Oscar Health, Inc.是一家领先的健康保险提供商，专注于根据《平价医疗法案》（ACA）提供个人市场计划，已发布其 2025 年 10-K 表格报告。该报告全面概述了公司的财务表现、业务运营、战略举措以及在不断变化的医疗市场中面临的挑战。
财务亮点
<ul>
<li>总收入：117.01 亿美元，比去年增长 28%，主要得益于会员增加和 2025 年开放注册期间的市场增长。</li>
<li>运营收益（亏损）：-3.96 亿美元，较 2024 年的 5700 万美元有所下降，反映出运营费用的增加。</li>
<li>归属于 Oscar Health, Inc.的净收入（亏损）：-4.43 亿美元，较 2024 年的 2500 万美元有所下降，主要由于医疗费用增加和市场发病率上升。</li>
<li>基本每股收益（EPS）：-1.69 美元，较 2024 年的 0.11 美元有所下降，反映出年度净亏损。</li>
<li>稀释每股收益（EPS）：-1.69 美元，较 2024 年的 0.10 美元显著下降，表明每股收益大幅减少。</li>
</ul>
业务亮点
<ul>
<li>收入细分：Oscar 的业务主要由其在个人市场的健康保险产品驱动，包括 ACA 的五个金属类别：灾难性、青铜、白银、黄金和铂金。公司还通过其 +Oscar 平台为提供者和支付方提供服务，并通过其经纪服务和注册平台产生收入。</li>
<li>地理表现：在 2025 年，Oscar 在 18 个州提供覆盖，并计划在 2026 年扩展到 20 个州。佛罗里达州和德克萨斯州是重要市场，截至 2025 年 12 月 31 日，佛罗里达州的会员人数最高，达到 1,179,934 人。</li>
<li>销售单位：截至 2025 年 12 月 31 日，Oscar 约有 200 万有效会员，较 2024 年的 1,676,970 人有所增长。会员增长主要归因于个人和小型团体市场。</li>
<li>新产品发布：在 2025 年，Oscar 收购了早期阶段的企业，以增强其在个人覆盖健康报销安排（ICHRA）方面的能力，包括 Lucie, Inc.、IHC Specialty Benefits, Inc.和 Healthinsurance.org, LLC。</li>
<li>未来展望：Oscar 旨在通过将 ICHRA 作为雇主团体覆盖的颠覆性力量，建立领先的消费者健康市场。公司计划扩展其产品并改善其技术平台，以增强会员参与度和运营效率。</li>
<li>运营效率：Oscar 的技术平台是其业务的关键驱动因素，提供支持会员参与和运营效率的云原生基础设施。该平台包括人工智能和机器学习技术，以增强个性化和服务交付。</li>
<li>监管影响：预计到 2025 年底，增强的高级保费税收抵免（eAPTCs）到期以及新的 CMS 法规将影响 2026 年的注册和市场动态。Oscar 正在监测这些变化，以相应调整其战略。</li>
</ul>
战略举措
<ul>
<li>扩展与收购：Oscar Health, Inc.已采取战略举措，通过收购 Lucie, Inc.、IHC Specialty Benefits, Inc.和 Healthinsurance.org, LLC.来扩展其在个人市场的能力。这些收购旨在增强公司的直接注册技术平台并多样化其产品。</li>
<li>市场退出：公司已通过不续签 Cigna+Oscar 小型团体安排退出小型团体市场，从而将资源集中于其核心的个人和家庭计划。</li>
<li>资本管理：Oscar Health, Inc.在资本管理方面积极，通过发行可转换高级票据进行融资。在 2025 年，公司发行了 4.1 亿美元的可转换高级票据，到期日为 2030 年，并管理了 2.5 亿美元 2031 年票据的转换为 A 类普通股。公司利用配额再保险安排有效管理资本需求，并向其健康保险子公司进行资本注入，以维持法定资本水平。此外，Oscar Health, Inc.还进行了上限回购交易，以减轻可转换票据可能带来的稀释。</li>
<li>未来展望：展望未来，Oscar Health, Inc.计划继续利用其技术平台推动增长并改善会员体验。公司旨在通过战略再保险安排和潜在的资本市场活动有效管理其资本。Oscar Health, Inc.还专注于维持流动性和资本充足性，以支持其增长举措并应对医疗市场的监管变化。</li>
</ul>
挑战与风险
<ul>
<li>监管和运营风险：公司面临与战略执行和增长管理相关的重大风险，包括扩展到新市场和业务线，这可能会产生大量费用和监管挑战。获得监管批准和许可证的需求，以及满足健康保险市场的要求，给运营和财务表现带来了风险。此外，健康保险子公司的资本需求可能会显著增加，可能超过净收入，并需要通过债务或股权获得额外资金。</li>
<li>竞争压力：公司还面临竞争压力，这可能迫使价格降低，从而影响盈利能力。没有先前经验进入新业务线可能导致意外的负债和财务损失。+Oscar 平台的货币化涉及获得必要的许可证和批准，这可能无法在预期的时间内实现，从而带来运营和财务风险。</li>
<li>监管变化：监管变化，例如 CMS 项目完整性规则和 OBBBA，可能会影响入学流程和 APTC 资格，从而影响公司的会员和财务状况。eAPTC 在 2025 年底到期带来了不确定性，2026 年的潜在续期可能导致运营中断和财务压力。</li>
<li>市场风险：公司面临市场风险，包括利率波动可能影响其投资组合的价值。不利的市场条件也可能影响流动性和满足融资需求的能力，从而可能影响运营和财务稳定。公司依赖配额分保来满足资本需求，这引入了额外风险，因为再保险条款或监管批准的变化可能需要筹集额外资本。</li>
<li>管理策略：管理层承认维持盈利能力的挑战，正如在 2025 年恢复亏损所示，而在 2024 年实现盈利。公司计划专注于扩大利润率和优化计划设计以改善财务表现。然而，考虑到市场条件和监管环境的波动，这些策略的成功仍然不确定。</li>
</ul>
SEC 文件：Oscar Health, Inc. [ OSCR ] - 10-K -2026 年 2 月 13 日

OSCR

OSCX

OSCG

Oscar Health, Inc. 发布了其 2025 年的 10-K 表格报告，强调总收入为 117 亿美元，比去年增长了 28%。然而，公司报告净亏损为 4.43 亿美元，主要由于医疗费用增加。Oscar 的会员人数增长至约 200 万，在佛罗里达州和德克萨斯州实现了显著扩张。公司专注于提升其技术平台和扩展产品，同时也面临监管和竞争挑战。战略举措包括收购以改善其注册技术，并逐步退出小型团体市场

Oscar Health, Inc., a leading health insurance provider specializing in individual market plans under the Affordable Care Act (ACA), has released its 2025 Form 10-K report. The report provides a comprehensive overview of the company's financial performance, business operations, strategic initiatives, and the challenges it faces in the evolving healthcare market.
<div class="lb-trans">Oscar Health, Inc.是一家领先的健康保险提供商，专注于根据《平价医疗法案》（ACA）提供个人市场计划，已发布其 2025 年 10-K 表格报告。该报告全面概述了公司的财务表现、业务运营、战略举措以及在不断变化的医疗市场中面临的挑战。
</div>Financial Highlights
<div class="lb-trans">财务亮点
</div><ul>
<li>Total Revenue: $11,701 million, a 28% increase from the previous year, driven by higher membership and above-market growth during the 2025 Open Enrollment.</li>
<li>Earnings (loss) from operations: $(396) million, compared to $57 million in 2024, reflecting increased operating expenses.</li>
<li>Net income (loss) attributable to Oscar Health, Inc.: $(443) million, compared to $25 million in 2024, primarily due to increased medical expenses and higher market morbidity.</li>
<li>Basic EPS: $(1.69), compared to $0.11 in 2024, reflecting the net loss for the year.</li>
<li>Diluted EPS: $(1.69), compared to $0.10 in 2024, indicating a significant decrease in earnings per share.</li>
</ul>
<div class="lb-trans"><ul>
<li>总收入：117.01 亿美元，比去年增长 28%，主要得益于会员增加和 2025 年开放注册期间的市场增长。</li>
<li>运营收益（亏损）：-3.96 亿美元，较 2024 年的 5700 万美元有所下降，反映出运营费用的增加。</li>
<li>归属于 Oscar Health, Inc.的净收入（亏损）：-4.43 亿美元，较 2024 年的 2500 万美元有所下降，主要由于医疗费用增加和市场发病率上升。</li>
<li>基本每股收益（EPS）：-1.69 美元，较 2024 年的 0.11 美元有所下降，反映出年度净亏损。</li>
<li>稀释每股收益（EPS）：-1.69 美元，较 2024 年的 0.10 美元显著下降，表明每股收益大幅减少。</li>
</ul>
</div>Business Highlights
<div class="lb-trans">业务亮点
</div><ul>
<li>Revenue Segments: Oscar's business is primarily driven by its health insurance offerings in the individual market, which include plans under the ACA's five metal categories: Catastrophic, Bronze, Silver, Gold, and Platinum. The company also generates revenue through its +Oscar platform, which serves providers and payors, and its brokerage services and enrollment platform.</li>
<li>Geographical Performance: In 2025, Oscar offered coverage in 18 states and expanded to 20 states for 2026. Florida and Texas were significant markets, with Florida having the highest membership at 1,179,934 members as of December 31, 2025.</li>
<li>Sales Units: As of December 31, 2025, Oscar had approximately 2.0 million effectuated members, reflecting growth from 1,676,970 members in 2024. The majority of membership growth was attributed to the individual and small group market.</li>
<li>New Product Launches: In 2025, Oscar acquired early-stage businesses to enhance its capabilities in Individual Coverage Health Reimbursement Arrangements (ICHRA), including Lucie, Inc., IHC Specialty Benefits, Inc., and Healthinsurance.org, LLC.</li>
<li>Future Outlook: Oscar aims to build the leading consumer health marketplace by focusing on ICHRA as a disruptive force in employer group coverage. The company plans to expand its offerings and improve its technology platform to enhance member engagement and operational efficiencies.</li>
<li>Operational Efficiency: Oscar's technology platform is a key driver of its business, providing a cloud-native infrastructure that supports member engagement and operational efficiencies. The platform includes AI and machine learning technologies to enhance personalization and service delivery.</li>
<li>Regulatory Impact: The expiration of enhanced Advanced Premium Tax Credits (eAPTCs) at the end of 2025 and new CMS regulations are expected to impact enrollment and market dynamics in 2026. Oscar is monitoring these changes to adapt its strategies accordingly.</li>
</ul>
<div class="lb-trans"><ul>
<li>收入细分：Oscar 的业务主要由其在个人市场的健康保险产品驱动，包括 ACA 的五个金属类别：灾难性、青铜、白银、黄金和铂金。公司还通过其 +Oscar 平台为提供者和支付方提供服务，并通过其经纪服务和注册平台产生收入。</li>
<li>地理表现：在 2025 年，Oscar 在 18 个州提供覆盖，并计划在 2026 年扩展到 20 个州。佛罗里达州和德克萨斯州是重要市场，截至 2025 年 12 月 31 日，佛罗里达州的会员人数最高，达到 1,179,934 人。</li>
<li>销售单位：截至 2025 年 12 月 31 日，Oscar 约有 200 万有效会员，较 2024 年的 1,676,970 人有所增长。会员增长主要归因于个人和小型团体市场。</li>
<li>新产品发布：在 2025 年，Oscar 收购了早期阶段的企业，以增强其在个人覆盖健康报销安排（ICHRA）方面的能力，包括 Lucie, Inc.、IHC Specialty Benefits, Inc.和 Healthinsurance.org, LLC。</li>
<li>未来展望：Oscar 旨在通过将 ICHRA 作为雇主团体覆盖的颠覆性力量，建立领先的消费者健康市场。公司计划扩展其产品并改善其技术平台，以增强会员参与度和运营效率。</li>
<li>运营效率：Oscar 的技术平台是其业务的关键驱动因素，提供支持会员参与和运营效率的云原生基础设施。该平台包括人工智能和机器学习技术，以增强个性化和服务交付。</li>
<li>监管影响：预计到 2025 年底，增强的高级保费税收抵免（eAPTCs）到期以及新的 CMS 法规将影响 2026 年的注册和市场动态。Oscar 正在监测这些变化，以相应调整其战略。</li>
</ul>
</div>Strategic Initiatives
<div class="lb-trans">战略举措
</div><ul>
<li>Expansion and Acquisitions: Oscar Health, Inc. has undertaken strategic initiatives to expand its capabilities in the individual market by acquiring Lucie, Inc., IHC Specialty Benefits, Inc., and Healthinsurance.org, LLC. These acquisitions are aimed at enhancing the company's direct enrollment technology platform and diversifying its offerings.</li>
<li>Market Exit: The company has exited the small group market by not renewing its Cigna+Oscar Small Group arrangement, allowing it to focus resources on its core individual and family plans.</li>
<li>Capital Management: Oscar Health, Inc. has been active in capital management through the issuance of convertible senior notes. In 2025, the company issued $410 million in aggregate principal amount of convertible senior notes due 2030, and also managed the conversion of $250 million of its 2031 Notes into Class A common stock. The company has utilized quota share reinsurance arrangements to manage capital requirements efficiently and has made capital contributions to its Health Insurance Subsidiaries to maintain statutory capital levels. Additionally, Oscar Health, Inc. has entered into capped call transactions to mitigate potential dilution from convertible notes.</li>
<li>Future Outlook: Looking ahead, Oscar Health, Inc. plans to continue leveraging its technology platform to drive growth and improve member experiences. The company aims to manage its capital efficiently through strategic reinsurance arrangements and potential capital market activities. Oscar Health, Inc. is also focused on maintaining liquidity and capital adequacy to support its growth initiatives and navigate regulatory changes in the healthcare market.</li>
</ul>
<div class="lb-trans"><ul>
<li>扩展与收购：Oscar Health, Inc.已采取战略举措，通过收购 Lucie, Inc.、IHC Specialty Benefits, Inc.和 Healthinsurance.org, LLC.来扩展其在个人市场的能力。这些收购旨在增强公司的直接注册技术平台并多样化其产品。</li>
<li>市场退出：公司已通过不续签 Cigna+Oscar 小型团体安排退出小型团体市场，从而将资源集中于其核心的个人和家庭计划。</li>
<li>资本管理：Oscar Health, Inc.在资本管理方面积极，通过发行可转换高级票据进行融资。在 2025 年，公司发行了 4.1 亿美元的可转换高级票据，到期日为 2030 年，并管理了 2.5 亿美元 2031 年票据的转换为 A 类普通股。公司利用配额再保险安排有效管理资本需求，并向其健康保险子公司进行资本注入，以维持法定资本水平。此外，Oscar Health, Inc.还进行了上限回购交易，以减轻可转换票据可能带来的稀释。</li>
<li>未来展望：展望未来，Oscar Health, Inc.计划继续利用其技术平台推动增长并改善会员体验。公司旨在通过战略再保险安排和潜在的资本市场活动有效管理其资本。Oscar Health, Inc.还专注于维持流动性和资本充足性，以支持其增长举措并应对医疗市场的监管变化。</li>
</ul>
</div>Challenges and Risks
<div class="lb-trans">挑战与风险
</div><ul>
<li>Regulatory and Operational Risks: The company faces significant risks related to its strategy execution and growth management, including the expansion into new markets and lines of business, which may incur substantial expenses and regulatory challenges. The need to obtain regulatory approvals and licenses, as well as meeting Health Insurance Marketplaces' requirements, poses a risk to operational and financial performance. Additionally, capital requirements for Health Insurance Subsidiaries could increase significantly, potentially exceeding net income and requiring additional funding through debt or equity.</li>
<li>Competitive Pressures: The company also faces competitive pressures that may force price reductions, impacting profitability. Entering new business lines without prior experience could result in unexpected liabilities and financial harm. The monetization of the +Oscar platform involves obtaining necessary licenses and approvals, which may not be achieved on the expected timeline, posing operational and financial risks.</li>
<li>Regulatory Changes: Regulatory changes, such as the CMS Program Integrity Rules and the OBBBA, could impact enrollment processes and APTC eligibility, affecting the company's membership and financial condition. The expiration of eAPTCs at the end of 2025 introduces uncertainty, with potential renewal in 2026 causing operational disruptions and financial strain.</li>
<li>Market Risks: The company is exposed to market risks, including interest rate fluctuations that could affect the value of its investment portfolio. Adverse market conditions may also impact liquidity and the ability to meet financing needs, potentially affecting operations and financial stability. The company's reliance on quota share reinsurance to meet capital requirements introduces additional risk, as changes in reinsurance terms or regulatory approvals could necessitate raising additional capital.</li>
<li>Management Strategies: Management acknowledges the challenges in maintaining profitability, as demonstrated by the return to losses in 2025 after achieving profitability in 2024. The company plans to focus on margin expansion and optimizing plan design to improve financial performance. However, the success of these strategies is uncertain, given the volatile market conditions and regulatory environment.</li>
</ul>
<div class="lb-trans"><ul>
<li>监管和运营风险：公司面临与战略执行和增长管理相关的重大风险，包括扩展到新市场和业务线，这可能会产生大量费用和监管挑战。获得监管批准和许可证的需求，以及满足健康保险市场的要求，给运营和财务表现带来了风险。此外，健康保险子公司的资本需求可能会显著增加，可能超过净收入，并需要通过债务或股权获得额外资金。</li>
<li>竞争压力：公司还面临竞争压力，这可能迫使价格降低，从而影响盈利能力。没有先前经验进入新业务线可能导致意外的负债和财务损失。+Oscar 平台的货币化涉及获得必要的许可证和批准，这可能无法在预期的时间内实现，从而带来运营和财务风险。</li>
<li>监管变化：监管变化，例如 CMS 项目完整性规则和 OBBBA，可能会影响入学流程和 APTC 资格，从而影响公司的会员和财务状况。eAPTC 在 2025 年底到期带来了不确定性，2026 年的潜在续期可能导致运营中断和财务压力。</li>
<li>市场风险：公司面临市场风险，包括利率波动可能影响其投资组合的价值。不利的市场条件也可能影响流动性和满足融资需求的能力，从而可能影响运营和财务稳定。公司依赖配额分保来满足资本需求，这引入了额外风险，因为再保险条款或监管批准的变化可能需要筹集额外资本。</li>
<li>管理策略：管理层承认维持盈利能力的挑战，正如在 2025 年恢复亏损所示，而在 2024 年实现盈利。公司计划专注于扩大利润率和优化计划设计以改善财务表现。然而，考虑到市场条件和监管环境的波动，这些策略的成功仍然不确定。</li>
</ul>
</div>SEC Filing: Oscar Health, Inc. [ OSCR ] - 10-K - Feb. 13, 2026
<div class="lb-trans">SEC 文件：Oscar Health, Inc. [ OSCR ] - 10-K -2026 年 2 月 13 日
</div>

Oscar Health, Inc.的 SEC 10-K 年度报告