Oscar Health, Inc. (NYSE:OSCR) Q3 2023 Earnings Call Transcript

Adam Ron: Thanks. And then, a couple of clarifications. So you talked about risk adjustment related to 2023. And I think one of your major competitors in Florida, according to a CMS report, kind of had like a shortfall on the risk adjustment payments they were supposed to make. And there was a CMS report saying it was like $200 million in Florida alone. And two of your competitors took kind of like reserve accruals, assuming that they wouldn’t be collecting on those payments. And so I’m wondering if that flows through to you at all and if you’ve already made an adjustment for that.

Scott Blackley: So just a couple of points, Adam. So, in the quarter, we recognized $27 million of risk adjustment benefit related to 2023. And with respect to risk adjustment, we are a payer, so we’re not exposed to collection of receivables that others in the market are exposed to. So the issues related to some exiting carriers don’t apply to us.

Adam Ron: Okay. Great. And then, my last question, as you pointed to $320 million, I think, of excess capital to subsidiaries. Do you think a lot of companies talk about having excess capital, and I’m not sure if the goal is to run some amount of excess capital, but given that amount, do you feel comfortable with if the market grows 20%, you grow 20%, that you can fund all of your statutory capital outlays through just that excess capital alone? Or do you actually need a substantial portion to come from the parent? Thanks.

Mark Bertolini: Yes. Great question. And so, as I said in my talking points, we do think that our excess capital positions us to fund the growth next year based on our estimates. And not only do we have excess capital, but that excess capital is backed by our quota share reinsurance. So we don’t fund 100% of the growth, and we will continue to use quota share next year, and we’ll evaluate our total footprint. I think that there’s a likelihood that we increase that modestly in certain states as opposed to taking it down. So I think that at this point, we feel very comfortable that we have the right level of excess capital to support growth in most of the scenarios that we see.

Operator: [Operator Instructions]. Your next question comes from the line of Josh Raskin from Nephron Research. Your line is open.

Josh Raskin: Hi, thanks. Two questions for me. The first one just on the new +Oscar arrangement with Stanford. Is that — is there any risk involved or just fees at risk or sort of any risk on the revenue side? And then, more importantly, can you speak to your strategy in the small group market? I’m just curious your views on expansion of the partnership with Cigna, how important the ICRA opportunity is longer-term and kind of what you’re trying to do with the small group market.

Mark Bertolini: Hi, Josh. On the Stanford Health agreement, there is no risk. All of our campaign builder relationships are no risk at this point. Don’t expect to have any in the future. This is really a program that reaches out and engages patients for medical groups and others. And so we see this being a high margin — high — a high margin product and a good growth product for us, just the first of many that will roll out through +Oscar. On the small group market, we are in the midst of putting together a strategy to approach ICRA, not only in the small group market, but the middle market. We continue to value our relationship with Cigna and that will continue to move forward. And we see the small group market evolving as well as the middle market, and we think that it will be more individualized and digitized and so we look forward to driving that change and looking for ultimately partners in distribution to be able to make that work across the country.