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FRESH Analysis Report
Jun 9, 2026
3 days ago · 85% complete · +6 refreshed

Oscar Health, Inc.

OSCR NYSE Categories PDF
Healthcare · Medical - Healthcare Plans
New York City, NY 10013, United States IPO 2021 hioscar.com Updated Jun 9, 4:23pm
Price
$27.22
Market Cap
$7.1B
Employees
2,400
Beta
2.39
Avg Volume
7,177,569
CEO
Mark Thomas Bertolini
Business Description

Oscar Health, Inc. operates as a health insurance provider across the United States. Its offerings include various health plans such as those for individuals and families, small businesses, and Medicare Advantage options. The company also features "+Oscar," a proprietary technology platform designed to facilitate engagement between healthcare providers, payers, and their members or patients. Additionally, Oscar Health provides reinsurance solutions. Originally established as Mulberry Health Inc., the firm officially changed its name to Oscar Health, Inc. in January 2021. It was founded in 2012 and maintains its main office in New York, New York.

Business History
Generated: May 1, 2026 4:29pm
Price Overview
Last updated: Jun 9, 2026 4:23pm (3d ago)
$27.22
-0.17 (-0.62%)
Day Range
$26.08 – $28.16
52-Week Range
$10.69 – $28.16
50-Day MA
$18.75
200-Day MA
$16.90
Volume
8,809,292.00
Analyst Price Targets
Low $16.00
Consensus $20.80
High $30.00
(21 analysts)
Share Structure
Outstanding 259,273,092.00
Float 246,755,135.00
Free Float 95.2%
High free float — 95.2% of shares trade freely, ~4.8% held by insiders/institutions
Very liquid — most shares trade freely. Low insider ownership can mean less management alignment, but makes large position sizing straightforward.
Price History (1 Year)
Last updated: Jun 9, 2026 4:28pm (3d ago)
Revenue & Net Income Trend
The directional story — useful even when net income is negative.
Last updated: Jun 9, 2026 4:23pm (3d ago)
Revenue
The top line — total sales before any costs or taxes are subtracted. A measure of how much business the company is doing.
Net Income
The bottom line — profit left after subtracting all expenses, interest, and taxes from revenue. Reflects accounting profitability, but includes non-cash items like depreciation, so it isn't the same as cash earned.
Operating Cash Flow
The real cash generated by the day-to-day business — selling products, paying suppliers, collecting from customers. Calculated from net income by adding back non-cash items and adjusting for timing (unpaid bills, unsold inventory). When OCF consistently lags net income, the reported profit may not be converting to real money.
Period Revenue Net Income Net Margin YoY/QoQ
Key Metrics
API Direct from provider CALC Derived from statements
Industry comparison last run: Jun 9, 2026 4:26pm
P/E Ratio (Price per dollar of earnings)
CALC
Stock Price / EPS (Diluted)
-16.11
Stock Price: $27.22
EPS (Diluted): -1.69
P/B Ratio (Price vs net asset value)
API
Stock Price / Book Value Per Share
3.86
Stock Price: $27.22
Total Equity: $977.65M
Shares: 262,388,000
EV/EBITDA (Total value vs operating profit)
API
Enterprise Value / EBITDA
139.52
Market Cap: $7.06B
Total Debt: $430.10M
Cash: $2.77B
EBITDA: -$391.05M
Enterprise Value (Takeover price (cap + debt - cash))
API
Market Cap + Total Debt - Cash
$1.4B
Market Cap: $7.06B
Total Debt: $430.10M
Cash: $2.77B
P/S Ratio (Price per dollar of revenue)
API
Stock Price / Revenue Per Share
0.32
Stock Price: $27.22
Revenue: $11.70B
Shares: 262,388,000
EV/Sales (Total value vs revenue — works when P/E can't)
API
0.12
Gross Margin (Revenue left after direct costs)
API
Gross Profit / Revenue
14.4%
Gross Profit: $1.68B
Revenue: $11.70B
Operating Margin (Revenue left after all operations)
API
Operating Income / Revenue
-3.4%
Operating Income: -$396.36M
Revenue: $11.70B
Net Margin (Revenue left as actual profit)
API
Net Income / Revenue
-3.8%
Net Income: -$443.15M
Revenue: $11.70B
ROE (Profit from shareholder equity)
API
Net Income / Total Equity
-3.3%
Net Income: -$443.15M
Total Equity: $977.65M
ROIC (Profit from all invested capital)
API
NOPAT / Invested Capital
0.5%
Operating Income: -$396.36M
Tax Rate: -1.3%
Equity: $977.65M
Total Debt: $430.10M
Cash: $2.77B
Current Ratio (Can it pay short-term bills)
API
Current Assets / Current Liabilities
0.95
Current Assets: $4.61B
Current Liabilities: $4.86B
Debt/Equity (Leverage — debt vs equity)
CALC
Total Debt / Total Equity
0.44
Short-Term Debt: $0.00
Long-Term Debt: $430.10M
Total Debt: $430.10M
Total Equity: $977.65M
Rev/Share (Top-line per share)
CALC
Revenue / Shares Outstanding
$44.60
Revenue: $11.70B
Shares: 262,388,000
Book Value/Share (Net assets per share)
CALC
(Total Assets - Total Liabilities) / Shares
$3.73
Total Equity: $977.65M
Shares: 262,388,000
FCF/Share (Real cash generated per share)
CALC
(Operating Cash Flow + CapEx) / Shares
$4.03
Operating CF: $1.09B
CapEx: -$36.37M
Shares: 262,388,000
CapEx is negative (outflow) — added to OCF to get FCF
Div Yield (Annual income from holding)
API
Last Annual Dividend / Stock Price
0.0%
Last Dividend: N/A
Stock Price: $27.22
Payout Ratio (Earnings paid out as dividends)
Dividends Paid / Net Income
Dividends Paid: N/A
Net Income: -$443.15M
Dividends paid not available in cash flow statement
Industry Benchmarks
Last run: Jun 9, 2026 4:26pm
Compares OSCR against LLM-researched typical ranges for its industry. One research call per industry, cached indefinitely — every stock in the same industry reuses the same baseline.
Deep Analysis
Last run: Jun 9, 2026 4:30:21 pm

Pre-flight intelligence scans the company first, then routes to the right analytical methods.

0 Company Classification — What type of company is this?
1 Industry Landscape — Where is the industry headed?
2 Company Momentum — Where is this company trending?
3 Forward Projection — 1Y & 2Y projected metrics (requires Layer 1 + 2)
4a DCF Valuation — Present value of future cash flows
Not applicable for Pre Profit Growth companies
4b Earnings Power Value — Floor value — worth with zero growth
Not applicable for Pre Profit Growth companies
4c Anchored PE — Industry PE adjusted for growth differential
Not applicable for Pre Profit Growth companies
4d Reverse DCF — What growth is the market pricing in?
Not applicable for Pre Profit Growth companies
4e Revenue-Based DCF — For growth/narrative companies (skip if mature earner)
4f Anchored P/S — Price-to-Sales peer comparison (skip if mature earner)
4g Scenario Analysis — Bull / Base / Bear (skip if mature earner)
4h Dividend Discount Model — For dividend/income stocks only
Not applicable for Pre Profit Growth companies
4i Book Value Analysis — For deep value / turnaround stocks only
Not applicable for Pre Profit Growth companies
4j Insider Activity — Are insiders buying or selling?
4f Cash Flow Quality — How trustworthy is the FCF?
4g Debt Maturity Risk — Can it handle its debt?
4h Macro Environment — Rates, market valuation, volatility
4i Sector Intelligence — How does this company compare within its sector?
4j Revenue Confidence — How reliable is the growth projection?
4k Sensitivity Analysis — How fragile is the fair value estimate?
Not applicable for Pre Profit Growth companies
4l Sector Demand Cycle — Is the sector in a boom, steady state, or contraction?
5 AI Investigation — Adaptive research engine (Claude)
5b Thesis Evaluation — What does the market believe? (narrative/platform stocks only)
6 Valuation Synthesis — Weighted verdict from all methods (requires Layer 4)
Income Statement (Annual)
Last updated: Jun 9, 2026 4:23pm (3d ago)
Metric 2021 2022 2023 2024 2025
Revenue $1.9B $4.1B $5.9B $9.2B $11.7B
Cost of Revenue $0 $0 $4.6B $7.3B $10.0B
Gross Profit $1.9B $4.1B $1.2B $1.8B $1.7B
Operating Expenses $2.5B $4.7B $1.5B $1.8B $2.1B
Operating Income -$570.6M -$610.1M -$235.6M $57.3M -$396.4M
Net Income -$572.6M -$606.3M -$270.7M $25.4M -$443.2M
EBITDA -$551.3M -$572.2M -$212.0M $89.3M -$391.1M
EPS $-3.19 $-2.85 $-1.22 $0.11 $-1.69
EPS (Diluted)
Balance Sheet (Annual)
Last updated: Jun 9, 2026 4:26pm (3d ago)
Metric 2021 2022 2023 2024 2025
Cash & Equivalents $1.1B $1.6B $1.9B $1.5B $2.8B
Total Current Assets $2.8B $4.1B $2.1B $2.8B $4.6B
Total Assets $3.3B $4.5B $3.6B $4.8B $6.3B
Current Liabilities $1.6B $3.3B -$175.3M $3.2B $4.9B
Long-Term Debt $0 $298.0M $298.8M $299.6M $430.1M
Total Liabilities $1.9B $3.6B $2.8B $3.8B $5.3B
Total Equity $1.4B $890.4M $804.0M $1.0B $977.6M
Retained Earnings -$2.0B -$2.6B -$2.9B -$2.9B -$3.3B
Cash Flow (Annual)
Last updated: Jun 9, 2026 4:23pm (3d ago)
Metric 2021 2022 2023 2024 2025
Operating Cash Flow -$181.7M $380.3M -$272.2M $978.2M $1.1B
Capital Expenditure -$25.9M -$29.0M -$25.6M -$27.9M -$36.4M
Free Cash Flow -$207.6M $351.3M -$297.7M $950.3M $1.1B
Acquisitions (net) $7.2M $0 $0 $0 $0
Debt Repayment
Dividends Paid
Stock Buybacks $0 $0 $0 $0 $0
Net Change in Cash $282.5M $454.9M $311.5M -$340.9M $1.3B
Analyst Estimates (Annual)
Last updated: Jun 9, 2026 4:25pm (3d ago)
Metric 2027 2028 2029 2030
Revenue $19.9B
$19.6B – $20.2B
$22.2B
$22.1B – $22.3B
$25.3B
$23.2B – $26.2B
$28.2B
$25.9B – $29.2B
EBITDA -$1.9B
-$2.0B – -$1.9B
-$2.2B
-$2.2B – -$2.1B
-$2.5B
-$2.5B – -$2.3B
-$2.7B
-$2.8B – -$2.5B
Net Income $546.4M
$12.7M – $636.8M
$554.1M
$498.0M – $610.3M
$582.5M
$519.7M – $608.9M
$739.9M
$660.1M – $773.5M
EPS
Growth Trends (YoY %)
Last updated: Jun 9, 2026 4:23pm (3d ago)
Metric 2022 2023 2024 2025
Revenue Growth +114.8% +42.1% +56.5% +27.5%
Gross Profit Growth +114.8% -70.4% +51.1% -8.8%
Operating Income Growth -6.9% +61.4% +124.3% -792.1%
Net Income Growth -5.9% +55.3% +109.4% -1,842.5%
EBITDA Growth -3.8% +62.9% +142.1% -537.9%
Insider Trading (Recent)
Last updated: Jun 9, 2026 4:23pm (3d ago)
Type codes PPurchase SSale AAward / grant MOption exercise FIn-kind (tax) CConversion GGift DReturn to issuer
All SEC Form 4 codes
Open market
P Purchase
Open-market or private purchase of shares.
S Sale
Open-market or private sale of shares.
Compensation (Rule 16b-3)
A Award / grant
Grant or award of securities (RSUs, options, etc.) under Rule 16b-3.
D Return to issuer
Securities disposed back to the company under Rule 16b-3.
F In-kind (tax)
Shares withheld or delivered to pay the option-exercise price or tax — not an open-market sale.
I Discretionary
Discretionary transaction under an employee plan — Rule 16b-3(f).
M Option exercise
Exercise or conversion of a derivative (option/RSU) into shares — exempt.
Derivatives
C Conversion
Conversion of a derivative security into the underlying shares.
E Short expiration
Expiration of a short derivative position.
H Long expiration
Expiration or cancellation of a long derivative position with value received.
O OTM exercise
Exercise of an out-of-the-money derivative.
X ITM exercise
Exercise of an in-the-money or at-the-money derivative.
Other exempt
G Gift
Bona fide gift of securities.
L Small acquisition
Small acquisition under Rule 16a-6.
W Inheritance
Acquisition or disposition by will or the laws of descent.
Z Voting trust
Deposit into or withdrawal from a voting trust.
Other
J Other
Other acquisition or disposition (explained in a Form 4 footnote).
K Equity swap
Transaction in an equity swap or similar instrument.
U Tender / buyout
Disposition via tender of shares in a change-of-control transaction.

Compensation-plan codes (A, D, F, M) are routine and rarely directional. Open-market P (buy) and S (sale) carry the most signal.

Date Insider Type Shares Price Value
2026-06-04 Lang Laura W A-Award 8,475.00 $0.00 $0
2026-06-04 Plouffe David A-Award 8,475.00 $0.00 $0
2026-06-04 Sankaran Sid A-Award 8,475.00 $0.00 $0
2026-06-04 Gassen William A-Award 8,475.00 $0.00 $0
2026-06-04 WITTMAN VANESSA AMES A-Award 8,475.00 $0.00 $0
2026-06-02 Baltrus Victoria S-Sale 1,091.00 $21.74 $23,718
2026-06-02 Baltrus Victoria S-Sale 432.00 $22.45 $9,698
2026-06-02 Schlosser Mario S-Sale 24,452.00 $21.74 $531,586
2026-06-02 Schlosser Mario S-Sale 9,668.00 $22.45 $217,047
2026-06-02 McAnaney Adam S-Sale 7,065.00 $21.74 $153,593
2026-06-02 McAnaney Adam S-Sale 2,794.00 $22.45 $62,725
2026-06-02 Liang Janet S-Sale 8,940.00 $21.74 $194,356
2026-06-02 Liang Janet S-Sale 3,535.00 $22.45 $79,361
2026-06-02 Blackley Richard Scott S-Sale 22,706.00 $21.74 $493,628
2026-06-02 Blackley Richard Scott S-Sale 8,977.00 $22.45 $201,534
2026-05-18 Blackley Richard Scott S-Sale 110,000.00 $25.03 $2.8M
2026-05-14 Blackley Richard Scott S-Sale 91,259.00 $23.10 $2.1M
2026-05-14 Blackley Richard Scott S-Sale 8,741.00 $23.79 $207,948
2026-04-09 Sankaran Sid A-Award 1,203.00 $0.00 $0
2026-04-09 Gassen William A-Award 1,418.00 $0.00 $0
Narrative Economics
The story the market is telling about this stock — the intangible X-factor (founder mythology, cult dynamics, TAM-of-imagination) that moves price beyond what cash flows alone explain. After Shiller, Narrative Economics.
No narrative profile yet for OSCR.
Delvantic AI Findings
Independent analyst synthesis · Delvantic - Cairn AI · generated 2026-06-09 16:31:00
Reviews the pipeline's own verdicts
Verdict Overvalued on extrapolated Q1 seasonality — fair value $16-20 absent APTC extension confirmation and a non-Q1 profitable quarter; avoid at $27, revisit after Q3'26 print and post-election healthcare policy clarity.

The Q1 2026 print is the entire ballgame here and the models are dramatically underweighting how strange it is. Revenue jumped from $2.81B in Q4'25 to $4.65B in Q1'26 — a 66% sequential leap — with net income swinging from -$352.6M to +$679M, a 14.6% margin in a business that has never sustained positive margins. For an ACA-exposed insurer this is not "operational leverage emerging" — it's the seasonal pattern of risk-adjustment true-ups and the front-loaded premium recognition that hits Q1 every year. Look at Q1'25: +$275M NI, then three consecutive losses totaling -$718M for the rest of the year. The TTM picture flatters a business whose full-year 2025 was -$443M on $11.7B of revenue, an operating margin of -3.4%. The synthesis verdict of "Reasonable Premium" is leaning on a number that historically reverses.

The 41% revenue CAGR is real but it's almost entirely ACA enrollment growth juiced by enhanced premium tax credits — the same subsidies scheduled to sunset at end of 2025 absent Congressional extension. This is the contrarian case the models barely touch: Oscar's membership base, MLR, and revenue trajectory are all levered to a policy variable that is currently a live political fight. If enhanced APTCs lapse, marketplace enrollment estimates drop 30-40% and the adversely-selected residual pool gets sicker — exactly the dynamic that blew up Oscar's MLR in 2021-2022. The "tech-enabled disruptor" narrative the pre-flight model entertains is doing real work here; +Oscar platform revenue is a rounding error and gross margin is 14.4%, which is normal-to-thin for a health plan, not a software business. P/S of 0.32 (not 0.6 as the synthesis claims — check the math, $7.06B / $11.7B = 0.60, so the synthesis is right and the ratios tile's 0.32 is using a different share base or TTM revenue near $22B annualizing Q1).

Insider activity is more bearish than "neutral" — five sales on June 2 totaling ~42,700 shares immediately followed by awards on June 4 looks like routine RSU vest-and-sell, but the absence of any open-market buying after a stock that's been volatile in the $13-30 range tells you insiders don't see it as cheap at $27. Balance sheet is fine — $2.77B cash, $1.06B FCF in 2025 despite GAAP losses (the FCF/NI divergence is float dynamics typical of insurers and shouldn't be read as "quality"). Current ratio of 0.95 is normal for an insurer but leaves no buffer if claims spike. The market-forces module failing to run and the EV/EBITDA of 139x being flagged unreliable means the synthesis is leaning on revenue-DCF and scenario work that almost certainly extrapolates the Q1'26 margin — a heroic assumption.

I dissent from the "Reasonable Premium" verdict. At $27.22 the stock prices in sustained mid-single-digit operating margins on a continued 20%+ growth ramp, which requires both APTC extension and structural MLR improvement Oscar has never demonstrated across a full year. Strip the Q1 seasonality and you have a company that lost $443M on $11.7B last year trading at 16x trailing FCF of $1.06B that is itself float-inflated. Fair value on a normalized 1-2% net margin (generous for a subscale ACA-focused plan) and 15% growth fade is closer to $16-20. The setup to own this is post-APTC-resolution clarity plus two consecutive non-Q1 quarters of positive NI — neither exists yet. The bull case isn't crazy, it's just being underwritten on one quarter of seasonal accounting.

GPT Critique
Second-opinion review · gpt-4o · generated 2026-06-09 16:31:06
Reviews the Opus findings above
Verdict I disagree with Opus's "overvalued" verdict — I see fair value closer to $18-22, slightly above their range, given cash flow strength, but acknowledge the risks tied to policy and cyclicality.

Examining Oscar Health's recent financial data, a few key trends emerge. The company shows substantial revenue growth, with a 41.3% CAGR over recent years, driven largely by ACA enrollment and enhanced premium tax credits. However, the net income volatility is striking, with significant losses in most quarters except for notable Q1 profitability, such as the $679M net income in Q1 2026 on $4.65B revenue. This suggests a pattern of front-loaded premium recognition and risk-adjustment true-ups, rather than sustainable operational leverage. The cash flow remains positive despite GAAP losses, indicating typical insurance float dynamics rather than true profitability. With a market cap of $7.06B and a P/S ratio of 0.6, the valuation leans heavily on expected future efficiencies and policy extensions.

Opus's analysis underlines the seasonal nature of Oscar's profits, particularly in Q1, which I agree is a critical point. The 66% sequential revenue jump from Q4 2025 to Q1 2026, coupled with a swing from negative to positive margins, is unlikely to be sustainable without policy support like the APTC. Their assessment that the market is pricing in structural improvements not yet demonstrated across a full year is valid. The insider sales and lack of open-market buying at $27 suggest insiders might not view the stock as undervalued, aligning with Opus's skepticism on current pricing.

Where I diverge is in the valuation perspective. Opus suggests a fair value of $16-20, hinging on normalized margins and growth assumptions. While I concur that the current price of $27.22 may be optimistic given the dependency on policy variables and cyclicality, I see potential for a slightly higher valuation range, around $18-22, considering the cash flow strength and possibility of renewed policy support. This acknowledges some of the operational progress and growth trajectory, albeit cautiously.

A careful skeptic might argue that both perspectives underestimate Oscar's tech-enabled potential and brand positioning within the healthcare market. They might point to the company's innovative platform and recent profitable quarters as indicators of a longer-term shift in healthcare economics. However, the inherent cyclicality and policy dependencies in the health insurance sector pose substantial risks that cannot be ignored.

Advanced Analysis Forensic deep-dive · two lenses
Two separate reads — Company Quality (is it a great business?) and Valuation (is it mispriced?), kept deliberately apart · 2026-06-09 20:33:33
Delvantic - Cairn AI
Pass at $27 — revisit in low $20s after MLR data 7/10
Mixed business (-4) trading at a rich price (-71) with the bull turnaround already in the tape — I'm not paying up for an insurer whose MLR just blew out.
The cruxWhether the 2025 gross-margin collapse from 20.1% to 14.4% was a one-off MLR spike or the start of a structural underwriting problem — everything else is secondary.
Company Quality
-4
Mixed
edge √Σ 138 · risk √Σ 142 · conf 6/10
Valuation / Mispricing
-71
Rich
edge √Σ 39 · risk √Σ 110 · conf 7/10
Liquidity & RunwayFortress Balance Sheet
DilutionHeavy Dilution
Earnings QualityGood Earnings Quality
The Play — combined read across both lenses Delvantic - Cairn AI

Reconciling a -4 quality grade with a -71 value score, the two lenses agree on direction: this is a real, scaled, cash-generative business that I do not want to own at this price. The fortress balance sheet and the FCF inflection are genuine, but a health insurer is its MLR, and 2025's 570bp gross-margin collapse plus a $443M GAAP loss is exactly the moment the multiple should compress — instead the stock is asking me to underwrite the rebound. Layer on ~10%/yr dilution silently raising my per-share hurdle and there's just no asymmetry at $27. I'm passing, not shorting — the cash pile and ACA scale make this no zero.

My playbook: zero position today. I get interested with a starter (roughly 1% of book) at $21 or below, which is where the value lens flags attractiveness and where I'd be paying for the cash and franchise rather than the turnaround. I scale to a 2.5-3% position only if I get a 1-2 quarter MLR print in 2026 showing 2025 was the anomaly (gross margin re-expanding back toward 18-20%) AND the stock is still sub-$24. Catalysts that flip me aggressive: a clean Q1/Q2 2026 MLR, evidence reinsurance/risk-adjustment normalized, and any pause in dilution. Catalysts that keep me sidelined or send me lower: another MLR miss, ACA subsidy policy noise into the 2026 election cycle, or continued 10% share creep without margin recovery. This is a watchlist name with a clear price and a clear data trigger — not a buy here.

The evidence behind each score — switch lenses
-4 Mixed edge √Σ 138 · risk √Σ 142 · conf 6/10

Oscar has scaled revenue from $1.92B (2021) to $11.70B (2025) — roughly a 6x in four years, a genuinely impressive top-line trajectory in ACA-exchange health insurance. The balance sheet is a fortress for an insurer: ~$3.99B liquid cash, $3.56B net cash, and operating cash flow that has turned decisively positive ($950M FCF in 2024, $1.06B in 2025). OCF/NI of 7.3x and accruals of -15.5% of assets indicate reported earnings are conservative relative to cash — typical of an insurer with growing float, but still clean.

The quality concerns sit on the income statement and cap table. Gross margin compressed from 20.8% (2023) to 20.1% (2024) to 14.4% (2025) — a meaningful deterioration suggesting medical loss ratio is rising. Operating margin swung from +0.6% in 2024 back to -3.4% in 2025, and net income flipped from +$25M to -$443M. So the 'path to profitability' narrative just took a step backward. Meanwhile diluted shares grew from 179M (2021) to 262M (2025) — a 10% CAGR — meaning per-share economics lag the business by a wide margin. SBC at only 0.8% of revenue suggests most of the dilution came from earlier capital raises/IPO mechanics rather than ongoing comp, but the damage to per-share value is done.

Altman Z of 1.66 flags 'distress,' but that model is calibrated for industrial firms and is largely meaningless for a regulated insurer sitting on $4B cash with positive FCF — I'd discount it heavily. Insider tape shows coordinated June 2026 sales across multiple NEOs (Schlosser, Blackley, Liang, McAnaney) right after director equity awards — looks like scheduled/programmatic selling, not a panic signal, but no insider conviction buying either.

Strengths 4
m80
Fortress cash position
$3.99B liquid cash, $3.56B net cash — 56.5% of market cap. Survival risk is effectively nil for a regulated insurer of this scale.
m75
Cash generation has inflected
FCF went from -$298M (2023) to +$950M (2024) to +$1.06B (2025). OCF/NI of 7.3x reflects insurance-float dynamics but is genuinely cash-positive.
m70
Revenue scale-up is real
Revenue 6x'd from $1.92B (2021) to $11.70B (2025); the business has clearly achieved scale on the ACA exchanges.
m45
Clean accruals/Beneish
Accruals -15.5% of assets and Beneish M of -3.2 — no evidence of earnings manipulation; reported numbers look conservative.
Concerns 6
m75
Gross margin collapse in 2025
GM fell from 20.1% (2024) to 14.4% (2025) — a ~570bp compression suggesting medical loss ratio deterioration, the single most important KPI for a health insurer.
m70
Profitability backslide
Op margin went +0.6% (2024) → -3.4% (2025); net income flipped from +$25M to -$443M. The 'first profitable year' narrative just reversed.
m70
10%/yr share dilution
Diluted shares: 179M → 213M → 222M → 266M → 262M. Per-share value creation lags business growth materially; 47% more shares than 2021.
m50
Still GAAP-unprofitable cumulatively
Net income totals over 5 years: -$572M, -$606M, -$271M, +$25M, -$443M — ~$1.9B cumulative GAAP losses. No demonstrated through-cycle profitability.
m35
Coordinated insider selling
On 2026-06-02, five officers (CEO Schlosser, CFO Blackley, Liang, McAnaney, Baltrus) sold simultaneously. Likely programmatic/10b5-1, but no offsetting insider conviction buying.
m30
ACA policy dependence (inferred)
Business is structurally exposed to ACA subsidy policy and risk-adjustment mechanics — durability depends heavily on regulatory continuity I can't verify here.
This is a real business that has achieved meaningful scale and finally generates cash, but it's not yet a quality compounder. The 2025 gross margin drop from 20.1% to 14.4% is a yellow flag I can't ignore — for a health insurer, MLR is the whole game, and that swing took them from marginal profitability back to a $443M loss. Layer on 10%/yr dilution and you have a business where per-share progress is much slower than the revenue chart suggests. The fortress balance sheet and positive FCF keep this from being Shaky, and the earnings look honest. But until I see MLR stabilize and the share count stop bleeding, this is a Mixed-quality business — promising, scaled, cash-rich, but structurally exposed to ACA policy and not yet a proven through-cycle earner.
Verify before trusting this (7)
  • Medical Loss Ratio (MLR) trend by year — is the 2025 GM compression a one-year reset or structural?
  • Membership growth vs. revenue/member — is revenue growth volume or pricing?
  • Risk-adjustment receivable/payable balances and any one-time accruals in 2025
  • ACA enhanced subsidy exposure (set to expire end-2025) — what % of members rely on enhanced subsidies?
  • Source of share count growth — secondary offerings vs. converts vs. SBC vesting
  • Statutory capital at insurance subsidiaries vs. holdco cash (the $4B may not all be dividendable)
  • Whether June 2026 insider sales were under 10b5-1 plans
-71 Rich edge √Σ 39 · risk √Σ 110 · conf 7/10
Price $27.22 vs deserved low-$20s on a quality-and-dilution-adjusted basis — roughly 15-25% rich, not egregious but no margin of safety. attractive below $21.00

The e2e synthesis lands at 'Reasonable Premium' and the company-quality lens grades the business Mixed (-4) — a fast-growing ACA insurer that just slipped from 20.1% to 14.4% gross margin and printed a $443M loss in 2025. You don't pay a premium for an insurer whose MLR just deteriorated; you pay a discount. At $7.06B market cap on a thin-margin, cash-generative-but-GAAP-loss business with 10%/yr dilution, the market is already underwriting the bull turnaround narrative.

Deserved value for a commoditized health plan that earns, at best, low-single-digit underwriting margins should be a modest multiple of normalized earnings — and normalized earnings here are unproven. Even crediting the fortress cash and real operating cash flow, paying ~$7B for a business that lost $443M last year requires believing 2025's MLR spike was a one-off and that ACA pricing/reinsurance dynamics cooperate. That's the bull case priced in, not a margin of safety. Per-share progress is further taxed by ~10% annual dilution, which silently raises the deserved-price hurdle every year.

I don't see cheapness here. I see a fair-to-rich price on a business the market wants to call a tech compounder before the unit economics have proven repeatable.

Cheap signals 2
m30
Fortress cash and real operating cash flow
Cash generation and balance sheet strength raise deserved value modestly and put a floor under downside — but not enough to call $27 cheap.
m25
Scale in ACA is a real asset if margins normalize
If 2025's MLR spike proves transient and underwriting returns to 2024 levels, normalized earnings power could justify today's price — but that's a 'priced for' case, not a margin of safety.
Rich / priced-in 3
m70
Premium multiple on a business that just lost $443M
$7.06B market cap against a 2025 GAAP loss of $443M and a gross margin collapse from 20.1% to 14.4%. You don't pay a premium for an insurer whose MLR is moving the wrong way.
m65
Dilution silently raises the deserved-price hurdle
~10%/yr share count growth means even flat enterprise value implies per-share value erosion of ~10% annually. The deserved price-per-share is a moving target downward.
m55
Turnaround already in the tape
The 'Reasonable Premium' synthesis plus a turnaround-bet narrative implies the bull case is partially priced. There's little room for another MLR miss or reinsurance whipsaw.
I think this is fully-to-richly priced. Paying $7B for an insurer whose MLR just blew out and that dilutes me 10% a year is not how I want to enter — the turnaround is already in the price. I'd want it in the low $20s, ideally with a 2026 MLR print showing 2025 was the anomaly, before I'd call it interesting. At $27 it's not absurd, but there's no margin of safety and the asymmetry isn't there.
Verify before trusting this (5)
  • 2026 MLR guidance and whether the 2025 gross-margin drop was pricing-cycle or structural
  • Reinsurance recoverables and any one-time items inside the $443M loss
  • Medicare Advantage segment economics and contribution to consolidated MLR
  • Stock-based comp run-rate and any buyback authorization to offset 10% dilution
  • ACA risk-adjustment true-ups that could swing reported margins materially
Two lenses kept deliberately separate — Company Quality is price-agnostic; Valuation is price-conditional. The scores are not blended (yet). Filing-level items (convertibles, lock-ups, customer concentration) are v2 — see each lens's "verify."
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Data via Financial Modeling Prep · Cached for performance · fmp
v1.1.330 · 344c2a54 · 2026-06-09 20:20:16