| Schedule of Effects of Reinsurance |
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | Three Months Ended June 30, | | Six Months Ended June 30, | | | | (in thousands) | 2026 | | 2025 | | 2026 | | 2025 | | | | | | Direct policy premiums | $ | 5,666,469 | | | $ | 3,482,764 | | | $ | 11,696,744 | | | $ | 6,832,435 | | | | | | | Risk adjustment transfers | (871,470) | | | (692,245) | | | (2,314,281) | | | (1,065,994) | | | | | | | Reinsurance premiums ceded | (4,989) | | | (2,690) | | | (10,607) | | | (5,232) | | | | | | Assumed premiums (1) | (679) | | | 15,615 | | | (1,663) | | | 38,056 | | | | | | | Premium | $ | 4,789,331 | | | $ | 2,803,444 | | | $ | 9,370,193 | | | $ | 5,799,265 | | | | | | (1) The Company did not renew the Cigna+Oscar Small Group arrangement with Cigna Health and Life Insurance Company after its initial term ended on December 31, 2024. Following termination, the Company has been providing transition and run-off services, and will continue to provide such services through December 31, 2026. The Company also continues to share in premiums and claims for plans sold or issued prior to December 15, 2024. | | | | |
The following table reconciles total Medical expenses to the amount presented in the Condensed Consolidated Statements of Operations: | | | | | | | | | | | | | | | | | | | | | | | | | Three Months Ended June 30, | | Six Months Ended June 30, | | (in thousands) | 2026 | | 2025 | | 2026 | | 2025 | Direct claims incurred | $ | 3,872,861 | | | $ | 2,562,117 | | | $ | 7,166,698 | | | $ | 4,830,401 | | Ceded reinsurance claims | (78,390) | | | (22,203) | | | (141,074) | | | (53,215) | | Assumed reinsurance claims | (26) | | | 13,059 | | | (1,322) | | | 35,438 | | Medical expenses | $ | 3,794,445 | | | $ | 2,552,973 | | | $ | 7,024,302 | | | $ | 4,812,624 | |
The composition of the Reinsurance recoverable balance on the Consolidated Balance Sheets is as follows:
| | | | | | | | | | | | | (in thousands) | June 30, 2026 | | December 31, 2025 | | Reinsurance premium and claim recoverables | $ | 194,808 | | | $ | 98,014 | | | Reinsurance ceding commissions | 7,002 | | | 7,002 | | | Experience refunds on reinsurance agreements | (5,266) | | | (5,266) | | | Reinsurance recoverable | $ | 196,544 | | | $ | 99,750 | |
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