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  #1  
Old 05-17-2015, 11:09 PM
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Default Oscar

I'm curious what the health actuaries on this board think about Oscar Health Insurance.

Official site: https://www.hioscar.com/

NYT Article: http://www.nytimes.com/2014/03/29/bu...-new-york.html

It seems that they exclusively offer individual plans through the public exchanges or brokers. They are only offered in NYC at the moment and rent their network from Magnacare. They also outsource the claim processing.

Oscar is attracting a lot of venture capital money and has been valued at over $1.5B based on the last round of funding.

It seems like they are almost exclusively investing in technology and marketing. I'm struggling to see how this company survives and why it would attract so much funding with seemingly no competitive advantage and plenty of disadvantages.

Anyone see something that I don't see?
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  #2  
Old 05-17-2015, 11:20 PM
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So, you are asking how to short it?
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  #3  
Old 05-17-2015, 11:37 PM
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http://www.bloomberg.com/news/articl...laims-s-p-says

Quote:
There may be just $1 in the piggy bank to cover every $10 in claims at an Obamacare program designed to spread risk among insurers, Standard & Poor’s said.

...

In New York, Oscar Insurance Co. and Health Republic Insurance of New York Corp. had risk corridor receivables equal to more than half their capital, as of Dec. 31.

...
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Old 05-17-2015, 11:38 PM
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Quote:
Originally Posted by Dr T Non-Fan View Post
So, you are asking how to short it?
No - but I'm amazed that it has attracted so much funding when it really doesn't offer a compelling story for investment.
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Old 05-18-2015, 07:36 AM
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Originally Posted by Dismal Science View Post
No - but I'm amazed that it has attracted so much funding when it really doesn't offer a compelling story for investment.
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Old 05-18-2015, 10:22 AM
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Quote:
Originally Posted by Dismal Science View Post
I'm curious what the health actuaries on this board think about Oscar Health Insurance.

Official site: https://www.hioscar.com/

NYT Article: http://www.nytimes.com/2014/03/29/bu...-new-york.html

It seems that they exclusively offer individual plans through the public exchanges or brokers. They are only offered in NYC at the moment and rent their network from Magnacare. They also outsource the claim processing.

Oscar is attracting a lot of venture capital money and has been valued at over $1.5B based on the last round of funding.

It seems like they are almost exclusively investing in technology and marketing. I'm struggling to see how this company survives and why it would attract so much funding with seemingly no competitive advantage and plenty of disadvantages.

Anyone see something that I don't see?
It's the cute subway ads
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  #7  
Old 05-18-2015, 10:35 AM
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Originally Posted by Sloop John B View Post
It's the cute subway ads
Yeah - and these people who buy it based on the subway ads are the people who later bitch about their out of pocket costs because they don't understand deductibles. Then they leave a 1 star review on Yelp.

I will also say that I find their "simple plan" idea interesting. Essentially it is a pure deductible plan. After you pay the (really high) deductible you are covered 100%. That means they don't have to explain coinsurance or copays or out of pocket maximums.
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Old 05-18-2015, 11:05 AM
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Oscar has 2 actuarial positions open:
Associate Actuary - Medical Cost Mgmt
Associate Actuary - Pricing
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Old 05-18-2015, 11:08 AM
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The NYT article, dated mid-March 2014, indicated they have 10,600 members, and expect that to hit 13,000 by the end of the deadline.

So that puts them in the low $60M range for total revenue. At 10% admin they have $6M. If that was somehow 5% profit margin, their bottom line is a little over $3M. How that reaches $1.5B valuation must require some kind of secret sauce the investors know about that hasn't been made known publicly.
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Old 05-18-2015, 11:20 AM
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Found a more recent article reflecting 2015 results:

http://www.cnbc.com/id/102597584

Quote:
Originally Posted by CNBC
"I think we've come very far, very quickly," CEO and co-founder Mario Schlosser told CNBC.com. "We manage about $200 million in health-care spend right now."

Oscar is "incredibly happy" with its rising membership, which now stands at around 40,000 customers, Schlosser said. That's "about twice as high as we originally thought we'd be after two years of operation," he said, noting that it's been less than two full years since Oscar's Obamacare policies have been in effect.

About 85 percent of Oscar's members are in New York City, Long Island and several counties just north of the Big Apple, with the rest coming from a handful of counties in northern New Jersey.

Schlosser said he believes Oscar now has 12 percent to 15 percent of the individual insurance market in the New York counties where it operates—a healthy level given the significant amount of competition the company has from longstanding insurers as well as hospitals that jumped into the Obamacare market. That market share includes plans sold both on the state-run health insurance market and in the so-called off-exchange market.

Last edited by Guest; 05-18-2015 at 11:24 AM.. Reason: added link
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