call over to our CEO, Mark Bertolini. Mark Bertolini: Good morning. Thank you, Chris, and thank you all for joining us. Today, Oscar Health announced strong second quarter 2026 results with significant year-over-year improvement across all core metrics. Oscar delivered record profitability for the first half of 2026, generating $1.1 billion in earnings from operations -- and $1 billion in net income. In the second quarter, revenue grew 70% year-over-year to $4.9 billion. MLR improved 12 points to 79.2% year-over-year with utilization moderately favorable to our expectations. Our SG&A expense ratio improved 450 basis points to a record low of 14.2%, reflecting disciplined expense management, technology-driven efficiencies and continuing operating leverage. Earnings from operations increased by $619 million year-over-year to $389 million. Our performance demonstrates superior execution against the fundamentals of our strategy. Disciplined pricing, differentiated consumer products and a scalable technology platform work together to fuel individual market growth. We are raising our full year 2026 outlook based on the strength of our operating performance and our model built for long-term profitable growth. Now I will share our view on trends in the individual market, then I'll dive into our business highlights. The individual market is vital to our nation's economy and was built for the labor market now taking shape. The market is expanding coverage for people outside of traditional employer plans, including a growing number of entrepreneurs, gig workers, part-time employees and early retirees. Over the past decade, the market drove down the uninsured rate and prevented billions in uncompensated care. Over the next decade, its role will only grow as people move between full-time jobs, contract work and retirement at twice the rate of prior generations. AI will accelerate that shift. Our nation's leaders should promote policies that put the next generation of American workers in charge of choosing their health care. Oscar is leading the charge with portable coverage and experiences that meet the expectations of the people powering our economy. The future of American Healthcare depends on a durable individual market, and 2026 trends reinforce our conviction in its long-term strength. Total ACA membership stands at 19.2 million, down 12% year-over-year, tracking favorable to our pricing assumptions and reflecting continued consumer demand. Wakely's first claim-based report of 2026 market morbidity is also favorable to our expectations, suggesting potential upside to our outlook. We expect further market contraction and remain cautious with only 4 months of morbidity data, but we expect both trends to remain favorable to our pricing assumptions. Looking ahead to 2027, we anticipate a rational pricing environment with rates that reflect the effects of CMS' program integrity efforts. Now I will review our business highlights. Oscar ended the second quarter with 2.96 million members, up 46% year-over-year. Membership reflects above-market open enrollment growth and solid retention. Our consumer products designed around clinical, lifestyle and cultural needs are driving higher member satisfaction, and we continue to launch features that help members find high-value care and manage costs. We are also building momentum in ICHRA with steady growth in demand from small businesses in the health care and professional services industries. Our technology continues to differentiate the member experience. This quarter, we piloted a radiology program with our Oswell Agent. Oswell uses our members' claims history and clinical interactions to initiate their next step for care. It confirms coverage, guides members to high-quality providers based on cost, location and availability and shows estimated savings from switching facilities. 1 in 4 members choose Oswell's recommended site of care and save $75 on average per appointment. We will expand this capability to additional procedures using care standards from leading centers of excellence. AI is powering operations across benefits, billing, claims, clinical care and member support. Our claims platform delivers 98.7% first pass accuracy and processes most claims in under 48 hours. We are also deploying AI in medical economics programs to identify cost signals early and act before they become trends. Pharmacy is a clear example. Our models analyze pharmacy activity alongside utilization, provider, broker and member data to flag outliers. Root cause analysis identifies the drivers so our teams respond with precision. We expect these capabilities to generate tens of millions of dollars in annual savings. Oscar's technology is transforming the economics of the business. The team is embedding intelligence into all core workflows across our platform, making it smarter and more efficient with every deployment. As membership grows, we can serve more members without adding headcount at the same rate. That scale fuels operating leverage, expands margins and bends the medical cost trend for us and for our members. In summary, Oscar delivered a strong second quarter and record profitability in the first half of 2026. The fundamentals of the business are strong. Our performance is favorable to plan, and our improved 2026 outlook reflects that momentum. We are entering the second half of the year from a position of strength with the technology, scale and operating discipline to deliver profitable growth. The ACA is the only health care market where private insurers compete directly for the consumer. Our job is to give consumers real choices, real price transparency and reward what they value. When that happens, the competitive market does what it does best. It drives out inefficiency, accelerates innovation and lowers costs. Oscar is defining that future. We are replacing one-size-fits-all coverage with solutions that make health care as easy to use as any other consumer product. Our results reflect the team's focused execution across our products, platform and strategy. We will outline how we translate that performance into durable growth and long-term value at our Investor Day on September 16. I will now turn the call over to Scott. Scott? Richard Blackley: Thank you, Mark, and good morning, everyone. This morning, we reported strong second quarter results, and we are raising our full year 2026 outlook to reflect our operating performance. Through the first half of the year, we delivered record profitability of approximately $1 billion of net income or $3.16 per diluted share. The fundamentals of the business are strong, and our results are favorable to our plan. Let me now turn to details on second quarter performance. We ended the second quarter with 2.96 million effectuated members, an increase of 46% year-over-year, driven by above-market growth during open enrollment and solid retention. Total revenue was $4.9 billion, an increase of 70% year-over-year, driven by higher membership and rate increases, partially offset by higher risk adjustment payable accrual. The second quarter medical loss ratio was 79.2%, an improvement of nearly 12 points year-over-year. Recall that in the prior year period, we recorded the entire first half impact of the 2025 risk adjustment true-up in the second quarter. The year-over-year MLR improvement was driven by our disciplined pricing strategy and a strong current year performance compared to the market reset experienced a year ago. We also benefited from favorable prior period reserve development in the quarter. Now I'll spend a moment on risk adjustment. In the second quarter, we received the final 2025 CMS risk adjustment report, which was approximately $160 million favorable to our first quarter accruals and fully recognized in the quarter. We also received the first risk adjustment report for 2026, covering claims through April, which showed market morbidity tracking quite favorable to both our pricing and first quarter accruals. With only 4 months of claims in the data, we recognized only a small portion of that favorability, which we believe is appropriate at this stage in the year. Through the first 6 months of the year, risk adjustment as a percentage of direct premiums was approximately 20%, consistent with our expectations for the full year. Overall year-to-date utilization was moderately favorable to our expectations. By category, inpatient, professional and pharmacy utilization were favorable, while outpatient was elevated through the first 6 months of the year. On administrative expenses, we delivered another record low SG&A expense ratio. The second quarter SG&A expense ratio was 14.2%, a 450 basis point year-over-year improvement and the lowest in the company's history. The improvement was primarily driven by disciplined expense management, including an increasing impact from technology and AI initiatives, fixed cost leverage and lower risk adjustment as a percentage of premium. We reported earnings from operations of $389 million in the second quarter, a $619 million year-over-year improvement. Operating margin was 8%, a 16-point improvement year-over-year. Net income was $362 million, a $590 million increase year-over-year. Adjusted EBITDA was $415 million in the quarter, an increase of $615 million year-over-year. Through the first 6 months of 2026, our results reflect disciplined execution and strong year-over-year improvement across all key metrics. Shifting to the balance sheet. Our capital position remains very strong. We ended the second quarter with approximately $10.2 billion of cash and investments, including $462 million of cash and investments at the parent. As of June 30, 2026, our insurance subsidiaries had approximately $1.9 billion of capital and surplus, including $994 million of excess capital, which was driven by our strong operating performance. Let me now turn to updates on our 2026 full year guidance. Based on our first half performance, we are raising our full year earnings from operations guidance to a range of $500 million to $700 million, an increase of $250 million from our prior outlook. We continue to expect total revenues of $18.7 billion to $19 billion. We now expect full year MLR in the range of 81.5% to 82.5%, an improvement of 90 basis points at the midpoint from our prior outlook. On administrative expenses, we now expect our SG&A expense ratio to be in the range of 15.6% to 16.1%, an improvement of 20 basis points at the midpoint. We continue to expect adjusted EBITDA to run roughly $115 million above earnings from operations. Our improved outlook reflects our strong first half performance, including favorable prior period development and market morbidity trends and an expectation of increasing membership churn in the back half of the year as CMS program integrity processes continue. As I mentioned, the market morbidity data that we received for claims through April was quite favorable to our expectations. Given this early stage in the year, we have not taken full credit for that favorability in our outlook. If the favorability holds as claims develop, that could present a tailwind to our full year outlook. In closing, our disciplined execution drove strong operating results and record profitability through the first half of the year. We are confident in our improved 2026 outlook and are on track to deliver our strongest performance to-date. With that, let's turn the call over to the operator for the Q&A portion of our call. Operator: [Operator Instructions] And your first question comes from Andrew Mok with Barclays. Andrew Mok: On utilization trends, you noted inpatient and professional and pharmacy was favorable, but outpatient was elevated. Can you elaborate a bit on what you saw there, particularly on the outpatient side and how you're thinking about the pace of utilization for the balance of the year? Mark Bertolini: Yes. Andrew, in outpatient, I would say that there are a handful of areas that we're paying attention to. Honestly, none of them is particularly outsized. And what I think is most important there is that we're seeing stability in these trends. And so while outpatient is a bit elevated, as you mentioned, we're seeing the other categories running favorable. And at this point, the trends are stable. And so the utilization looks very reasonable and is favorable to our -- to what we would expect it at this point in the year. Andrew Mok: Great. And I appreciate all the comments that AI is accelerating the shift to untraditional employment. I would love to hear what you're observing in the market driving that commentary and how that impacts your view of intermediate-term growth. Mark Bertolini: A couple of things on AI. First, we don't see the massive unemployment that a lot of other CEOs have painted a very dark picture of. We see a transition to different kind of job groups. And those are in the gig economy that's in part-time work, that's in multiple part-time jobs, that's in early retirees. And in that economy, employer-based insurance doesn't necessarily work well. There are a lot of people who don't have coverage as a result. And we are now working with some very large groups around that on part-time employees, people who work in multiple places with multiple part-time jobs. So as that market evolves, we see it as a huge opportunity for ICHRA in expanding the total TAM of the marketplace. In small group and middle-market, there's 115 million lives alone that we think have some -- will have some impact on [ employment ] in growing these other jobs in our economy. As far as AI goes, internally, our investment is not something that we do separately. Every business owner has a platform. That platform has engineers, product management, AI and business people evaluating how we can advance every one of our platforms every day to reduce friction for our members and for the providers we work with. And it's through those -- that analysis that we fund those projects with expected returns and expected investments. I note that in the press you hear of billions of dollars being spent by our competitors. And I would just make the point that we have one platform, we have one data set. As a result, we start with a huge advantage in being able to use AI at scale without having to make the investments in platform integration and data rationalization that a lot of our competitors do. And that has been -- that is why we are so far ahead in deploying AI at scale in the organization. Operator: Your next question comes from the line of Jessica Tassan with Piper Sandler. Jessica Tassan: So first question is just can you clarify that the 2025 reconciliation accounts for about 80 basis points of the 90 basis point MLR revision at the midpoint? And then just do you mind helping us kind of understand what you're seeing? I mean, you helped a little bit on utilization or a lot on utilization for this year, but just how do we get comfortable that you all have visibility into utilization just despite kind of the potentially the current effect of higher deductibles? How do we get comfortable essentially with the reiterated or the slightly raised core MDR guide? Mark Bertolini: Yes, Jess, starting off with MLR and the impacts from PPD. I would say that MLR, excluding PPD in the first quarter was a little bit over 82% -- and MLR comes is impacted by 2 components of prior year development. There's the piece that impacts risk adjustment, which we talked about getting the final CMS report, and that was roughly $160 million. There's also favorable development around claims. And so when you look at all those things, I consider those core parts of the business, and they give us confidence that the reserves that we're booking our pricing are headed in the right direction. So everything there looks appropriate and stable. Turning to your question on utilization and our confidence in the back half. I would just make a couple of observations. One, at this point in the year, we've had enough time to have a pretty good sense of the risk of the membership that we've got. I would say that it is consistent with our expectations. As I talked about with utilization, we're seeing trends that are stable. We're not seeing anything that looks to be kind of pushing and running from us. So when I step back and look at all of the components of our operations and our business, I am pleased with the stability and with the clarity and visibility that we have into our current book. And with the weekly report that we got in the first quarter, it confirms a lot of what we thought was going to be shaping up for this year in terms of -- I would characterize as the reduction in membership that we had all planned for, looks like that's coming in a bit lighter. That results in morbidity in the marketplace that's likely going to be less than what we priced for and could present a tailwind to our full year outlook. Richard Blackley: And I would add one more thing, Jess. In our management process and the way we operate the business and our operating plans, we actually create targets for affordability and reducing the actual trend we put into pricing. And we measure the results of our programs that we're developing, including some of the things we talked about with AI today that go against those targets. And so we're constantly measuring the opportunity and what we call flares where we see hotspots in the utilization, making sure we go after those immediately that we're acting quickly with precision and moving that utilization back to where we expect it to be. Operator: Your next question comes from the line of Parker Snure with Raymond James. Parker Snure: Just curious on how you guys are thinking about the 2027 rate cycle. We're seeing some of the preliminary rate filings beginning to roll through. But just generally, how are you thinking about positioning of your rates within the market and baking in conservatism for all things that could happen? Mark Bertolini: Parker, thanks for the question. We believe the market so far has been rational. And again, we price by market. So we look at opportunities by market. And so comparing the overall rate filings is probably not a good way of measuring it. Just take a look at what happened in '26 based on our overall rate filings versus our competitors. We've done quite well in spite of what people thought was underpricing. And so I would suggest so far rational. We still have another bite at the apple as we go forward. And as we look at what could happen with the NBPP or the stay, which we probably don't think will be released at all this year. But in event it does, we have an opportunity to change product and pricing should we need to do that. So we have more time. We're on it every day. We already have plans in place on how to do changes if we need to make them. So we're pretty confident that we're in a good place. Parker Snure: And if I can just get a follow-up. I know it's early, but how are you thinking about the overall ACA market enrollment in 2027 at this point in time? Do you think -- I know there's still some unknowns, but do you think it's relatively flat or you see some more declines or just some general thoughts there? Mark Bertolini: We think that based on what's already in place through regulation because we are reacting to a few program integrity efforts through CMS that are coming through in regulation and review that absent any dramatic changes to the NBPP, which again, we don't think will happen, that the market -- that a lot of the program integrity efforts have been built into the marketplace. We think we're through all the enhanced premium tax credits impact from 2026. So we think that the market has opportunity in it. Obviously, we're not resting on our laurels and we're looking at things like ICHRA and other markets to grow our total available market, but we believe there's still opportunity for the market to remain stable or grow and for us to take share. Operator: Your next question comes from the line of Stephen Baxter with Wells Fargo. Stephen Baxter: I wanted to follow up on utilization. It looks like medical expense was up 17% quarter-over-quarter, and I think probably 20% on a PMPM basis. Could you give us some color on what's driving that? It seems like a much sharper increase than what you might normally expect. Obviously, there's a lot of unusual dynamics this year. And then how should we think about kind of either the upward sloping of MLR or maybe medical cost expense PMPM as we move through the balance of the year? And then I have a follow-up. Mark Bertolini: Yes. Thanks, Steve. I think that in utilization, we're really seeing and translating that into MLR and PMPMs. We're really just seeing the seasonal pattern of the membership that we have this year. And so as we've talked about, we saw some transition in our book from silver into higher deductible Bronze plans. We also have more gold membership. So I do think that the seasonality that we're expecting is emerging. I would expect that's going to continue to pick up into the second half as members burn through their deductibles. So MLR from the first 6 months, I would expect it to continue to trend higher quarterly and the seasonal patterns will look, I think, pretty similar to what we've seen historically. Stephen Baxter: Got it. Okay. And then just to follow up on that. You have obviously a lot of new members this year. You also have like a lot of new members in new products. Can you speak at all to the performance of new members and some of the new products that you rolled out this year, like the new Bronze and the new Gold that you're speaking to? Mark Bertolini: Yes. I would say that when I look across the book, we're really pretty pleased with the performance overall of the new products, membership behaving, as I talked about, pretty consistently with our expectations. The risk in the book looks very much with what we would have expected. So we're not really seeing any deviations in any particular metal. It is an interesting situation where Bronze now has a lot of members that moved out of Silver and moved into Bronze. Gold has members that moved out of Silver and now in Gold. So you can't really look at these metals in the same way historically. So we do a lot of -- trying to refactor how these metals are going to perform. And against those adjusted expectations, I would say things are performing consistent or favorable to our plan. Operator: Your next question comes from the line of Scott Fidel with Goldman Sachs. Scott Fidel: First question, just hoping you could maybe just decompress the SG&A performance was quite strong in the quarter. Maybe walk us through that. And then were there any timing dynamics that in terms of expenses that may be sort of played out in other quarters? And then also maybe just talk about as you look towards the rest of this year, how you're thinking about investment spending that may be in SG&A as well? Richard Blackley: Yes, sure. So SG&A, I would just say that, as Mark talked about, we've really made tremendous progress in SG&A. And in the -- both in the quarter and in the 6 months, I don't think I would call out anything that is driving the trend. What I observed there is that there are higher taxes this year, exchange fees that we're experiencing. We're basically offsetting that by efficiencies in our variable costs that are really being driven by a lot of the AI and other technology innovations that we've been putting into place. So I would characterize our SG&A as being -- what you've seen in the first 6 months is a good indication of the rest of the year. I do think that we'll see the fourth quarter will be the highest SG&A ratio on a percentage basis. That is typically the pattern for us, and that really reflects our investments in future growth and getting ready for '27 enrollment. So from here, pretty stable third quarter and then an increase in the fourth quarter. Scott Fidel: Okay. And then I just wanted to ask about just with some of the shifts that you have in the metal mix and with the shift to more Bronze, how that affects the risk adjustment accruals that you're making? Clearly, it seems like utilization is coming in favorable, but at the same time, you also have this -- the metal mix shift, I guess, and now that you've had the Wakely report. And if I could just layer into that -- into the metal mix question because it's interesting you guys have that perspective, I guess, because obviously, there's a big focus on seasonality in the exchanges with the market mix shift to Bronze from Silver, but you have the perspective of having both the Bronze and the Gold. How was that seasonality playing out so far this year in terms of -- did you see what would be expected in terms of different type of seasonality around the higher cost sharing Bronze and sort of lower utilization as a result of that in the first half compared to Gold or was there any other observations that you found interesting there? Richard Blackley: Yes. I would say that on the metals, against our refactored expectations, again, recognizing that a lot of our members that were historically Silver are now in different metals. The performance there is coming in, in line to favorable with our expectation and the risk is as we would have expected to slightly favorable. Just a comment about risk adjustment. So in general, we're a risk adjustment payer because our members skew younger. They're healthier. We tend to be more urban than the overall market, and that is particularly the case as we grow. Risk adjustment really is driven by morbidity, not necessarily plan design. I talked about this in the past, but the risk adjustment formula is intended to neutralize the impacts of the different benefit designs by different metals. That's always not a perfect exact science in terms of how that -- those algorithms work there. But what we are seeing is we're getting what we would expect in terms of claims activity and the risk adjustment benefits from that. So at this point in the year, which we do have now, we're 6 months into the year. So we've got some visibility into this and all things are looking like they're running as we would have expected. Operator: Your next question comes from the line of Raj Kumar with Stephens Inc. Raj Kumar: Maybe kind of focusing on ICHRA and I guess, yesterday's announcement with a partnership that you are undergoing with ICHRAx. So curious on what type of capabilities that offers to your current platform? And kind of how should we be thinking about kind of the kind of pace going into 2027 for that offering? Mark Bertolini: So ICHRAx is an EDE that we built off of an ACA approved, CMS-approved Electronic Data Exchange that we purchased last year. We mentioned it in, I think, the third or fourth quarter call last year. And that EDE has a lower cost structure than current ACA alternatives as well as agreements to have all of our competitors as part of that platform. So we now have the rails upon which to run ICHRA, which has not been the case in the past. How do we convert members from a defined benefit to a defined contribution, how does the employer step aside and allow these people to sign up. And what happens is because network is always an issue for employers because they have to have wide area networks at higher cost, by the way, than we do in the ACA with narrow networks, those employers want to know how we can get member coverage. And what we tell them is that we have all of our competitors on the platform and the members can select whatever competitor they want that has the network they need. So all of a sudden, we have the largest PPO network in the nation at narrow network rates. And what that allows those employers to do is to stand down on the issue of is there enough network coverage. Couple that with benefit selection tools that we're using with brokers to get people into the right plan design allows savings as high as 26% of the employers' cost versus what the employee would need to pay by following this option. So that EDE, that ICHRAx invites all of our competitors to the table. They've all joined. We all get access to all those members as they convert. And then the real opportunity is on the front end of the conversion with the employer where they spend sizable sums to convert from defined benefit to defined contribution where the revenue is not regulated like insurance revenue doesn't require reserves and has higher margins. And so that will allow for competition in that market. ICHRAx is then connected to Lucie where we are now starting to have -- we have Allstate Health. We have Aflac. We have a lot of retailers that want to get access to our members. Mark Cuban is talking to us about coming on board. Other organizations that want to join us to be able to offer retail opportunities to our members once they have to shop for their out-of-pocket costs as members in the program. Raj Kumar: Got it. And then maybe as a follow-up, just kind of more on the technical side. I guess, kind of looking at your short-term investments that kind of increased quite a bit quarter-over-quarter. So curious on kind of that underlying dynamic given just the cash kind of being pretty steady quarter-over-quarter. So any color on that would be helpful. Mark Bertolini: I mean the investment is to get the platform ready. And so -- but it's not sizable. It's not a big, big number. It's a pretty easy-to-use platform and easy to change platform. Operator: Your next question comes from the line of Jonathan Yong with UBS. Jonathan Yong: I guess when you guys think about the pricing that's being put into next year from yourself in the market, do you guys kind of see yourselves getting incrementally better G&A leverage just given kind of your productivity efforts and the pricing that's going to go into the market or should it be a little bit more muted relative to the improvement that you're seeing this year? Mark Bertolini: I appreciate the question. Look, I think that -- we set out some long-term targets, and one of those was around SG&A ratio, and we're basically getting there a year ahead of plan. I still think there's opportunity for more leverage if we grow the top line faster than our cost structure, that's going to be a positive in terms of that ratio. So given everything we're doing with AI and focusing on running the most effective and efficient operation we can, I think there's more opportunity for improvement going forward. Jonathan Yong: Okay. And then I think in your prepared remarks, you said there was an expectation of increasing membership churn in the back half of the year. I just wanted to be sure, is that in line with the previous expectation of that 1% to 2% per month or is it going to be a little bit more elevated than is typical? Mark Bertolini: Yes. So we ended the second quarter, as we talked about, with 2.96 million effectuated members, which is basically flat in the second quarter. And so the -- what we saw in that quarter basically was significantly better than our expectations. So lapse was quite favorable. Some of the lapse that we expected in the quarter, we -- is related to CMS eligibility and data issues that we now expect to happen in the second half of the year. So I would expect that churn, we previously thought it was 1% to 2%. It's probably going to be closer to twice that amount. That's really a timing move and doesn't impact revenue. You can see that we reaffirmed our full year guidance on revenue. So I would characterize that again more as just a delay in those members being unenrolled versus anything more fundamental in terms of the ongoing churn that we would expect in the business. Operator: Your next question comes from the line of Michael Ha with Baird. Hua Ha: Another firstly, a clarification to MLR. Scott, you mentioned first quarter MLR ex PPD was, I think, a little over 82%. For this quarter, if I exclude the favorable PPD and prior year risk adjustment true-up, I'm getting something around like 85.2%. Is that roughly correct? I know you mentioned utilization was moderately favorable. I just wanted to confirm the 85.2% is what you're thinking about as underlying MLR. And if there's anything to note even on like monthly cadence, was the favorability pretty consistent throughout the quarter, any moderation of trend? Richard Blackley: Yes. As I mentioned, my math says that if you exclude the favorable PPD in the quarter, you do get an MLR that's approximately 82%. So we'll have to do some reconciliation with your numbers after the call. But I would say that we have seen, again -- total favorable prior period development of $164 million in the second quarter. Year-to-date, that's $232 million. So those are the numbers that you should be excluding if you're looking to try to adjust our second quarter or 6-month MLRs. Hua Ha: Okay. And multiparter on risk adjustment. So if I exclude the prior year true-up, I'm getting current year risk adjustment transfer is about, I think, 17.9% of premiums, a lot better than the 20% expectation. So first question, is the implied transfer payable percentage in your updated guide for back half still 20%? I mean, I guess, for full year? And what does it imply for back half? And Mark, you mentioned the June Wakely could actually suggest upside to your updated guide. Curious if you could elaborate more on that. What does that layer of possible conservatism look like within the guide? How much confidence do you have in the durability of it through year-end? And also, like what types of, I guess, scenarios in the back half of the year do you think could even pose a threat to full year expectations when it comes to risk adjustment? Is it membership attrition running hotter or something else? Mark Bertolini: Yes. So on risk adjustment, I would recommend that you look at the first half as the best lens in terms of what's going on with risk adjustment. And in the first half, risk adjustment was 20%, which is -- continues to be our expectation for the full year. So there was modest favorability, as you talked about in Q2 related to the final CMS report that's embedded in the quarter. But overall, again, every quarter, we're doing a kind of a year-to-date true-up and what our expectation is around risk adjustment. And so the fact that we were at 20% for the 6 months, and we continue to expect 20% for the full year, I think, shows that things are progressing as we expected. Operator: Your next question comes from the line of Dave Windley with Jefferies. David Windley: Mark, you -- the company invested a lot in working with your sales channel to navigate members between products for 2026. In your earlier answer, you talked about '27 being relatively stable. I'm wondering if you also think your tier mix will be relatively stable or do you see more of that navigation? And then I think a product like HelloMeno is new to '26. Do you have any plans of similar sort for '27? Mark Bertolini: Yes, we do have new products rolling out. We continue to innovate and by market. So we expect that there will be more opportunity to move people into better plan designs that work for them and to demonstrate more of our capability of developing these kinds of products, along with the tools like the radiology tool I talked about in our talking points, which goes alongside the pharmacy tool. We talked about in the last quarter, we have more of those coming along so that it assist people. And our whole idea is can we reduce friction at every opportunity when we invest in the platform, thereby reducing barriers for people to get the care they need when they need it. So yes, we have more navigation to do. It's not as significant as the level we did last year with the enhanced premium tax credits. It's more about delivering on new products in certain markets. Operator: Your next question comes from the line of Kevin Fischbeck with Bank of America. Kevin Fischbeck: Just want to try to help bridge the increase in guidance. Obviously, with Q1, you didn't change guidance, but you had $164 million of PPD this quarter, $68 million of PPD in Q1 and then $160 million of '25 risk adjustment this year. So those things all seem incremental to your original guidance, so like $392 million, but you raised the income guidance by $250 million. So can you help kind of bridge the delta between those numbers? Richard Blackley: Yes. So first of all, the 2025 risk adjustment of $160 million is the largest part of the total Q2 favorable prior period development of $164 million. So the RA is a subset of the $164 million. As I talked about, there's $232 million of total favorable prior period development through the 6 months. And we raised guidance by $250 million. We think that the core business is running really well. When we got the first '26 Wakely report, I would say that, that was -- again, it's quite favorable to our expectations. We know that report is based on early-stage claims, and there will be some evolution there in terms of how that evolves. And so we're not banking on all that favorability coming through. That's not part of our guide. But I would just say like we feel like there's more tailwinds than headwinds in our outlook, and we're well-positioned to have a strong rest of the year. Kevin Fischbeck: Okay. Great. And then I guess one of your competitors talked about the IDR process being a headwind to them. And obviously, that can be a bigger issue that the more narrow the networks are. So just love to hear kind of your thoughts about how the IDR process is working relative to your expectations. Mark Bertolini: Yes. I mean I think IDR is part of the business. I think we support the ultimate goal, which is to protect members from cost surprises. Those are all good things. But for us, I would say that IDR is not a trend driver. Operator: Your next question comes from the line of Justin Lake with Wolfe Research. Justin Lake: Mark, Scott, you guys have both mentioned CMS program integrity efforts and the impact on second half enrollment a few times during the call, and I want to follow up here. I talked to one of your peers who indicated that in June, CMS sent out a list of 1 million members that they believe might be unauthorized due to a lack of social security numbers and 0 claims. I'd also heard that about 80% of these members are in Florida and Texas, which I know are 2 big states for the company. So the -- I know you expect some impact here in the second half. So curious if you could share with us how many of these million members were Oscar members? What percentage do you think you can hold on to or save? And what financial impact do you expect the potential loss of the rest of these members might have on your results given lower utilization of these folks? Mark Bertolini: Yes. I appreciate the question. I would just say we continue to see CMS focusing on eligibility verification. And that is a topic that they have been really focused on throughout the year. In my comments, I talked about the fact that we expected to see some disenrollments in the second half that we had thought would start happening in really Q2. So that is something that we continue to anticipate. With respect to the financial implications, we don't recognize revenue for members that we anticipate are going to be disenrolled. We set up those -- the payments that we received from CMS as a liability on the balance sheet. And all of the impacts of what's going on across the industry with payment integrity is baked into our full year guidance. Justin Lake: Got it. Is there any way you could share how big that assumption is relative to what CMS sent you here in terms of the enrollment that they expect might not be correct? Mark Bertolini: Well, I would put it this way. We're reviewing the file that we received. And there are a number of cases where we know that people were authorized appropriately. There are a number of cases where we've actually had contact with people. So their list was based on a set of assumptions that they went through on the file. The actual result will depend on our ability to go through those files, and we are going through them actively. And the appropriate accommodations for what we might think being lapsed members are in our guidance that we shared with you. Richard Blackley: Yes. And I think we've got good visibility into that. So I don't think this is an area that we see as a risk to our -- to the rest of the year. Operator: There are no further questions at this time. Ladies and gentlemen, that concludes today's call. Thank you all for joining. You may now disconnect. 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This article is a transcript of this conference call produced for The Motley Fool. While we strive for our Foolish Best, there may be errors, omissions, or inaccuracies in this transcript. As with all our articles, The Motley Fool does not assume any responsibility for your use of this content, and we strongly encourage you to do your own research, including listening to the call yourself and reading the company's SEC filings. Please see our Terms and Conditions for additional details, including our Obligatory Capitalized Disclaimers of Liability. The Motley Fool has no position in any of the stocks mentioned. The Motley Fool has a disclosure policy. Oscar Health (OSCR) Q2 2026 Earnings Call Transcript was originally published by The Motley Fool

Our analysts just identified a stock with the potential to be the next Nvidia. Tell us how you invest and we'll show you why it's our #1 pick. Tap here. Achieved record first-half profitability with $1 billion in net income, driven by disciplined pricing and a scalable technology platform that expanded operating leverage. Attributed significant MLR improvement to a strong current-year performance and a market reset compared to the prior year, alongside favorable utilization trends. Leveraged the proprietary 'Oswell' AI agent to guide 1 in 4 members to high-value care sites, resulting in an average savings of $75 per appointment. Utilized AI-powered medical economics models to identify pharmacy cost outliers early, expecting these capabilities to generate tens of millions in annual savings. Positioned the individual market as a vital solution for the evolving labor market, specifically targeting gig workers, part-time employees, and early retirees. Maintained a competitive advantage through a single-platform data architecture, allowing for AI deployment at scale without the integration costs faced by competitors. Reported that 2026 market morbidity is tracking favorably to pricing assumptions, suggesting the market contraction is less severe than initially anticipated. Raised full-year 2026 earnings from operations guidance to $500 million - $700 million, reflecting strong first-half momentum and favorable morbidity trends. Anticipates a rational 2027 pricing environment with rates reflecting CMS program integrity efforts and the potential for market stability or growth. Expects increasing membership churn in the second half of 2026 as CMS eligibility verification processes accelerate, though revenue guidance remains reaffirmed. Assumes full-year MLR will land between 81.5% and 82.5%, incorporating an expectation of seasonal utilization increases as members meet deductibles. Projects continued SG&A efficiency with a full-year ratio of 15.6% to 16.1%, despite planned fourth-quarter investments for 2027 open enrollment. Recognized a $160 million favorable risk adjustment true-up for 2025 in the second quarter following the final CMS report. Launched 'ICHRAx', an electronic data exchange platform designed to facilitate employer transitions from defined benefit to defined contribution plans. Noted that while outpatient utilization was slightly elevated in the first half, it remains stable and is offset by favorability in inpatient and pharmacy categories. Flagged ongoing CMS program integrity reviews regarding member eligibility, noting that the company does not recognize revenue for members anticipated to be disenrolled. One stock. Nvidia-level potential. 30M+ investors trust Moby to find it first. Get the pick. Tap here. Management noted that while outpatient costs are slightly elevated, the trend is stable and offset by favorability in professional and pharmacy categories. Expects MLR to trend higher quarterly in the back half as members burn through deductibles, following historical seasonal patterns. Management views AI as a catalyst for shifting workers toward the gig economy and part-time roles rather than causing mass unemployment. This shift expands the Total Addressable Market (TAM) for Individual Coverage Health Reimbursement Arrangements (ICHRA) among small and mid-market employers. Management is actively reviewing CMS files regarding unauthorized members and noted that many on the list have had verified contact or claims. Confirmed that the financial impact of potential disenrollments is already baked into the full-year guidance and risk assumptions. Achieved long-term SG&A targets a year ahead of schedule due to variable cost efficiencies driven by AI and fixed cost leverage. Indicated further room for margin expansion if top-line growth continues to outpace the underlying cost structure.

Oscar Health, Inc. (OSCR) came out with quarterly earnings of $1.1 per share, beating the Zacks Consensus Estimate of $0.43 per share. This compares to a loss of $0.89 per share a year ago. These figures are adjusted for non-recurring items. This quarterly report represents an earnings surprise of +155.81%. A quarter ago, it was expected that this company would post earnings of $1.21 per share when it actually produced earnings of $2.07, delivering a surprise of +71.07%. Over the last four quarters, the company has surpassed consensus EPS estimates three times. Oscar Health, which belongs to the Zacks Insurance - Multi line industry, posted revenues of $4.88 billion for the quarter ended June 2026, missing the Zacks Consensus Estimate by 0.92%. This compares to year-ago revenues of $2.86 billion. The company has not been able to beat consensus revenue estimates over the last four quarters. The sustainability of the stock's immediate price movement based on the recently-released numbers and future earnings expectations will mostly depend on management's commentary on the earnings call. Oscar Health shares have added about 109.5% since the beginning of the year versus the S&P 500's gain of 12.8%. While Oscar Health has outperformed the market so far this year, the question that comes to investors' minds is: what's next for the stock? There are no easy answers to this key question, but one reliable measure that can help investors address this is the company's earnings outlook. Not only does this include current consensus earnings expectations for the coming quarter(s), but also how these expectations have changed lately. Empirical research shows a strong correlation between near-term stock movements and trends in earnings estimate revisions. Investors can track such revisions by themselves or rely on a tried-and-tested rating tool like the Zacks Rank, which has an impressive track record of harnessing the power of earnings estimate revisions. Ahead of this earnings release, the estimate revisions trend for Oscar Health was favorable. While the magnitude and direction of estimate revisions could change following the company's just-released earnings report, the current status translates into a Zacks Rank #1 (Strong Buy) for the stock. So, the shares are expected to outperform the market in the near future. You can see the complete list of today's Zacks #1 Rank (Strong Buy) stocks here. It will be interesting to see how estimates for the coming quarters and the current fiscal year change in the days ahead. The current consensus EPS estimate is -$0.22 on $4.75 billion in revenues for the coming quarter and $0.63 on $18.92 billion in revenues for the current fiscal year. Investors should be mindful of the fact that the outlook for the industry can have a material impact on the performance of the stock as well. In terms of the Zacks Industry Rank, Insurance - Multi line is currently in the bottom 40% of the 250 plus Zacks industries. Our research shows that the top 50% of the Zacks-ranked industries outperform the bottom 50% by a factor of more than 2 to 1. Pelagos Insurance Capital (PLGO), another stock in the same industry, has yet to report results for the quarter ended June 2026. The results are expected to be released on August 12. This insurance and reinsurance company is expected to post quarterly earnings of $0.88 per share in its upcoming report, which represents a year-over-year change of +633.3%. The consensus EPS estimate for the quarter has been revised 8.5% lower over the last 30 days to the current level. Pelagos Insurance Capital's revenues are expected to be $645.88 million, up 10.9% from the year-ago quarter. Want the latest recommendations from Zacks Investment Research? Today, you can download 7 Best Stocks for the Next 30 Days. Click to get this free report Oscar Health, Inc. (OSCR) : Free Stock Analysis Report Pelagos Insurance Capital Limited (PLGO) : Free Stock Analysis Report This article originally published on Zacks Investment Research (zacks.com). Zacks Investment Research

This article first appeared on GuruFocus. Total Revenue: $4.9 billion in Q2 2026, up 70% year-over-year. Medical Loss Ratio (MLR): Improved 12 points year-over-year to 79.2%. SG&A Expense Ratio: Record low of 14.2%, a 450 basis point improvement year-over-year. Earnings from Operations: $389 million in Q2, up $619 million year-over-year. Net Income: $362 million in Q2, up $590 million year-over-year. Adjusted EBITDA: $415 million in Q2, up $615 million year-over-year. Membership: 2.96 million effectuated members, up 46% year-over-year. First-Half Net Income: Approximately $1 billion, or $3.16 per diluted share. Cash and Investments: Approximately $10.2 billion at end of Q2, including $462 million at the parent. Insurance Subsidiary Capital: Approximately $1.9 billion capital and surplus, including $994 million excess capital. Full-Year 2026 Guidance: Earnings from operations raised to $500 million-$700 million; MLR expected at 81.5%-82.5%; SG&A ratio expected at 15.6%-16.1%. Warning! GuruFocus has detected 5 Warning Sign with OSCR. Is OSCR fairly valued? Test your thesis with our free DCF calculator. Release Date: August 06, 2026 For the complete transcript of the earnings call, please refer to the full earnings call transcript. Oscar Health Inc (NYSE:OSCR) delivered record profitability in the first half of 2026, with $1.1 billion in earnings from operations and $1 billion in net income. Second-quarter revenue grew 70% year-over-year to $4.9 billion, driven by a 46% increase in membership to 2.96 million. The medical loss ratio (MLR) improved by 12 points year-over-year to 79.2%, reflecting disciplined pricing and favorable utilization trends. The SG&A expense ratio hit a record low of 14.2%, a 450 basis point improvement, driven by AI-driven efficiencies and operating leverage. The company raised its full-year 2026 earnings from operations guidance to $500-$700 million, a $250 million increase, citing strong performance and favorable market morbidity trends. Oscar Health Inc (NYSE:OSCR) is expanding its ICHRA platform (ICHRA-X), which includes all competitors, to capture the growing defined contribution market and potentially lower employer costs by up to 26%. Outpatient utilization was elevated in the first half of 2026, although management noted the trends were stable and not outsized. The company expects increasing membership churn in the back half of 2026 due to CMS program integrity efforts, with churn potentially reaching twice the previously expected 1%-2% monthly rate. Oscar Health Inc (NYSE:OSCR) remains cautious about the 2026 risk adjustment data, recognizing only a small portion of the favorability from the first Wakely report due to the early stage of claims data. The company anticipates higher SG&A ratio in the fourth quarter due to investments in future growth and preparation for 2027 enrollment. There is uncertainty regarding the 2027 rate environment, with potential impacts from the MBPP (Marketplace Benchmark Premium Program) and ongoing CMS program integrity efforts, although management views the market as rational so far. The company faces potential financial impacts from CMS's list of potentially unauthorized members, though it has baked these assumptions into its guidance and is actively reviewing the files. Q: Can you clarify the impact of the 2025 risk adjustment reconciliation on the MLR guidance revision, and how should we think about the visibility into utilization trends for the back half of the year?A: Richard Blackley (CFO) confirmed that the favorable prior period development (PPD), including the $160 million final 2025 CMS risk adjustment report, is a core part of the business and gives confidence in reserve adequacy. He noted that utilization trends are stable and favorable to expectations, with the Wakely morbidity report suggesting the market is tracking lighter than priced, which could present a tailwind to the full-year outlook. Q: How are you thinking about the 2027 rate cycle and the positioning of your rates within the market?A: Mark Bertolini (CEO) stated that the market has been rational so far, and Oscar prices by market rather than comparing overall rate filings. He noted that Oscar performed well in 2026 despite perceived underpricing by competitors. He also mentioned that if the MBPP (Market-Based Pricing Program) is released, there is an opportunity to adjust products and pricing, but they do not expect it this year. Q: Can you elaborate on the elevated outpatient utilization trends and how you are thinking about the pace of utilization for the balance of the year?A: Richard Blackley (CFO) explained that while outpatient utilization is slightly elevated, no single area is outsized, and the trends are stable. Inpatient, professional, and pharmacy utilization are favorable, and overall utilization is tracking favorably to expectations. He expects seasonal patterns to continue, with MLR trending higher in the second half as members burn through deductibles. Q: Can you provide more detail on the ICHRA-X partnership and its capabilities, and how should we think about the pace of that offering into 2027?A: Mark Bertolini (CEO) detailed that ICHRA-X is an EDE (Electronic Data Exchange) built on a CMS-approved platform purchased last year. It offers a lower cost structure than current ACA alternatives and includes all competitors on the platform, creating the largest PPO network at narrow network rates. This allows employers to save up to 26% on costs. The platform is connected to Lucy, with partners like Allstate Health and Aflac, and Mark Cuban in discussions, expanding retail opportunities for members. Q: Can you help bridge the increase in guidance, given the favorable PPD and risk adjustment items?A: Richard Blackley (CFO) explained that the $232 million of total favorable PPD through six months is a key driver of the $250 million guidance raise. He noted that the core business is running well, and the first 2026 Wakely report is favorable, but they are not banking on all of that favorability in the guide. He emphasized there are more tailwinds than headwinds in the outlook. Q: What is driving the sharp increase in medical expense quarter-over-quarter, and how should we think about the MLR trajectory for the rest of the year?A: Richard Blackley (CFO) attributed the increase to seasonal patterns of the current membership, which includes a shift from silver to higher-deductible bronze plans and more gold membership. He expects MLR to trend higher quarterly in the second half as members meet deductibles, with seasonal patterns similar to historical trends. Q: Can you discuss the performance of new members and new products, like the new bronze and gold plans?A: Richard Blackley (CFO) stated that the performance of new products and membership is consistent with expectations. The risk in the book looks as expected, with no significant deviations in any metal. He noted that bronze and gold now have members who moved from silver, so they refactor expectations for these metals, and performance is coming in line to favorable. Q: Can you provide more color on the strong SG&A performance and any timing dynamics or investment spending for the rest of the year?A: Richard Blackley (CFO) said the SG&A improvement is driven by efficiencies in variable costs from AI and technology innovations, offsetting higher taxes and exchange fees. He expects the first-half SG&A ratio to be a good indicator for the rest of the year, with the fourth quarter typically the highest due to investments in future growth and 2027 enrollment preparation. Q: How is the metal mix shift affecting risk adjustment accruals, and what observations have you seen on seasonality between bronze and gold?A: Richard Blackley (CFO) explained that risk adjustment is driven by morbidity, not plan design, and the formula is intended to neutralize benefit design differences. He noted that claims activity and risk adjustment benefits are running as expected. Against refactored expectations for the new metal mix, performance is in line to favorable, with risk slightly favorable. Q: Can you share details on the CMS program integrity efforts and the potential impact on second-half enrollment, particularly regarding the list of members flagged for potential disenrollment?A: Richard Blackley (CFO) stated that CMS continues to focus on eligibility verification, and they expect some disenrollments in the second half that were previously anticipated in Q2. He noted that revenue is not recognized for members expected to be disenrolled, and all impacts are baked into full-year guidance. Mark Bertolini (CEO) added that they are actively reviewing the CMS file, and appropriate accommodations for potential lapsed members are included in guidance. For the complete transcript of the earnings call, please refer to the full earnings call transcript.