Oscar Health wants to reach 4 million members by 2027.
In a June presentation to investors, the insurer said it plans to enter approximately 150 new metropolitan areas by 2027 and targeted expansion of its individual coverage Health Reimbursement Arrangement business.
The insurer currently has 1.5 million members, primarily in ACA exchange plans.
Here are five things to know about Oscar's growth strategy:
- Oscar Health reported its first profitable quarter in 2024. The company is targeting full-year profitability in 2024. According to its presentation, Oscar is targeting a 5% profit margin in 2027 and 20% year-over-year revenue growth.
- The company expects the size of the individual market to reach 31 million people by 2027 if enhanced subsidies for coverage are maintained. Oscar projected the market will reach 24 million in 2027 if Congress does not extend enhanced subsidies.
- The company is targeting the individual coverage health reimbursement arrangement, or ICHRA market, as part of its growth strategy. With employees of small and medium companies, the total addressable individual insurance market can grow to 96 million lives, according to Oscar's estimates.
- Oscar Health has already doubled down on its ICHRA strategy. The arrangements allow employers to offer employees contributions to purchase an individual health plan rather than offering group insurance. In April, Oscar said it would end its small-group offering with Cigna in 2025, betting ICHRA would become the dominant way small employers offer insurance to their employees.
- Its ICHRA approach offers Oscar the opportunity to "create a whole new market," CEO Mark Bertolini told CNBC on June 7.
"Our view is, how can we get more people into an individual market, not necessarily only through the ACA? That's the big part of our strategy: going after the 71 million lives that are in small group and middle market employers," he said.