Tag Archives: oscar

Oscar Health sues Florida Blue, alleging monopoly of individual ACA health insurance market


Naseem S. Miller / Orlando Sentinel

Oscar Health, the new player in Florida’s ACA marketplace, has filed a federal lawsuit against Florida Blue, alleging that the insurer is using improper tactics to stifle competition in the state and monopolize the individual plan market.

In an antitrust lawsuit filed on Tuesday morning in the federal court’s Middle District of Florida, Oscar alleges that Florida Blue, the largest provider of ACA plans in Florida, has launched a “targeted campaign” to prevent Oscar from entering Orlando by “coercing” brokers into “anticompetitive exclusive agreements” and preventing them from selling Oscar’s plans.

More than 190 brokers have backed out of agreements to sell Oscar’s individual plans, resulting in loss of sales for Oscar, it said.

“When we go to a new city, one of the first things we do is to introduce ourselves to local brokers,” said Bruce Gottlieb, general counsel and executive vice president of strategic partnerships at Oscar. “In every city we’ve gone to, we’ve been able to sign up most of the largest brokers in the city. … Except for Orlando. Florida Blue is preventing brokers telling clients about the lowest-priced plans in the region.”

Google invests in Oscar Health Plans

From Oscar on August 16, 2018:

we are thrilled to announce that Google’s parent company, Alphabet, is planning to invest $375 million in Oscar.

Alphabet has been a supporter of Oscar for years and this reflects an incredible vote of confidence in Oscar’s unique ability to deliver a consumer-focused, tech-driven member experience in health care. This investment will allow Oscar to continue to invest in and bring Oscar’s unique product to more people, markets, and business lines. For more details, check out our CEO Mario’s interview in the Wired story: Health Care is Broken. Google Thinks Oscar Health Can Fix It.

Oscar and Axa team up

From Oscar Health Plans on February 1:

There’s been a lot of attention and excitement in the industry, and we’re happy to be a part of it.

First, I’m excited to share that Oscar has recently partnered with multinational insurer AXA! It’s a great indicator of Oscar’s solid financials, and we’re excited to continue to grow.

You can learn more by reading about it here, or by following along in the notes below:

Why did Oscar pursue a quota share deal with AXA?

  • All health insurers are required to hold a certain percentage of its premiums as “reserves” so that regulators can ensure that carriers have enough money to pay their future claims.
  • With the AXA deal, Oscar will cede 50% of it’s premiums/claims to AXA, which will free up 50% of its capital requirements
  • We expect that the deal will free up nearly $100 million in capital over the next few years, providing capital relief as we continue to grow

I’m also thrilled to report that we’ve enrolled over 250k members across six states, and expect to generate $1 billion in revenue in 2018. Learn more below:

We’re grateful to have you as a partner during this exciting time of growth at Oscar. If you’ve written Oscar business and haven’t yet filled out our survey, please click the link. Five minutes of feedback could make a big difference!

Best,
Louis DeStefano
National VP of Sales
Oscar Health

OSCAR HEALTH loses 105 million

(Bloomberg) — Startup Oscar Health Insurance Corp. lost $105.2 million in its New York and New Jersey businesses last year, a sign that insurers of all sizes are struggling in the new markets created by the Patient Protection and Affordable Care Act (PPACA).

The losses, $92.4 million in New York and $12.8 million in New Jersey, were disclosed by Oscar in filings with state regulators. Chief Executive Officer Mario Schlosser said some of Oscar’s losses stem from the cost of starting a new health insurer. Others are tied to the same problems befalling bigger health plans: costlier customers and a shortfall in a key government program.

Schlosser said last month that Oscar is adjusting its strategy to limit costs as it enters new markets in California and Texas. The insurer — valued at $2.7 billion in its latest round of funding, according to a person familiar with the matter — has struck deals with limited groups of hospitals and doctors, rather than offering broad networks like traditional insurers. Oscar has also been narrowing its network in New York, and Schlosser said the company is getting better prices for some services as its membership increases.

For the full article click here

 

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Reeve Conover is a Registered Representative. Securities offered through Cambridge Investment Research, Inc., a Broker/dealer member FINRA/SPIC. Cambridge and Conover Consulting are not affiliated. Licensed in SC, NC, NY, CT, NJ, and CA.
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