Oscar Health Enters South Carolina, Expands to 713 Counties for 2027 as Cigna Exits Individual Market

Oscar Health (NYSE: OSCR) is growing in the individual health insurance market while two much larger insurers leave it.

The company said today, Oct. 20, that it is entering South Carolina for 2027 and expanding to 713 counties across 21 states. That is a 24% increase in counties from last year. Open enrollment for 2027 coverage runs Nov. 1 through Dec. 15, with coverage starting Jan. 1.

Rivals are leaving

Cigna disclosed earlier this year that it will exit the individual market, which leaves about 369,000 members in 11 states shopping for new coverage in 2027. CVS Health announced a year ago that Aetna would leave, affecting roughly 1 million members in 17 states.

Oscar is moving the other way. CEO Mark Bertolini said in the announcement: "The individual market is built for everyone from entrepreneurs launching businesses to people working part-time to employees and gig workers of companies large and small."

What Oscar is selling

The 2027 lineup includes several new products:

• RetireEase, a plan for people between early retirement and Medicare eligibility, with set prices for preventive visits, labs, physical therapy, heart care and bone-and-joint care, plus $0 generic drugs. It is available in Arizona, Florida, Ohio, South Carolina and Texas.
• HelloMeno, a menopause package covering hormone therapy, bone-density scans, insomnia medication and cancer screenings at $0, expanding to 15 states.
• Hy-Vee Health with Oscar, growing beyond Des Moines to the rest of Iowa and into Nebraska, Missouri and Kansas. It is part of the employer-funded ICHRA model, where employers give workers a monthly amount to buy coverage on their own.
• More than 250 new plans with dental and vision automatically bundled, including $0 preventive dental checkups and $0 eye exams.
• A partnership with Allstate Health Solutions in Florida and Texas, offering cash-pay supplemental coverage for accidents, serious illness and hospital stays.

Oscar says its life-stage and condition-specific products deliver 15% to 25% in savings.

The numbers behind the push

Oscar's growth is documented in its 2026 results. Second-quarter revenue hit $4.88 billion, up from $2.86 billion a year earlier. Effectuated membership reached about 2.96 million as of June 30, up from 2.03 million.

The company's SG&A expense ratio fell to 14.2% from 18.7%. Second-quarter results also included $164 million in favorable prior-period reserve development. At a Sept. 16 investor presentation, Oscar raised its 2026 operating earnings guidance to $600 million to $800 million, from $500 million to $700 million.

The stock has followed. Shares closed at $33.10 on Oct. 8, up 130.3% from the $14.37 close on Dec. 31, 2025. The market cap was about $10.21 billion, and the 52-week range is $10.69 to $34.48. U.S. regular trading has not opened yet today.

The risk is concentration

The enhanced ACA premium subsidies expired at the end of 2025. Oscar's retention, pricing and medical-cost control now have to work in that changed environment, and the company has little business outside the individual market to cushion a misstep.

An analysis published on TradingView argues that Oscar's heavy ACA exposure is a concentration risk. It says subsidy changes could weaken affordability, raise member churn and shift the risk profile of the membership, pressuring underwriting margins. Rising medical utilization and pricing errors could do further damage, it says.

The same analysis puts Oscar's price-to-book multiple at 4.94, against an industry average of 2.64.

Bertolini's own pitch points the other way. He argues that technology and consumer-friendly design give Oscar an edge across a broad customer base, including gig workers, small-business owners and the self-employed.

The peer picture is mixed. Molina Healthcare's total membership fell 14.3% year over year to around 4.9 million as of June 30, 2026. Centene has shifted from chasing membership to improving earnings quality through pricing discipline.

The 2027 results hinge on open enrollment. Oscar added counties and a state, but the open question is who signs up. A sicker or more price-sensitive pool would show up in medical costs, and the company's pricing for 2027 will be tested starting Nov. 1.