Oscar Health expands individual health coverage to Boulder

BOULDER — Just eight months after entering the Denver market, Oscar Health, a New York-based health-insurance company focused on the individual market, is expanding into Boulder.

Oscar will enter the Boulder market as of Jan. 1, 2021, pending state regulatory approval. Expansion to Boulder and other markets in Arkansas, Florida, North Carolina and Oklahoma will see the company’s reach grow to 19 states and 47 markets, the company said.

Oscar specializes in providing health insurance to individuals who wouldn’t otherwise have coverage, including freelancers and independent contractors. But the company’s base has expanded far beyond those groups to encompass people from all walks of life, said Basil Kim, Oscar’s director of West region P&L and partnerships.

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Kim told BizWest that Boulder was a natural progression for the company after finding success in Denver.

“As we were looking at our Denver market and potential adjacent markets that would be interesting and exciting for us, Boulder was identified as a market for us to grow into,” Kim said.

He said Oscar weighs a variety of factors in deciding on expansion markets, including any existing provider partnerships, population and competition.

Oscar will deliver an average rate reduction of 3.8% in the Colorado market in 2021, according to data provided by the Colorado Division of Insurance. That compares with an average increase of 3% across all carriers (not including Oscar) for the Boulder metropolitan statistical area, which encompasses Boulder County.

Oscar’s primary provider partner in the Denver market is HCA Healthcare, which operates eight hospitals in the Denver metro area. HCA was a logical choice, given that Oscar already partners with the system in other states, Kim said.

“With regard to Boulder, we’re still pending regulatory approval on the network there, so we’re not yet sharing who our formal partner is in that market,” Kim said.

Oscar has been in a rapid expansion, raising $225 million in June alone, in a funding round that included Baillie Gifford, Coatue, Alphabet, General Catalyst, Khosla Ventures, Lakestar and Thrive Capital.

The company has seen rapid growth through its individual-market offerings, and the COVID-19 pandemic has only accelerated that growth, as employees are laid off and seek other health-insurance options as they lose employer coverage.

“We’re seeing the job losses that are coming out of COVID,” Kim said. “We’re seeing a lot of new individuals enter the market. We do anticipate that there will be an uptick, maybe more than we normally would have seen due to COVID and job losses, etc.”

Oscar also recently announced the launch of its $0 Virtual Primary Care product, through which customers can access unlimited virtual visits, Tier I prescriptions, labs, diagnostic imaging and other services. Kim said that product will be tested in Denver and will not immediately be available in Boulder.

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