Oscar Health
36 named things its latest annual report says its results depend on, each in the company's own words. 17 of them are also named by other companies we've read.
Customers
Suppliers
AdventHealth
depends on · approximately 9%named as a riskWhen aggregating the payments we make to each provider through its local affiliates, AdventHealth, HCA Healthcare, and Baptist Health South Florida accounted for a total of approximately 9%, 8% and 7%, respectively, of total allowable medical costs for the year ended December 31, 2025.Risk factors (Item 1A)
HCA Healthcare
depends on · 8%named as a riskWhen aggregating the payments we make to each provider through its local affiliates, AdventHealth, HCA Healthcare, and Baptist Health South Florida accounted for a total of approximately 9%, 8% and 7%, respectively, of total allowable medical costs for the year ended December 31, 2025.Risk factors (Item 1A)
Baptist Health South Florida
depends on · 7%named as a riskWhen aggregating the payments we make to each provider through its local affiliates, AdventHealth, HCA Healthcare, and Baptist Health South Florida accounted for a total of approximately 9%, 8% and 7%, respectively, of total allowable medical costs for the year ended December 31, 2025.Risk factors (Item 1A)
CVS Caremark
depends onnamed as a riskFor example, Oscar delegates pharmacy claims and network management to a pharmacy benefit manager, CVS/Caremark.Risk factors (Item 1A)
Optum
depends onnamed as a riskWe also contract with Optum to provide us with access to its network of behavioral health providers and manage behavioral health benefits for us.Risk factors (Item 1A)
Also named by SOLV
Partners and platforms
Quota share reinsurance
depends on · approximately $683.1 million of additional capitalnamed as a riskFor example, we estimate that had we not had any quota share reinsurance arrangements in place, the Health Insurance Subsidiaries would have been required to hold approximately $683.1 million of additional capital as of December 31, 2025, which our parent company would have been required to fund to the extent the applicable Health Insurance Subsidiary did not have excess capital to cover the requirement.Risk factors (Item 1A)
Amazon Web Services (AWS)
depends onnamed as a riskOur operations depend on protecting the virtual cloud infrastructure hosted in AWS and GCP by maintaining its configuration, architecture, and interconnection specifications, as well as the information stored in these cloud platforms and which third-party internet service providers transmit.Risk factors (Item 1A)
Also named by AAON, ABNB, ADSK, AIOT, BLK, CARR, CG, COF and 56 more
Google Cloud Platform (GCP)
depends onnamed as a riskFor example, we currently offer our products through our website and online app using platforms for cloud computing provided by AWS, a provider of cloud infrastructure services, as well as the Google Cloud Platform (“GCP”).Risk factors (Item 1A)
Also named by CRWV, DDOG, DOCN, EXTR, FFIV, INTU, MDB, MELI and 5 more
HealthCare.gov
depends onnamed as a riskIn addition, the EDE platform depends on real-time integration with HealthCare.gov (the Federally Facilitated Marketplace), applicable state-based exchanges, and other third-party systems to determine eligibility, subsidies, and enrollment status.Risk factors (Item 1A)
Oscar Medical Group
depends onnamed as a riskWhile we expect that our relationship with the Oscar Medical Group will continue, a material change in our relationship with the Oscar Medical Group, whether resulting from a dispute among the entities or the loss of these relationships or contracts with the Oscar Medical Group, may temporarily disrupt our ability to provide virtual healthcare services to our members and could harm our business.Risk factors (Item 1A)
Insurance brokers
depends onnamed as a riskThe vast majority of our membership is acquired through the broker channel, and brokers typically use an EDE platform to enroll the members in plans offered on the Health Insurance Marketplace.Business (Item 1)
Other companies
2026 Revolving Credit Facility (JPMorgan Chase Bank)
$475.0 millionnamed as a riskOn February 6, 2026, we entered into a $475.0 million secured three-year revolving credit facility (the “2026 Revolving Credit Facility”), pursuant to that certain Credit Agreement, dated as of February 6, 2026, by and among the Company, as borrower, certain subsidiaries of the Company, as subsidiary guarantors, JPMorgan Chase Bank, N.A., as administrative agent, and the several lenders party thereto (the “2026 Credit Agreement”).Risk factors (Item 1A)
Thrive Capital
67.9% of the voting powernamed as a riskThrive Capital and Joshua Kushner (as the sole managing member of the Thrive General Partners), in particular, beneficially own 14.5% of our outstanding capital stock and hold 67.9% of the voting power of our outstanding capital stock as of December 31, 2025.Risk factors (Item 1A)
Competitors
Kaiser Foundation Health Plan of Georgia
competes withnamed as a riskBecause we have the next-lowest priced plans in the Georgia Health Insurance Marketplace, if the Suppression Order had remained in place, we might have acquired a disproportionate number of members who enroll after open enrollment, during an SEP.Risk factors (Item 1A)
Places
Florida
concentrated in · 1,179,934named as a riskThe states in which we operate that have the largest concentrations of revenues as of December 31, 2025 include Florida, Texas and Georgia.Risk factors (Item 1A)
Also named by ABR, ALLY, AN, AXP, AZO, BBY, BJ, BRO and 54 more
Texas
concentrated in · 358,910named as a riskThe states in which we operate that have the largest concentrations of revenues as of December 31, 2025 include Florida, Texas and Georgia.Risk factors (Item 1A)
Also named by ABR, AFRM, ALLY, AN, ASO, ASTS, ATO, AXP and 70 more
Hazards
Hurricanes
concentrated innamed as a riskFor example, natural disasters, such as a major hurricane affecting Florida, Georgia, or Texas, could have a significant impact on the health of a large number of our covered members.Risk factors (Item 1A)
Also named by AIG, AN, ASO, BAC, BBY, BJ, BPOP, BRO and 89 more
Regulators
Georgia Office of the Commissioner of Insurance
subject tonamed as a riskIf this were to occur, we could petition the Georgia Regulator to take additional actions to address the impact of the Suppression Order.Risk factors (Item 1A)
U.S. House Committee on the Judiciary
subject tonamed as a riskOn February 9, 2026, we received a subpoena from the Congressional Committee on the Judiciary requesting certain documents in connection with their examination of potential APTC fraud in the Health Insurance Marketplace.Risk factors (Item 1A)
National Committee for Quality Assurance (NCQA)
subject tonamed as a riskIf we fail to achieve and maintain accreditation from agencies, such as NCQA, we could lose the ability to offer our health plans on Health Insurance Marketplaces, or in certain jurisdictions, which would materially and adversely affect our results of operations, financial position, and cash flows.Risk factors (Item 1A)
Laws and programs
Affordable Care Act (ACA)
subject to · approximately 98% of our revenuenamed as a riskFor each of the years ended December 31, 2025 and 2024, approximately 98% of our revenue was derived from sales of health plans subject to regulation under the ACA, primarily comprised of policies directly purchased by individuals and families.Risk factors (Item 1A)
Also named by ABBV, ABT, ADP, AFL, BBSI, BRO, BWIN, COR and 8 more
Advanced Premium Tax Credits (APTC)
earns from · approximately 97%, and 92%, respectively, of the direct policy premiumsnamed as a riskDuring the years ended December 31, 2025, and 2024, approximately 97%, and 92%, respectively, of the direct policy premiums of our members were subsidized by APTCs, including eAPTCs under the ARPA.Risk factors (Item 1A)
One Big Beautiful Bill Act (OBBBA)
subject tonamed as a riskWhile we expect these provisions to result in a reduction in the number of enrolled individuals in the Health Insurance Marketplace, we cannot predict with certainty the magnitude of the impact on our membership or our business.Risk factors (Item 1A)
Also named by AA, ABR, ADI, ADM, ALB, AMAT, AMGN, AMKR and 121 more
False Claims Act
subject tonamed as a riskIf the risk adjustment data we submit are found to incorrectly overstate the health risk of our members, we may be required to refund funds previously received by us and/or be subject to penalties or sanctions, including potential liability under the FCA, which could be significant and would reduce our revenue in the year that repayment or settlement is required.Risk factors (Item 1A)
Also named by ACN, ASTS, CDW, CHE, CI, CVS, DGX, FLR and 13 more
No Surprises Act
subject tonamed as a riskThe uncertainty of the amount to pay to such providers and the possibility of subsequent adjustment of the payment could materially and adversely affect our business, financial condition, cash flows, or results of operations.Risk factors (Item 1A)
Pharmaceutical tariffs
exposed to its pricenamed as a riskAny such tariffs could result in higher costs for medical providers and facilities, higher pharmaceutical prices, higher costs of medical devices, and shortages of certain medicines and medical supplies.Risk factors (Item 1A)
NAIC Risk-Based Capital requirements
subject tonamed as a riskThese laws typically require increasing degrees of regulatory oversight and intervention if a company’s RBC declines below certain thresholds.Business (Item 1)
ACA Risk Adjustment Program
subject tonamed as a riskIn the fourth quarter, the Company received third party reports indicating that overall market morbidity had stabilized, but that the Company had lower-than-anticipated relative risk scores, which resulted in the Company increasing its estimated risk adjustment transfer payable as of December 31, 2025.Risk factors (Item 1A)
Also named by CNC
Enhanced Advanced Premium Tax Credits (eAPTC)
subject tonamed as a riskThe eAPTCs expired at the end of 2025, and this expiration, as well as any future elimination or reduction of other APTCs or subsidies, could make such coverage unaffordable to some individuals and thereby reduce overall participation in the Health Insurance Marketplaces and/or our membership.Risk factors (Item 1A)
CMS Program Integrity Rules
subject tonamed as a riskWe expect the Program Integrity Rules could result in a number of individuals in states where we operate losing eligibility for APTCs and could therefore reduce the number of individuals enrolled in the Health Insurance Marketplace.Risk factors (Item 1A)
Notice of Benefit and Payment Parameters (NBPP)
subject tonamed as a riskHowever, the NBPP includes a number of proposed provisions that, if adopted, could significantly impact the Health Insurance Marketplace.Risk factors (Item 1A)
Medicare Advantage RADV audits
subject tonamed as a riskOn June 12, 2025, CMS initiated the payment year 2019 Medicare Advantage RADV audits and expects to begin issuing payment year 2019 audit findings in mid-calendar year 2027.Risk factors (Item 1A)
Medicaid redeterminations
named as a riskWe believe that members who have enrolled in the ACA through the Medicaid redetermination process have increased the overall morbidity of the Health Insurance Marketplaces.Business (Item 1)