Reporting its third-quarter results Thursday (Nov. 5), the health plan carrier highlighted how macroeconomic workforce shifts — driven by those workers as well as early retirees — are guiding how Americans purchase insurance. The earnings showed the company’s revenues rising 70% to $5.1 billion, with its membership ticking up from 2.1 million to 2.6 million.
As more workers step away from traditional corporate employment, consumer demand is shifting toward flexible individual health plans. CEO Mark Bertolini emphasized that changing labor dynamics require healthcare platforms to match modern digital retail expectations.
“Americans are building careers on their own terms,” Bertolini said on the earnings call. “They are starting businesses, combining part-time work, participating in the gig economy, and retiring early.”
He added: “People expect healthcare to work like the best consumer products — simple, transparent and personalized.”
To capitalize on these demographic shifts, Oscar is expanding tailored lifestyle products. These include “Retirees,” aimed at 2.5 million early retirees under the Affordable Care Act (ACA), and “Hy-Vee Health with Oscar,” a concierge care model targeted at gig workers, part-time employees, and workers at small businesses.
Central to the company’s expansion is technology and artificial intelligence. Oscar integrated new AI capabilities into its core platform to clarify complex benefits and expanded its standalone “Lucy” shopping platform.
Lucy uses automated tools to instantly match shoppers with carrier plans while walking brokers through regulatory eligibility.
Research by PYMNTS Intelligence shows that patients are already comfortable handling much of their care via digital channels. Upwards of 60% of consumers reported using at least one digital tool to manage their healthcare in the prior year, and 36% used a provider portal, according to the PYMNTS Intelligence report “Three in 10 Gen Zers and Millennials Use Telehealth. But Paying the Doctor Is Full of Friction.“
Meanwhile, Oscar noted that the shift toward a more consumer-led model presents operational friction. Tighter administrative oversight from the Centers for Medicare & Medicaid Services (CMS) led to industrywide membership disenrollments during eligibility audits.
In addition, new open enrollment verification requirements — including identity checks and broker consent protocols — could create some hurdles as 2026 moves into 2027.
“We do expect that some of these enhanced eligibility checks will result in some of the membership from ’26 not being able to continue into ’27,” said Scott Richard Blackley, Oscar’s chief financial officer.
“But we also anticipate that we’re going to see a continuation of new people coming into the marketplace. We saw that in ’26. We expect to see similar types of drivers for ’27. So net-net, we expect the market overall to be flat to the ’26 point.”
