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As of March 31, 2020

Authorized
Shares

Issued and
Outstanding
Shares

Aggregate
Liquidation
Preference

Convertible Preferred Stock:

Document and Entity Information - $ / shares	3 Months Ended
Document and Entity Information - $ / shares	Mar. 31, 2020	May 08, 2020
Cover [Abstract]
Entity Central Index Key	0001551306
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Mar. 31, 2020
Document Transition Report	false
Entity File Number	001-39100
Entity Registrant Name	Progyny, Inc.
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	27-2220139
Entity Address, Address Line One	1359 Broadway
Entity Address, City or Town	New York
Entity Address, State or Province	NY
Entity Address, Postal Zip Code	10018
City Area Code	212
Local Phone Number	888-3124
Title of 12(b) Security	Common Stock,$0.0001 par value per share
Trading Symbol	PGNY
Security Exchange Name	NASDAQ
Entity Current Reporting Status	No
Entity Interactive Data Current	Yes
Entity Filer Category	Non-accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	true
Entity Ex Transition Period	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		85,169,405
Entity Listing, Par Value Per Share	$ 0.0001
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2020
Document Fiscal Period Focus	Q1
Amendment Flag	false

Balance Sheets - USD ($) $ in Thousands	Mar. 31, 2020	Dec. 31, 2019
Current assets:
Cash and cash equivalents	$ 91,634	$ 80,382
Accounts receivable, net of $8,477 and $6,320 of allowances at March 31, 2020 and December 31, 2019, respectively	65,862	47,059
Prepaid expenses and other current assets	4,442	5,003
Total current assets	161,938	132,444
Property and equipment, net	3,673	3,083
Goodwill	11,880	11,880
Intangible assets, net	2,025	2,375
Other assets	629	652
Total assets	180,145	150,434
Current liabilities:
Accounts payable	39,438	19,388
Accrued expenses and other current liabilities	19,618	16,775
Total current liabilities	59,056	36,163
Total liabilities	59,056	36,163
Commitments and Contingencies (Note 7)
STOCKHOLDERS' EQUITY
Common stock, $0.0001 par value; 1,000,000,000 shares authorized at March 31, 2020 and December 31, 2019; 84,845,828 and 84,188,202 shares issued and outstanding at March 31, 2020 and December 31, 2019, respectively	8	8
Additional paid-in capital	231,516	228,755
Treasury stock, at cost , $0.0001 par value; 615,980 shares outstanding at March 31, 2020 and December 31, 2019	(1,009)	(1,009)
Accumulated deficit	(109,426)	(113,483)
Total stockholders' equity	121,089	114,271
Total liabilities and stockholders' equity	$ 180,145	$ 150,434

Balance Sheets (Parenthetical) - USD ($) $ in Thousands	Mar. 31, 2020	Dec. 31, 2019
Allowances for accounts receivable
Allowances for accounts receivable	$ 8,477	$ 6,320
Convertible preferred stock
Convertible preferred stock, shares authorized (in shares)	100,000,000
Convertible preferred stock, shares issued (in shares)	0
Convertible preferred stock, shares outstanding (in shares)	0
Common stock
Common stock, par value (in dollars per share)	$ 0.0001	$ 0.0001
Common stock, shares authorized (in shares)	1,000,000,000	1,000,000,000
Common stock, shares issued (in shares)	84,845,828	84,188,202
Common stock, shares outstanding (in shares)	84,845,828	84,188,202
Treasury stock
Treasury stock, shares outstanding (in shares)	615,980	615,980

Statements of Operations and Comprehensive (Loss) Income - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Condensed Consolidated Statements of Operations and Comprehensive Loss
Revenue	$ 81,024	$ 47,197
Revenue, type	us-gaap:ServiceMember	us-gaap:ServiceMember
Cost of services	$ 64,422	$ 37,233
Cost of services, type	us-gaap:ServiceMember	us-gaap:ServiceMember
Gross profit	$ 16,602	$ 9,964
Operating expenses:
Sales and marketing	3,267	2,346
General and administrative	9,476	4,508
Total operating expenses	12,743	6,854
Income from operations	3,859	3,110
Other income (expense):
Other income	164
Interest income (expense), net	150	(38)
Convertible preferred stock warrant valuation adjustment		(551)
Total other income (expense), net	314	(589)
Income before income tax	4,173	2,521
Provision for income taxes	116	0
Net income	4,057	2,521
Comprehensive income	4,057	2,521
Net income attributable to common stockholders	$ 4,057	$ 31
Net income per share attributable to common stockholders:
Basic (in dollars per share)	$ 0.05	$ 0.01
Diluted (in dollars per share)	$ 0.04	$ 0.01
Weighted-average shares used in computing net earnings per share:
Basic (in shares)	84,537,538	5,156,755
Diluted (in shares)	99,665,158	15,120,928

Statements of Changes in Convertible Preferred Stock - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Increase (Decrease) in Convertible Preferred Stock
Balance at beginning of period	$ 0	$ 106,237
Balance at beginning of period (in shares)		65,428,088
Period increase (decrease)	0	$ 0
Balance at end of period	$ 0	$ 106,237
Balance at end of period (in shares)	0	65,428,088

Statements of Changes in Stockholders' Deficit - USD ($) $ in Thousands	Common Stock	Treasury Stock	Additional Paid in Capital	Accumulated Deficit	Total
Balance at beginning of period at Dec. 31, 2018	$ 1	$ (884)	$ 10,622	$ (104,854)	$ (95,115)
Balance at beginning of period (in shares) at Dec. 31, 2018	5,155,407
Increase (Decrease) in Stockholders’ Equity
Stock option exercise			2		2
Options exercised (in shares)	1,804
Stock-based compensation			517		517
Net income				2,521	2,521
Balance at end of period at Mar. 31, 2019	$ 1	(884)	11,141	(102,333)	(92,075)
Balance at end of period (in shares) at Mar. 31, 2019	5,157,211
Balance at beginning of period at Dec. 31, 2019	$ 8	(1,009)	228,755	(113,483)	$ 114,271
Balance at beginning of period (in shares) at Dec. 31, 2019	84,188,202				84,188,202
Increase (Decrease) in Stockholders’ Equity
Stock option exercise			597		$ 597
Options exercised (in shares)	657,626
Stock-based compensation			2,049		2,049
Reduction in initial public offering costs			115		115
Net income				4,057	4,057
Balance at end of period at Mar. 31, 2020	$ 8	$ (1,009)	$ 231,516	$ (109,426)	$ 121,089
Balance at end of period (in shares) at Mar. 31, 2020	84,845,828				84,845,828

- Definition

The portion of profit or loss for the period, net of income taxes, which is attributable to the parent.

+ References + Details

Statements of Cash Flows - USD ($) $ in Thousands	3 Months Ended
Statements of Cash Flows - USD ($) $ in Thousands	Mar. 31, 2020	Mar. 31, 2019
OPERATING ACTIVITIES
Net income	$ 4,057	$ 2,521
Adjustments to reconcile net (loss) income to net cash provided by (used in) operating activities:
Deferred tax expense	116
Non-cash interest expense	19
Depreciation and amortization	520	510
Stock-based compensation expense	2,049	517
Bad debt expense	1,257	449
Loss on disposal of property and equipment		1
Change in fair value of warrant liabilities		551
Changes in operating assets and liabilities:
Accounts receivable	(20,054)	(16,596)
Prepaid expenses and current other assets	561	(388)
Accounts payable	20,359	3,378
Accrued expenses and other current liabilities	3,256	2,886
Net cash provided by (used in) continuing operations	12,140	(6,171)
Net cash provided by (used in) operating activities	12,140	(6,171)
INVESTING ACTIVITIES
Purchase of property and equipment, net	(693)	(125)
Net cash (used in) continuing operations	(693)	(125)
Net cash provided by discontinued operations		200
Net cash (used in) provided by investing activities	(693)	75
FINANCING ACTIVITIES
Payment of deferred initial public offering costs	(791)
Proceeds from revolving line of credit		41,308
Repayments made against revolving line of credit		(34,977)
Exercise of stock options	597	2
Net cash (used in) provided by continuing operations	(194)	6,333
Net cash (used in) provided by financing activities	(194)	6,333
Net increase in cash and cash equivalents	11,252	237
Cash and cash equivalents, beginning of year	80,382	127
Cash and cash equivalents, end of year	91,634	364
SUPPLEMENTAL DISCLOSURE OF CASH FLOW INFORMATION
Cash paid for interest		$ 38
SUPPLEMENTAL DISCLOSURE OF NON-CASH INVESTING ACTIVITIES
Additions of property and equipment, net included in accrued expenses	$ 68

Business and Basis of Presentation	3 Months Ended
Business and Basis of Presentation	Mar. 31, 2020
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Business and Basis of Presentation	1. Business and Basis of Presentation Description of Business Progyny, Inc. (referred to as “Progyny” or the “Company”) was incorporated in the state of Delaware on April 3, 2008, and maintains its corporate headquarters in New York, NY. Progyny is a provider of a fertility benefits solution and pharmacy benefits solution and operates and manages in one operating segment. The fertility benefits solution consists of a significant service that integrates: (1) the treatment services (“Smart Cycles”) that the Company has designed, (2) access to the Progyny network of high-quality fertility specialists that perform the Smart Cycle treatments and (3) active management of the selective network of high-quality provider clinics, real-time member eligibility and treatment authorization, member-facing digital tools and detailed quarterly reporting supported by the Company’s dedicated account management teams, and end to end comprehensive concierge member support provided by Progyny’s in-house staff of Patient Care Advocates (“PCAs”) (collectively, the “care management services”). The Company enhanced its fertility benefits solution with the launch of Progyny Rx, its pharmacy benefits solution, effective January 1, 2018. As part of this solution, the Company provides formulary plan design, simplified authorization, assistance with prescription fulfillment, and timely delivery of the medications by the Company’s network of specialty pharmacies, as well as medication administration training, pharmacy support services, and continuing PCA support. As a pharmacy benefits solution provider, Progyny manages the dispensing of pharmaceuticals through the Company’s specialty pharmacy contracts. The pharmacy benefits solution is only available as an add-on service to its fertility benefits solution. Initial Public Offering On October 29, 2019, the Company completed its initial public offering (“IPO”) in which it issued and sold 6,700,000 shares of its common stock at a public offering price of $13.00 per share. As part of the IPO, certain selling stockholders offered and sold an additional 4,800,000 shares (including 1,500,000 shares sold pursuant to the exercise of the underwriters’ over-allotment option), at an equivalent public offering price of $13.00 per share. The Company received net proceeds of $77.6 million from the IPO, after deducting underwriters’ discounts and commissions of $5.9 million and offering costs of $3.6 million. Upon completion of the IPO, these offering costs were reclassified to stockholders’ equity and offset against the proceeds from the offering on the balance sheet. Immediately prior to the completion of the IPO, all shares of convertible preferred stock then outstanding were converted into 65,428,088 shares of common stock on a one-to-one basis, $106.2 million of convertible preferred stock was reclassified to additional paid-in-capital and $7,000 of convertible preferred stock was reclassified to common stock on the Company’s balance sheet. Emerging Growth Company Status The Company is an emerging growth company, as defined in the Jumpstart Our Business Startups Act of 2012 (the “JOBS Act”). Under the JOBS Act, emerging growth companies can delay adopting new or revised accounting standards issued subsequent to the enactment of the JOBS Act, until such time as those standards apply to private companies. The Company has elected to use this extended transition period for complying with new or revised accounting standards that have different effective dates for public and private companies until the earlier of the date that it is (i) no longer an emerging growth company or (ii) affirmatively and irrevocably opt out of the extended transition period provided in the JOBS Act. As a result, the Company’s financial statements may not be comparable to companies that comply with the new or revised accounting pronouncements as of public company effective dates. The Company will remain an emerging growth company until the earliest of (1) December 31, 2024; (2) the last day of the Company’s first fiscal year in which the Company has total annual gross revenue of at least $1.07 billion; (3) the date on which the Company has issued more than $1.0 billion in non-convertible debt securities during the prior three-year period; and (4) the last day of the Company’s first fiscal year in which the market value of the Company’s common stock that is held by non-affiliates exceeds $700.0 million as of the prior June 30th. Basis of Presentation The interim unaudited financial statements have been prepared in accordance with accounting principles generally accepted in the United States of America (“U.S. GAAP”) and pursuant to the rules and regulations of the Securities and Exchange Commission (“SEC”) applicable to interim financial reporting. These interim financial statements have been prepared on a basis consistent with the annual financial statements and, in the opinion of management, include all adjustments necessary to fairly state our financial position as of March 31, 2020, the results of our operations for the three months ended March 31, 2020 and 2019 and the results of our cash flows for the three months ended March 31, 2020 and 2019. Therefore, these unaudited financial statements should be read in conjunction with the audited financial statements and related footnotes included in the Annual Report on Form 10-K filed with the SEC on March 10, 2020. The results for the three months ended March 31, 2020 are not necessarily indicative of the operating results expected for the year ending December 31, 2020 or any other future period. Additionally, there are many uncertainties regarding the current coronavirus (“COVID-19”) pandemic, and the Company is closely monitoring the impact of the pandemic on all aspects of its business, including how it will impact its customers and their members, its provider network, specialty pharmacy partners, employees, suppliers, vendors, and other business partners. The full extent to which the COVID-19 pandemic will directly or indirectly impact the Company’s business, future results of operations and financial condition will depend on future developments that are highly uncertain and cannot be accurately predicted, including new information that may emerge concerning COVID-19, the actions taken to contain it or treat its impact and the economic impact on local, regional and national markets. The overall disruption of the healthcare and fertility markets and the other risks and uncertainties associated with the pandemic could have a material adverse effect on the Company’s business, financial condition, results of operations and growth prospects. The Company will continue to assess the evolving impact of the COVID-19 pandemic and will make adjustments to its operations as necessary. Use of Estimates The preparation of financial statements in conformity with U.S. GAAP generally requires management to make estimates and assumptions that affect the reported amount of certain assets, liabilities, revenue, and expenses, and the related disclosure of contingent assets and liabilities. The accounting estimates that require the most complex and subjective judgements include accrued receivables, accrued claims payable, allowance for doubtful accounts, accrued rebates, and stock-based compensation. Management bases its estimates on historical experience and on various other assumptions that are believed to be reasonable under the circumstances, the results of which form the basis for making judgments about the carrying value of assets and liabilities that are not readily apparent from other sources. Actual results may differ from these estimates under different assumptions or conditions. Reverse Stock Split On October 14, 2019, Progyny’s stockholders approved and the Company effected a one-for-4.5454 reverse stock split of its common and convertible preferred stock. The par value of the common stock and convertible preferred stock was not adjusted as a result of the reverse stock split. Accordingly, the financial statements and notes retroactively reflect Progyny’s capital structure after giving effect to the reverse stock split.

Significant Accounting Policies

3 Months Ended

Mar. 31, 2020

Accounting Policies [Abstract]

Significant Accounting Policies

2. Significant Accounting Policies

There has been no material changes in the Company’s significant accounting policies as compared to the significant accounting policies described in the Company’s Annual Report on Form 10-K for the year ended December 31, 2019.

Revenue Recognition

Revenue is recognized when control of the promised goods or services is transferred to clients in an amount that reflects the consideration the Company expects to be entitled to in exchange for those goods or services.

The Company applies the following five-step model to recognize revenue from contracts with clients:

Identification of the contract, or contracts, with a client

Identification of the performance obligations in the contract

Determination of the transaction price

Allocation of the transaction price to the performance obligations in the contract

Recognition of revenue when, or as, a performance obligation is satisfied

Progyny’s contracts typically have a stated term of three years and include contractual termination options after the first year, allowing the client to terminate the contract with 30 to 90 days’ notice.

Fertility Benefits Revenue

Progyny primarily generates revenue through its fertility benefits solution, in which Progyny provides self-insured enterprise entities (“clients”) and their employees and partners (together, “members”) with fertility benefits. As part of the fertility benefits solution, Progyny provides access to effective and cost-efficient fertility treatments, referred to as Smart Cycles, as well as other related services. Smart Cycles are proprietary treatment bundles that include certain medical services available to members through Progyny’s proprietary, credentialed network of provider clinics. In addition to access to Progyny’s Smart Cycle treatment bundles and access to Progyny’s network of provider clinics, the fertility benefits solution includes other comprehensive services, which Progyny refers to as care management services, such as active management of the provider clinic network, real-time member eligibility and treatment authorization, member-facing digital tools throughout the Smart Cycle and detailed quarterly reporting all supported by client facing account management and end-to-end comprehensive member support provided by Progyny’s in house staff of PCAs.

The promises within Progyny’s fertility benefits contract with a client represent a single performance obligation because Progyny provides a significant service of integrating the Progyny designed Smart Cycles and access to the fertility treatment services provided by provider clinics with the other comprehensive services into the combined fertility benefits solution that the client contracted to receive. Progyny’s fertility benefits solution is a stand-ready obligation that is satisfied over the contract term.

Progyny’s contracts include the following sources of consideration, which are all variable: a per employee per month (“PEPM”) administration fee (in most, but not all contracts) and a fixed rate per Smart Cycle. The PEPM administration fee is allocated between the fertility benefits solution and the pharmacy benefits solution based on standalone selling price, estimated using an expected cost-plus margin method. The Company allocates the variable consideration related to the fixed rate per Smart Cycle to the distinct period during which the related services were performed as those fees relate specifically to the Company’s efforts to provide its fertility benefits solution to its clients in the period and represents the consideration the Company is entitled to for the fertility benefit services provided. As a result, the fixed rate per Smart Cycle is included in the transaction price and recognized in the period in which the Smart Cycle is provided to the member.

Progyny’s contracts also include potential service level agreement refunds related to outcome-based service metrics. These service level refunds, which are determined based on results of a full plan year, if met, are based on a percentage of the PEPM fee paid by clients. The Company estimates the variable consideration related to the total PEPM administration fee, less estimated refunds related to service level agreements, and recognizes the amounts allocated to the fertility benefits solution ratably over the contract term. Progyny’s estimate of service level agreement refunds, have not historically resulted in significant adjustments to the transaction price.

Clients are invoiced on a monthly basis for the PEPM administration fee. Progyny invoices its clients and members for their respective portions of the fixed rate per Smart Cycle bundle when all treatment services within a Smart Cycle are completed by the provider clinic. Once an invoice is issued, payment terms are typically between 30 to 60 days.

The Company assesses whether it is the principal or the agent for each arrangement with a client, since fertility treatment services are provided by a third party—the provider clinics. The Company is the principal in its arrangements with clients and therefore presents revenue gross of the amounts paid to the provider clinics because Progyny controls the specified service (the fertility benefits solution) before it is transferred to the client. Progyny integrates the fertility treatment services provided by the provider clinics into the overall fertility benefits solution that the client contracted to receive. In addition, Progyny defines the scope of the potential services to be performed by the provider clinics and monitors the performance of the provider clinics. Furthermore, Progyny is primarily responsible for fulfilling the promise to the client and has discretion in setting the pricing, as Progyny separately negotiates agreements with the provider clinics, which establish pricing for each treatment service. Pricing of services from provider clinics is independent from the fees charged to clients.

Pharmacy Benefits Revenue

For clients that have the fertility benefits solution, Progyny offers, as an add-on, its pharmacy benefits solution, which is a separate, fully integrated pharmacy benefit. As part of the pharmacy benefits solution, Progyny provides care management services, which include Progyny’s formulary plan design, prescription fulfillment, simplified authorization and timely delivery of the medications used during treatment through Progyny’s network of specialty pharmacies, and clinical services consisting of member assessments, UnPack It calls, telephone support, online education, medication administration training, pharmacy support services and continuing PCA support.

The pharmacy-related promises represent a single performance obligation because Progyny provides a significant service of integrating the formulary plan design, prescription fulfillment, clinical services and PCA support into the combined pharmacy benefits solution that the client contracted to receive. The pharmacy benefits solution is a stand-ready obligation that is satisfied over the contract term.

Progyny’s contracts include the following sources of consideration, all of which are variable: a PEPM administration fee (in most, but not all contracts) and a fixed fee per fertility drug. As described above, the PEPM administration fee, less estimated refunds related to service level agreements, is allocated to the pharmacy benefits solution and recognized ratably over the contract term. The Company allocates the variable consideration related to the fixed fee per fertility drug to the distinct period during which the related services were performed, as those fees relate specifically to the Company’s efforts to provide its pharmacy benefits solution to clients in the period and represents the consideration the Company is entitled to for the pharmacy benefit services provided. As a result, the fixed fee per fertility drug is included in the transaction price and recognized in the period in which the Company is entitled to consideration from a client, which is when a prescription is filled and delivered to the members.

As stated above, clients are invoiced on a monthly basis for the PEPM administration fee. Progyny invoices the client and the member for their respective portions of the fixed fee per fertility drug, when the prescription services are completed by the specialty pharmacy. Once an invoice is issued, payment terms are typically between 30 to 60 days.

The Company assesses whether it is the principal or the agent for each arrangement with a client, as prescription fulfillment and clinical services are provided by a third party—the specialty pharmacies. The Company is the principal in its arrangements with clients, and therefore presents revenue gross of the amounts paid to the specialty pharmacies. Progyny controls the specified service (the pharmacy benefits solution) before it is transferred to the client. Progyny integrates the prescription fulfillment and clinical services provided by the pharmacies and PCAs into the overall pharmacy benefits solution that the client contracted to receive. In addition, Progyny defines the scope of the potential services to be performed by the specialty pharmacies and monitors the performance of the specialty pharmacies. Furthermore, Progyny is primarily responsible for fulfilling the promise to the client and has discretion in setting the pricing, as Progyny separately negotiates agreements with pharmacies, which establish pricing for each drug. Pricing of fertility drugs is independent from the fees charged to clients.

The Company does not disclose the transaction price allocated to remaining performance obligations because all of the transaction price is variable and is allocated to the distinct periods to which the services relate, as discussed above. The remaining contract term is typically less than one year, due to the client’s contractual termination options.

There are no material contract asset or contract liability balances as of March 31, 2020 and December 31, 2019.

Accrued Receivable and Accrued Claims Payable

Accrued receivables are estimated based on historical experience for those fertility benefit services provided but for which a claim has not been received from the provider clinic. At the same time, cost of services and accrued claims payables are estimated based on the amount to be paid to the provider clinic and historical gross margin achieved on fertility benefit services. Estimates are adjusted to actual at the time of billing. Adjustments to original estimates have not been material.

As of March 31, 2020, accrued receivables and accrued claims payables were $12.0 million and $14.2 million, respectively, as compared to $16.0 million and $9.8 million, respectively, as of December 31, 2019. Accrued receivables are included within accounts receivable in the balance sheet. Accrued claims payable are included within accrued expenses and other current liabilities in the balance sheet. Claims payable are paid within 30 days based on contractual terms.

As of March 31, 2020 and December 31, 2019, unbilled receivables, which represent claims received and approved but unbilled at the end of the reporting period, were $21.1 million and $8.5 million, respectively. Unbilled receivables are typically billed to clients within 30 days of the approved claim based on the contractual billing schedule agreed upon with the client. Unbilled receivables are included in accounts receivable in the balance sheet.

Accounts Receivable and Allowance for Doubtful Accounts

The accounts receivable balance primarily includes amounts due from clients and members. Accounts receivable also includes accrued receivables for fertility benefits claims from provider clinics at the end of each period for services provided that have not yet been received. The Company estimates an allowance for changes and cancellations of services based upon historical experience and estimates member uncollectible amounts based upon historical bad debts, current member receivable balances and the age of member receivable balances. The following table provides a summary of the activity in these allowances for the three months ended March 31, 2020 and December 31, 2019 (in thousands):


March 31, 2020	Balance at Beginning of Period		Charged to Revenue		Charged to Costs and Expenses		Write-offs		Utilization		Balance at End of Period
Allowance for doubtful accounts	$	2,771	$	-	$	1,257	$	(4)	$	-	$	4,024
Allowance for service changes and cancellations		3,549		4,453		-		-		(3,549)		4,453
		6,320		4,453		1,257		(4)		(3,549)		8,477

December 31, 2019
Allowance for doubtful accounts	$	1,175	$	-	$	1,606	$	(10)	$	-	$	2,771
Allowance for service changes and cancellations		2,311		7,742		-		-		(6,504)		3,549
		3,486		7,742		1,606		(10)		(6,504)		6,320

Cost of Services

Fertility Benefit Services

Fertility benefit services costs include: (1) fees paid to provider clinics within our network, labs and anesthesiologists; (2) costs incurred (including salaries, bonuses, benefits, stock-based compensation, other related costs, and an allocation of our general overhead, depreciation and amortization) for those employees associated with our care management service functions: Provider Account Management, PCA and Provider Relations teams; and (3) related information technology support costs. Our contracts with provider clinics are typically for a term of one to two years.

Pharmacy Benefit Services

Pharmacy benefit services costs include: (1) the fees for prescription drugs dispensed and clinical services provided during the reporting period by our specialty pharmacy partners; (2) costs incurred (including salaries, bonuses, benefits, stock-based compensation, other related costs, and an allocation of our general overhead, depreciation and amortization) for those employees associated with our care management service functions: PCA and Provider Relations teams; and (3) related information technology support costs. Contracts with the specialty pharmacies are typically for a term of one year.

In the specialty pharmacy contracts, the contractual fees of prescription drugs sold includes the cost of the prescription drugs purchased and shipped to members by the Company’s specialty mail service dispensing pharmacy, net of any volume-related or other discounts.

Vendor rebates

The Company receives a rebate on formulations purchased and dispensed by the Company’s specialty pharmacy. The Company’s contractual arrangements with pharmaceutical manufacturers provide for the Company to receive a discount (or rebate) from established list prices paid subsequent to dispensing when products are purchased indirectly from a pharmaceutical manufacturer (e.g., through a specialty pharmacy.) These rebates are recognized as a reduction of Cost of services when prescriptions are dispensed and are generally estimated and billed to manufacturers within 15 days of the end of each month. The effect of adjustments resulting from the reconciliation of rebates recognized to the amounts billed and collected has not been material to the Company’s results of operations.

Recently Adopted Accounting Pronouncements

In May 2014, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) 2014-09, Revenue from Contracts with Customers (Topic 606), to achieve a consistent application of revenue recognition within the U.S., resulting in a single revenue model to be applied by reporting companies under U.S. GAAP. Under the new model, recognition of revenue occurs when a customer obtains control of promised goods or services in an amount that reflects the consideration to which the entity expects to be entitled in exchange for those goods or services. In addition, the revised guidance required that reporting companies disclose the nature, amount, timing, and uncertainty of revenue and cash flows arising from contracts with customers. The Company adopted this standard on January 1, 2019 using the full retrospective approach. The adoption of the new standard did not have a material impact on the financial statements.

In January 2017, the FASB issued ASU No. 2017-01, Clarifying the definition of a business. The new standard clarifies the definition of a business to assist entities with evaluating whether transactions should be accounted for as acquisitions (or disposals) of assets or businesses. The new standard is effective for the Company for fiscal years beginning after December 15, 2018 and interim periods within annual periods beginning after December 15, 2019. The Company adopted this guidance effective January 1, 2019, which did not have a material impact on the Company’s financial statements.

In March 2018, the FASB issued ASU No. 2018-05, Income Taxes (ASC 740), to conform to SEC Staff Accounting Bulletin No. 118 (“SAB 118”). The standard was issued to allow registrants to record provisional amounts during a measurement period not to extend beyond one year from the enactment date in instances when a registrant does not have the necessary information available, prepared, or analyzed in reasonable detail to complete the accounting for certain income tax effects of the Tax Cuts and Jobs Act (the “Tax Reform Act”). The standard was effective upon issuance. The adoption of this guidance did not have a material impact on the Company’s financial statements.

In June 2018, the FASB issued ASU No. 2018-07, Compensation—Stock Compensation (ASC 718): Improvements to Employee Share-Based Payment Accounting, which changes the accounting for share-based payment transactions with nonemployees. The Company adopted this guidance effective January 1, 2019. The adoption of this guidance did not have a material impact on the Company’s financial statements.

Accounting Pronouncements Issued but Not Yet Adopted

In February 2016, the FASB issued ASU No. 2016‑02, Leases (Topic 842). The new standard establishes a right-of-use (ROU) model that requires a lessee to record a ROU asset and a lease liability on the balance sheet for all leases with terms longer than 12 months. Leases will be classified as either finance or operating, with classification affecting the pattern of expense recognition in the income statement. In November 2019, the FASB most recently voted to defer the effective date of ASU 2016-02 for certain entities. As the Company has elected to use the extended transition period for complying with new or revised accounting standards applicable to private companies, the new standard is effective for fiscal years beginning after December 15, 2020. The Company plans to adopt the new standard using the modified retrospective approach of all leases entered into before the effective date. The Company is currently evaluating the impact this ASU will have on its financial statements.

In August 2018, the FASB issued ASU No. 2018-15, Intangibles — Goodwill and Other — Internal-Use Software (Subtopic 350-40): Customer’s Accounting for Implementation Costs Incurred in a Cloud Computing Arrangement That Is a Service Contract to determine which implementation costs to capitalize as assets. As the Company has elected to use the extended transition period for complying with new or revised accounting standards applicable for private companies, the new standard is effective for fiscal years beginning after December 15, 2020. Early adoption of the amendments is permitted, including adoption in any interim period, for all entities and should be applied either retrospectively or prospectively to all implementation costs incurred after the date of adoption. The Company is currently reviewing its cloud computing arrangements to evaluate the impact of adoption of the final guidance but does not expect that the pending adoption of this ASU will have a material effect on its financial statements.

In June 2016, the FASB issued ASU 2016-13 which replaces the incurred loss impairment methodology in current U.S. GAAP with a methodology that reflects expected credit losses and requires consideration of a broader range of reasonable and supportable information to inform credit loss estimates. In July 2019, the FASB voted to defer the effective date of the standard to fiscal years beginning after December 15, 2022. As the Company has elected to use the extended transition period for complying with new or revised accounting standards applicable to private companies, the ASU is effective for the Company for fiscal years beginning after December 15, 2022, and interim periods within those years. The Company is currently evaluating the impact this ASU will have on its consolidated financial statements.

In December 2019, the FASB issued ASU 2019-12, Income Taxes (Topic 740): Simplifying the Accounting for Income Taxes. The standard is intended to simplify the accounting for income taxes by removing certain exceptions to the general principles in Topic 740, as well as improve consistent application of and simplify GAAP for other areas of Topic 740 by clarifying and amending existing guidance. As the Company has elected to use the extended transition period for complying with new or revised accounting standards applicable to private companies, the new standard is effective for fiscal years beginning after December 15, 2021. The Company is currently evaluating the impact this ASU will have on its consolidated financial statements.

Revenue

3 Months Ended

Mar. 31, 2020

Revenue from Contract with Customer [Abstract]

Revenue

3. Revenue

Disaggregated revenue

The following table disaggregates revenue by service (in thousands):


	Three Months Ended
	March 31,
	2020		2019

Fertility benefit services revenue	$	59,433	$	40,365
Pharmacy benefit services revenue		21,591		6,832
Total revenue	$	81,024	$	47,197

Fair Value of Financial Instruments	3 Months Ended
Fair Value of Financial Instruments	Mar. 31, 2020
Fair Value Disclosures [Abstract]
Fair Value of Financial Instruments	4. Fair Value of Financial Instruments The fair value of financial instruments is determined based on assumptions that market participants would use when pricing an asset or liability at the balance sheet date. Certain assets are categorized based on the following fair value hierarchy of market participant assumptions: Level 1 — Unadjusted quoted prices in active markets that are accessible at the measurement date for identical assets or liabilities. Level 2 — Inputs, other than quoted prices in active markets, that are observable either directly or indirectly. Level 3 — Prices or valuation techniques that require inputs that are both significant to the fair value of the asset or liability and supported by little or no market activity. The Company uses observable market data when available, and minimizes the use of unobservable inputs when determining fair value As of March 31, 2020, the Company had $84.1 million, in financial assets held in money market accounts and U.S. treasury bills, all of which were classified as Level 1 in the fair value hierarchy. The Company measured these assets at fair value. The Company classified these assets as Level 1 because the values of these assets are determined using unadjusted quoted prices in active markets for identical assets. As of March 31, 2020 and December 31, 2019, the Company did not have any assets or liabilities classified as Level 2 or Level 3 in the fair value hierarchy.

- Definition

The entire disclosure for the fair value of financial instruments (as defined), including financial assets and financial liabilities (collectively, as defined), and the measurements of those instruments as well as disclosures related to the fair value of non-financial assets and liabilities. Such disclosures about the financial instruments, assets, and liabilities would include: (1) the fair value of the required items together with their carrying amounts (as appropriate); (2) for items for which it is not practicable to estimate fair value, disclosure would include: (a) information pertinent to estimating fair value (including, carrying amount, effective interest rate, and maturity, and (b) the reasons why it is not practicable to estimate fair value; (3) significant concentrations of credit risk including: (a) information about the activity, region, or economic characteristics identifying a concentration, (b) the maximum amount of loss the entity is exposed to based on the gross fair value of the related item, (c) policy for requiring collateral or other security and information as to accessing such collateral or security, and (d) the nature and brief description of such collateral or security; (4) quantitative information about market risks and how such risks are managed; (5) for items measured on both a recurring and nonrecurring basis information regarding the inputs used to develop the fair value measurement; and (6) for items presented in the financial statement for which fair value measurement is elected: (a) information necessary to understand the reasons for the election, (b) discussion of the effect of fair value changes on earnings, (c) a description of [similar groups] items for which the election is made and the relation thereof to the balance sheet, the aggregate carrying value of items included in the balance sheet that are not eligible for the election; (7) all other required (as defined) and desired information.

+ References + Details

Debt	3 Months Ended
Debt	Mar. 31, 2020
Debt Disclosure [Abstract]
Debt	5. Debt In June 2018, the Company entered into a loan agreement with Silicon Valley Bank for a revolving line of credit up to $15.0 million based upon an advance rate of 80% on “eligible” accounts receivable to fund its working capital and other general corporate needs (“SVB Line of Credit”). Eligible accounts receivable is defined in the loan agreement as accounts billed with aging 90 days or less and excludes accounts receivable due for member copayments, coinsurance, and deductibles. The Company is required to pay a revolving line commitment fee of $225,000 in three equal annual installments of $75,000 starting on the one-year anniversary of the SVB Line of Credit. The Company made the first installment payment of $75,000 in June 2019 and accrues this cost monthly. The SVB Line of Credit matures in June 2021. When the Company holds unrestricted cash balances greater than $5.0 million interest accrues at a floating rate per annum equal to the greater of prime rate or 4.75%. If the unrestricted cash balance is less than $5.0 million interest accrues at a floating rate per annum equal to the greater of prime rate plus 0.5% or 4.75%, with interest payable monthly. Interest is paid based upon the borrowed funds. The SVB Line of Credit contains customary affirmative covenants, financial covenants, as well as negative covenants that, among other things, restrict the Company’s ability to incur additional indebtedness (including guarantees of certain obligations); create liens; engage in mergers, consolidations, liquidations and dissolutions; sell assets; maintain collateral; pay dividends or make other payments in respect of capital stock; make acquisitions; make investments, loans and advances; enter into transactions with affiliates; make payments with respect to or modify subordinated debt instruments; and enter into agreements with negative pledge clauses or clauses restricting subsidiary distributions. The financial covenant requires the Company achieve minimum revenue targets established at 75% of the annual financial projections approved by the Board of Directors. The Company was in compliance with all requirements and covenants of the revolving credit facility as of March 31, 2020 and December 31, 2019. As of both March 31, 2020 and December 31, 2019, the Company had $0 drawn on the SVB Line of Credit. The Company recorded interest expense on the SVB Line of Credit of $0 and $38,000 in the three months ended March 31, 2020 and 2019, respectively.

Convertible Preferred Stock Warrants

3 Months Ended

Mar. 31, 2020

Warrants and Rights Note Disclosure [Abstract]

Convertible Preferred Stock Warrants

6. Convertible Preferred Stock Warrants

In connection with the IPO on October 25, 3019, the convertible preferred warrants converted to common stock warrants. Therefore, as of March 31, 2020 and December 31, 2019 the Company had no outstanding convertible preferred warrants. Prior to the conversion, the convertible preferred stock warrants were valued using the price as of the IPO date of $13 less the exercise price of $1.73 per common share. During the three months ended December 31, 2019, 482,661 common stock warrants were exercised for 441,307 shares of common stock at a weighted average exercise price of $1.59.

The Company recognized the warrants at fair value at the time of issuance and remeasured the warrants at their fair value on a recurring basis thereafter. Given the deemed liquidation provisions of the underlying convertible preferred stock, the convertible preferred stock warrant liabilities are recorded at fair value and are subject to remeasurement at each balance sheet date. The Company calculates the warrants’ fair value as follows:

The Company’s equity value is estimated using the market approach.

The Company’s equity value is then allocated among classes of its capital structure, including Series B convertible preferred shares. The allocation is performed using the Option Pricing Methodology. This method treats securities as options with the Company. The allocation is used to determine the value of Series B convertible preferred shares, as well as the Series B convertible preferred stock warrants. The Company assumes that any exercise of the warrants would be to purchase Series B convertible preferred shares, and assumes scenarios where the warrants will not be exercised.

Commitments and Contingencies	3 Months Ended
Commitments and Contingencies	Mar. 31, 2020
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	7. Commitments and Contingencies Arbitration/Litigation On January 14, 2019, a vendor filed a Demand for Arbitration and Statement of Claim against the Company (“Demand”) for alleged breach of the November 10, 2017 Preferred Specialty Pharmacy Agreement (“Agreement”) between the Company and the vendor. On March 13, 2019, the Company terminated the Agreement for material breach by the vendor. On April 3, 2019, the vendor filed a Second Amended Demand for Arbitration (“SAD”) for breach of the Agreement. The vendor seeks damages, fees, interest and cost. Pursuant to a schedule set forth by the Arbitration Panel, on May 3, 2019, the Company filed a Motion to Dismiss the SAD. That Motion was fully briefed on June 14, 2019 and was decided on July 31, 2019. The Arbitration Panel dismissed two of the vendor’s four claims. The Company believes the vendor’s claims are without merit and intends to vigorously defend against the claims in the Arbitration. Due to the inherent uncertainties of litigation, the Company cannot predict the outcome of the actions at this time and can give no assurances that the asserted claims will not have a material adverse effect on the financial position or results of operations of the Company. The Company believes there is no other litigation pending that could have, individually or in the aggregate, a material adverse effect on the Company’s financial position, results of operations, or cash flows.

Convertible Preferred Stock

3 Months Ended

Mar. 31, 2020

Temporary Equity Disclosure [Abstract]

Convertible Preferred Stock

8. Convertible Preferred Stock

During March, June and November 2017, the Company raised approximately $15.0 million through the issuance of 8,691,179 shares of its Series B convertible preferred stock at $1.73 per share to new and existing investors.

In June 2018, the Company redeemed and retired 1,202,196 shares of Series B convertible preferred stock from a former employee pursuant to its contractual right of first refusal at a purchase price of $2.5 million. The difference of $425,000 between the purchase price (at $2.04 per share) and the carrying value (at $1.73 per share) has been recorded as a dividend in accumulated deficit as of December 31, 2018.

In conjunction with the above convertible preferred stock redemption, certain stockholders purchased convertible preferred stock and common stock from the same former employee at the same price per share.

In connection with the transactions above, an outstanding severance liability was settled. As the total paid by the stockholders to the former employee was in excess of the common stock and preferred stock fair value, this premium was deemed consideration paid on behalf of the Company for the settlement of the severance liability. As such, the Company has accounted for this excess paid of $414,000 as a non-cash contribution in additional paid in capital.

The authorized, issued and outstanding shares, and liquidation preference of the Company’s convertible preferred stock as of the dates indicated were as follows (in thousands, except for share and per share data):


	As of March 31, 2019
	Authorized Shares	Issued and Outstanding Shares	Aggregate Liquidation Preference

Convertible Preferred Stock:
Series A Preferred	69,930,070	15,384,798	$ 20,000
Series B Preferred	245,000,000	50,043,290	86,369
Total	314,930,070	65,428,088	106,369

Stock-based Compensation

3 Months Ended

Mar. 31, 2020

Share-based Payment Arrangement [Abstract]

Stock-based Compensation

9. Stock-based Compensation

The following table summarizes stock-based compensation expense for employees, which was included in the statements of operations and comprehensive income as follows (in thousands):


	Three Months Ended
	March 31
	2020		2019
Cost of services	$	337	$	45
Selling and marketing		237		115
General and administrative		1,475		357
Total stock-based compensation expense	$	2,049	$	517

Income Taxes	3 Months Ended
Income Taxes	Mar. 31, 2020
Income Tax Disclosure [Abstract]
Income Taxes	10. Income Taxes For the three months ended March 31, 2020 and 2019, the Company calculated its year-to-date provision for income taxes by applying the estimated annual effective tax rate to the year-to-date profit from operations before income taxes and adjusts the provision for income taxes for discrete tax items recorded in the period. The Company updates its estimate of its annual effective tax rate at the end of each quarterly period. The estimate takes into account annual forecasted income before income taxes and any significant permanent tax items. During the three months ended March 31, 2020 and 2019, the Company recorded a provision of $116,000 and $0, respectively.

Net Earnings Per Share

3 Months Ended

Mar. 31, 2020

Earnings Per Share [Abstract]

Net Earnings Per Share

11. Net Earnings Per Share

Basic net income per share attributable to common stockholders is calculated by dividing the net income attributable to common stockholders by the weighted-average number of shares of common stock outstanding for the period. The Company adjusts its net income attributable to common stockholders to reflect the impact of deemed dividends recorded for convertible preferred stock during the period.

The Company’s convertible preferred stock was entitled to receive noncumulative dividends, prior and in preference to any declaration or payment of any dividend on common stock and thereafter participate pro rata on an as-converted basis with the common stockholders in any distributions to common stockholders and were therefore considered to be participating securities. As a result, the Company calculated the net income per share using the two-class method. Accordingly, the net income attributable to common stockholders is derived from the net income for the period and, in periods in which the Company has net income attributable to common stockholders, an adjustment is made for the allocations of undistributed earnings to participating securities based on their outstanding stockholder rights. Under the two-class method, the net income attributable to common stockholders is not allocated to the convertible preferred stock as the convertible preferred stockholders did not have a contractual obligation to share in the Company’s losses.

Diluted net income attributable to common stockholders is computed by adjusting income attributable to common stockholders to allocate undistributed earnings based on the potential impact of dilutive securities, including outstanding stock options, convertible preferred stock, convertible preferred stock warrants, and common stock warrants. Diluted net income per share attributable to common stockholders is computed by dividing the diluted net income attributable to common stockholders by the weighted average number of common shares outstanding for the period, including common stock equivalents. In periods when the Company has incurred a net loss, convertible preferred stock, options to purchase common stock, convertible preferred stock warrants, and common stock warrants are considered common stock equivalents but have been excluded from the calculation of diluted net loss per share attributable to common stockholders as their effect is antidilutive.

A reconciliation of net income available to common stockholders and the number of shares in the calculation of basic and diluted net loss per share follows (in thousands, except share and per share amounts):


	Three Months Ended
	March 31
	2020		2019
Basic earnings per common share:
Numerator:
Net income	$	4,057	$	2,521
Less:
Deemed dividends on convertible preferred stock		—		(2,098)
Undistributed earnings to participating securities		—		(392)
Net income attributable to common stockholders	$	4,057	$	31

Denominator:
Weighted-average shares used in computing basic net income per share attributable to common stockholders		84,537,538		5,156,755
Basic net income per share attributable to common stockholders	$	0.05	$	0.01

Diluted earnings per common share:
Numerator:
Net income attributable to common stockholders	$	4,057	$	31
Adjustments to undistributed earnings of participating securities		—		48
Diluted net income attributable to common stockholders	$	4,057	$	79

Denominator:
Weighted-average shares used in computing diluted net income per share attributable to common stockholder		84,537,538		5,156,755
Effect of dilutive securities		15,127,620		9,964,173
Weighted-average shares used in computing diluted net income per share attributable to common stockholders		99,665,158		15,120,928
Diluted net income per share attributable to common stockholders	$	0.04	$	0.01

The following weighted-average outstanding shares of potentially dilutive securities were excluded from the computation of diluted loss per share attributable to common stockholders for the period presented because including them would have been antidilutive:


	Three Months Ended
	March 31,
	2020	2019
Redeemable convertible preferred stock	—	65,428,088
Options to purchase common stock	256,679	9,964,173
Restricted stock units	115,741	—
Warrants to purchase common stock	—	96,198
Warrants to purchase convertible preferred stock	—	1,050,217
Total	372,420	76,538,676

Significant Accounting Policies (Policies)

3 Months Ended

Mar. 31, 2020

Accounting Policies [Abstract]

Basis of Presentation

The interim unaudited financial statements have been prepared in accordance with accounting principles generally accepted in the United States of America (“U.S. GAAP”) and pursuant to the rules and regulations of the Securities and Exchange Commission (“SEC”) applicable to interim financial reporting. These interim financial statements have been prepared on a basis consistent with the annual financial statements and, in the opinion of management, include all adjustments necessary to fairly state our financial position as of March 31, 2020, the results of our operations for the three months ended March 31, 2020 and 2019 and the results of our cash flows for the three months ended March 31, 2020 and 2019. Therefore, these unaudited financial statements should be read in conjunction with the audited financial statements and related footnotes included in the Annual Report on Form 10-K filed with the SEC on March 10, 2020.

The results for the three months ended March 31, 2020 are not necessarily indicative of the operating results expected for the year ending December 31, 2020 or any other future period. Additionally, there are many uncertainties regarding the current coronavirus (“COVID-19”) pandemic, and the Company is closely monitoring the impact of the pandemic on all aspects of its business, including how it will impact its customers and their members, its provider network, specialty pharmacy partners, employees, suppliers, vendors, and other business partners. The full extent to which the COVID-19 pandemic will directly or indirectly impact the Company’s business, future results of operations and financial condition will depend on future developments that are highly uncertain and cannot be accurately predicted, including new information that may emerge concerning COVID-19, the actions taken to contain it or treat its impact and the economic impact on local, regional and national markets. The overall disruption of the healthcare and fertility markets and the other risks and uncertainties associated with the pandemic could have a material adverse effect on the Company’s business, financial condition, results of operations and growth prospects. The Company will continue to assess the evolving impact of the COVID-19 pandemic and will make adjustments to its operations as necessary.

Use of Estimates

The preparation of financial statements in conformity with U.S. GAAP generally requires management to make estimates and assumptions that affect the reported amount of certain assets, liabilities, revenue, and expenses, and the related disclosure of contingent assets and liabilities. The accounting estimates that require the most complex and subjective judgements include accrued receivables, accrued claims payable, allowance for doubtful accounts, accrued rebates, and stock-based compensation. Management bases its estimates on historical experience and on various other assumptions that are believed to be reasonable under the circumstances, the results of which form the basis for making judgments about the carrying value of assets and liabilities that are not readily apparent from other sources. Actual results may differ from these estimates under different assumptions or conditions.

Revenue Recognition

The Company applies the following five-step model to recognize revenue from contracts with clients:

Identification of the contract, or contracts, with a client

Identification of the performance obligations in the contract

Determination of the transaction price

Allocation of the transaction price to the performance obligations in the contract

Recognition of revenue when, or as, a performance obligation is satisfied

Fertility Benefits Revenue

Pharmacy Benefits Revenue

There are no material contract asset or contract liability balances as of March 31, 2020 and December 31, 2019.

Accrued Receivable and Accrued Claims Payable

Accounts Receivable and Allowance for Doubtful Accounts


March 31, 2020	Balance at Beginning of Period		Charged to Revenue		Charged to Costs and Expenses		Write-offs		Utilization		Balance at End of Period
Allowance for doubtful accounts	$	2,771	$	-	$	1,257	$	(4)	$	-	$	4,024
Allowance for service changes and cancellations		3,549		4,453		-		-		(3,549)		4,453
		6,320		4,453		1,257		(4)		(3,549)		8,477

December 31, 2019
Allowance for doubtful accounts	$	1,175	$	-	$	1,606	$	(10)	$	-	$	2,771
Allowance for service changes and cancellations		2,311		7,742		-		-		(6,504)		3,549
		3,486		7,742		1,606		(10)		(6,504)		6,320

Cost of Services

Fertility Benefit Services

Pharmacy Benefit Services

Vendor rebates

Recently Adopted Accounting Pronouncements and Accounting Pronouncements Issued but Not Yet Adopted

Recently Adopted Accounting Pronouncements

Accounting Pronouncements Issued but Not Yet Adopted

Significant Accounting Policies (Tables)

3 Months Ended

Mar. 31, 2020

Accounting Policies [Abstract]

Schedule of accounts receivable and allowance for doubtful accounts


March 31, 2020	Balance at Beginning of Period		Charged to Revenue		Charged to Costs and Expenses		Write-offs		Utilization		Balance at End of Period
Allowance for doubtful accounts	$	2,771	$	-	$	1,257	$	(4)	$	-	$	4,024
Allowance for service changes and cancellations		3,549		4,453		-		-		(3,549)		4,453
		6,320		4,453		1,257		(4)		(3,549)		8,477

December 31, 2019
Allowance for doubtful accounts	$	1,175	$	-	$	1,606	$	(10)	$	-	$	2,771
Allowance for service changes and cancellations		2,311		7,742		-		-		(6,504)		3,549
		3,486		7,742		1,606		(10)		(6,504)		6,320

Revenue (Tables)

3 Months Ended

Mar. 31, 2020

Revenue from Contract with Customer [Abstract]

Schedule of disaggregation of revenue


	Three Months Ended
	March 31,
	2020		2019

Fertility benefit services revenue	$	59,433	$	40,365
Pharmacy benefit services revenue		21,591		6,832
Total revenue	$	81,024	$	47,197

Convertible Preferred Stock (Tables)

3 Months Ended

Mar. 31, 2020

Temporary Equity Disclosure [Abstract]

Schedule of authorized, issued and outstanding shares, and liquidation preference of convertible preferred stock


	As of March 31, 2019
	Authorized Shares	Issued and Outstanding Shares	Aggregate Liquidation Preference

Convertible Preferred Stock:
Series A Preferred	69,930,070	15,384,798	$ 20,000
Series B Preferred	245,000,000	50,043,290	86,369
Total	314,930,070	65,428,088	106,369

Stock-based Compensation (Tables)

3 Months Ended

Mar. 31, 2020

Share-based Payment Arrangement [Abstract]

Summary of stock based compensation expense for employees


	Three Months Ended
	March 31
	2020		2019
Cost of services	$	337	$	45
Selling and marketing		237		115
General and administrative		1,475		357
Total stock-based compensation expense	$	2,049	$	517

Net Earnings Per Share (Tables)

3 Months Ended

Mar. 31, 2020

Earnings Per Share [Abstract]

Reconciliation of net income loss available to common stockholders


	Three Months Ended
	March 31
	2020		2019
Basic earnings per common share:
Numerator:
Net income	$	4,057	$	2,521
Less:
Deemed dividends on convertible preferred stock		—		(2,098)
Undistributed earnings to participating securities		—		(392)
Net income attributable to common stockholders	$	4,057	$	31

Denominator:
Weighted-average shares used in computing basic net income per share attributable to common stockholders		84,537,538		5,156,755
Basic net income per share attributable to common stockholders	$	0.05	$	0.01

Diluted earnings per common share:
Numerator:
Net income attributable to common stockholders	$	4,057	$	31
Adjustments to undistributed earnings of participating securities		—		48
Diluted net income attributable to common stockholders	$	4,057	$	79

Denominator:
Weighted-average shares used in computing diluted net income per share attributable to common stockholder		84,537,538		5,156,755
Effect of dilutive securities		15,127,620		9,964,173
Weighted-average shares used in computing diluted net income per share attributable to common stockholders		99,665,158		15,120,928
Diluted net income per share attributable to common stockholders	$	0.04	$	0.01

Antidilutive securities excluded from computation of earnings per share


	Three Months Ended
	March 31,
	2020	2019
Redeemable convertible preferred stock	—	65,428,088
Options to purchase common stock	256,679	9,964,173
Restricted stock units	115,741	—
Warrants to purchase common stock	—	96,198
Warrants to purchase convertible preferred stock	—	1,050,217
Total	372,420	76,538,676

Business and Basis of Presentation - Description of Business (Details) - segment	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Segment Reporting, Disclosure of Entity's Reportable Segments [Abstract]
Number of operating segments	1	1

Business and Basis of Presentation - Initial Public Offering (Details) - USD ($) $ / shares in Units, $ in Thousands	Oct. 29, 2019	Oct. 25, 2019
IPO
Subsidiary, Sale of Stock [Line Items]
Number of shares issued and sold (in shares)	6,700,000
Share price (in dollars per share)	$ 13.00	$ 13
Net proceeds after deducting underwriters’ discounts, commissions, and offering costs	$ 77,600
Underwriters’ discounts and commissions	5,900
Offering costs	$ 3,600
Conversion of Convertible Preferred Stock to Common Stock upon initial public offering (in shares)	65,428,088
Conversion basis (in shares)	1
IPO \| Additional Paid in Capital
Subsidiary, Sale of Stock [Line Items]
Reclassification of temporary equity to permanent equity	$ 106,200
IPO \| Common Stock
Subsidiary, Sale of Stock [Line Items]
Reclassification of temporary equity to permanent equity	$ 7
Selling Shareholders, Including Over-Allotment Option
Subsidiary, Sale of Stock [Line Items]
Number of shares issued and sold (in shares)	4,800,000
Over-Allotment Option
Subsidiary, Sale of Stock [Line Items]
Number of shares issued and sold (in shares)	1,500,000

Business and Basis of Presentation - Reverse Stock Split (Details)	Oct. 14, 2019
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Reverse stock split ratio	0.22000264

Significant Accounting Policies - Revenue Recognition (Details)	3 Months Ended
	Mar. 31, 2020
Accounting Policies [Abstract]
Contract term	3 years
Contract termination, notice period, low end of range	30 days
Contract termination, notice period, high end of range	90 days

Significant Accounting Policies - Accrued Receivable and Accrued Claims Payable (Details) - USD ($) $ in Millions	Mar. 31, 2020	Dec. 31, 2019
Accounting Policies [Abstract]
Accrued receivables	$ 12.0	$ 16.0
Accrued claims payable	14.2	9.8
Unbilled receivables	$ 21.1	$ 8.5

Significant Accounting Policies - Accounts and Receivable and Allowance for Doubtful Accounts (Details) - USD ($) $ in Thousands	3 Months Ended	12 Months Ended
	Mar. 31, 2020	Dec. 31, 2019
SEC Schedule, 12-09, Movement in Valuation Allowances and Reserves [Roll Forward]
Balance at Beginning of Period	$ 6,320	$ 3,486
Charged to Revenue	4,453	7,742
Charged to Costs and Expenses	1,257	1,606
Write-offs	(4)	(10)
Utilization	(3,549)	(6,504)
Balance at End of Period	8,477	6,320
Allowance for doubtful accounts
SEC Schedule, 12-09, Movement in Valuation Allowances and Reserves [Roll Forward]
Balance at Beginning of Period	2,771	1,175
Charged to Costs and Expenses	1,257	1,606
Write-offs	(4)	(10)
Balance at End of Period	4,024	2,771
Allowance for service changes and cancellations
SEC Schedule, 12-09, Movement in Valuation Allowances and Reserves [Roll Forward]
Balance at Beginning of Period	3,549	2,311
Charged to Revenue	4,453	7,742
Utilization	(3,549)	(6,504)
Balance at End of Period	$ 4,453	$ 3,549

Significant Accounting Policies - Cost of Services (Details)	3 Months Ended
	Mar. 31, 2020
Accounting Policies [Abstract]
Contract Term, Clinics, Low End of Range	1 year
Contract Term, Clinics, High End of Range	2 years

Significant Accounting Policies - Recently Adopted Accounting Pronouncements and Accounting Pronouncements Issued but Not Yet Adopted (Details)	Mar. 31, 2020
Accounting Standards Update 2014-09
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Change in Accounting Principle, Accounting Standards Update, Adopted	true
Change in Accounting Principle, Accounting Standards Update, Adoption Date	Jan. 01, 2019
Change in Accounting Principle, Accounting Standards Update, Early Adoption	false
Change in Accounting Principle, Accounting Standards Update, Transition Option Elected	Retrospective
Accounting Standards Update 2017-01
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Change in Accounting Principle, Accounting Standards Update, Adopted	true
Change in Accounting Principle, Accounting Standards Update, Adoption Date	Jan. 01, 2019
Change in Accounting Principle, Accounting Standards Update, Early Adoption	false
Accounting Standards Update 2018-07
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Change in Accounting Principle, Accounting Standards Update, Adopted	true
Change in Accounting Principle, Accounting Standards Update, Adoption Date	Jan. 01, 2019
Change in Accounting Principle, Accounting Standards Update, Early Adoption	false
Accounting Standards Update 2016-02
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Change in Accounting Principle, Accounting Standards Update, Adopted	false
Change in Accounting Principle, Accounting Standards Update, Early Adoption	false
Change in Accounting Principle, Accounting Standards Update, Transition Option Elected	Modified Retrospective
Accounting Standards Update 2018-15
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Change in Accounting Principle, Accounting Standards Update, Adopted	false
Change in Accounting Principle, Accounting Standards Update, Early Adoption	false
Accounting Standards Update 2016-13
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Change in Accounting Principle, Accounting Standards Update, Adopted	false
Change in Accounting Principle, Accounting Standards Update, Early Adoption	false

Revenue (Details) - USD ($) $ in Thousands	3 Months Ended
Revenue (Details) - USD ($) $ in Thousands	Mar. 31, 2020	Mar. 31, 2019
Revenues [Abstract]
Revenue	$ 81,024	$ 47,197
Fertility benefit services revenue
Revenues [Abstract]
Revenue	59,433	40,365
Pharmacy benefit services revenue
Revenues [Abstract]
Revenue	$ 21,591	$ 6,832

Fair Value of Financial Instruments (Details) - USD ($) $ in Millions	Mar. 31, 2020	Dec. 31, 2019
Level 2
Assets, Fair Value Disclosure [Abstract]
Assets, Fair Value Disclosure	$ 0.0	$ 0.0
Level 3
Assets, Fair Value Disclosure [Abstract]
Assets, Fair Value Disclosure	0.0	$ 0.0
Recurring \| Level 1
Assets, Fair Value Disclosure [Abstract]
Assets, Fair Value Disclosure	$ 84.1

Debt (Details) - Line of Credit - Silicon Valley Bank Revolving Line of Credit $ in Thousands	1 Months Ended	3 Months Ended
	Jun. 30, 2018 USD ($) installment	Mar. 31, 2020 USD ($)	Mar. 31, 2019 USD ($)
Short-term Debt [Line Items]
Maximum borrowing capacity	$ 15,000
Advance rate upon which the borrowing capacity is based (as a percent)	80.00%
Threshold period of accounts receivable aging	90 days
Minimum revenue targets (as a percent)	75.00%
Short term debt		$ 0
Interest expense		$ 0	$ 38
Commitment fee	$ 225
Frequency of commitment fee	annual
Commitment fee, number of installments \| installment	3
Commitment fee, installment amount	$ 75
Unrestricted cash balance greater than 5 million, interest accrues
Short-term Debt [Line Items]
Interest rate (as a percent)	4.75%
Unrestricted cash balance less than 5 million, interest accrues
Short-term Debt [Line Items]
Interest rate (as a percent)	4.75%
Prime Rate \| Unrestricted cash balance greater than 5 million, interest accrues
Short-term Debt [Line Items]
Variable rate spread (as a percent)	0.00%
Prime Rate \| Unrestricted cash balance less than 5 million, interest accrues
Short-term Debt [Line Items]
Variable rate spread (as a percent)	0.50%

Convertible Preferred Stock Warrants (Details) - $ / shares	3 Months Ended
	Dec. 31, 2019	Mar. 31, 2020	Oct. 29, 2019	Oct. 25, 2019
IPO
Class of Warrant or Right [Line Items]
Share price (in dollars per share)			$ 13.00	$ 13
Exercise price (in dollars per share)				$ 1.73
Warrants to purchase common stock
Class of Warrant or Right [Line Items]
Warrants exercised (in shares)	482,661
Warrants to purchase convertible preferred stock
Class of Warrant or Right [Line Items]
Warrants outstanding (in shares)	0	0
Warrants exercised, shares issued (in shares)	441,307
Warrants to purchase convertible preferred stock \| Weighted Average
Class of Warrant or Right [Line Items]
Exercise price (in dollars per share)	$ 1.59

Commitments and Contingencies (Details) - Second Amended Demand for Arbitration, Vendor - claim	Jul. 31, 2019	Apr. 03, 2019
Loss Contingency, Quantities [Abstract]
Loss contingency, claims dismissed, number	2
Loss contingency, pending claims, number		4

Convertible Preferred Stock - Shares Issued (Details) - Series B Preferred Stock - USD ($) $ / shares in Units, $ in Millions	9 Months Ended
	Nov. 30, 2017	Jun. 30, 2018
Class of Stock [Line Items]
Value of shares issued	$ 15.0
Shares issued (in shares)	8,691,179
Share price (in dollars per share)	$ 1.73	$ 1.73

Convertible Preferred Stock - Related Party Transaction (Details) - Series B Preferred Stock - USD ($) $ / shares in Units, $ in Thousands	1 Months Ended
	Jun. 30, 2018	Nov. 30, 2017
Class of Stock [Line Items]
Share price (in dollars per share)	$ 1.73	$ 1.73
Former employee
Class of Stock [Line Items]
Shares redeemed and retired (in shares)	1,202,196
Purchase price	$ 2,500
Difference between the purchase price and the carrying value	$ 425
Purchase price (in dollars per share)	$ 2.04

Convertible Preferred Stock - Non-cash Contribution (Details) $ in Thousands	1 Months Ended
	Jun. 30, 2018 USD ($)
Temporary Equity Disclosure [Abstract]
Non-cash contribution	$ 414

Convertible Preferred Stock - Tabular Disclosure (Details) - USD ($) $ in Thousands	Mar. 31, 2020	Mar. 31, 2019	Dec. 31, 2018
Class of Stock [Line Items]
Convertible preferred stock, shares authorized (in shares)	100,000,000	314,930,070
Convertible preferred stock, shares issued (in shares)	0	65,428,088	65,428,088
Convertible preferred stock, shares outstanding (in shares)	0	65,428,088
Convertible preferred stock, aggregate liquidation preference	$ 0	$ 106,369
Series A Preferred Stock
Class of Stock [Line Items]
Convertible preferred stock, shares authorized (in shares)		69,930,070
Convertible preferred stock, shares issued (in shares)		15,384,798
Convertible preferred stock, shares outstanding (in shares)		15,384,798
Convertible preferred stock, aggregate liquidation preference		$ 20,000
Series B Preferred Stock
Class of Stock [Line Items]
Convertible preferred stock, shares authorized (in shares)		245,000,000
Convertible preferred stock, shares issued (in shares)		50,043,290
Convertible preferred stock, shares outstanding (in shares)		50,043,290
Convertible preferred stock, aggregate liquidation preference		$ 86,369

Stock-based Compensation (Details) - USD ($) $ in Thousands	3 Months Ended
Stock-based Compensation (Details) - USD ($) $ in Thousands	Mar. 31, 2020	Mar. 31, 2019
Share-based Payment Arrangement, Additional Disclosure [Abstract]
Stock-based compensation expense	$ 2,049	$ 517
Cost of services
Share-based Payment Arrangement, Additional Disclosure [Abstract]
Stock-based compensation expense	337	45
Selling and marketing
Share-based Payment Arrangement, Additional Disclosure [Abstract]
Stock-based compensation expense	237	115
General and administrative
Share-based Payment Arrangement, Additional Disclosure [Abstract]
Stock-based compensation expense	$ 1,475	$ 357

Income Taxes (Details) - USD ($) $ in Thousands	3 Months Ended
Income Taxes (Details) - USD ($) $ in Thousands	Mar. 31, 2020	Mar. 31, 2019
Income Tax Expense (Benefit), Continuing Operations [Abstract]
Provision for income taxes	$ 116	$ 0

Net Earnings Per Share - Reconciliation (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Net Income (Loss) Available to Common Stockholders, Basic [Abstract]
Net income	$ 4,057	$ 2,521
Less: Deemed dividends on convertible preferred stock		(2,098)
Less: Undistributed earnings to participating securities		(392)
Net income attributable to common stockholders	$ 4,057	$ 31
Weighted Average Number of Shares Outstanding, Basic [Abstract]
Weighted-average shares used in computing basic loss per share attributable to common stockholders (in shares)	84,537,538	5,156,755
Earnings Per Share, Basic [Abstract]
Basic net income per share attributable to common stockholders (in dollars per share)	$ 0.05	$ 0.01
Net Income (Loss) Available to Common Stockholders, Diluted [Abstract]
Net income attributable to common stockholders	$ 4,057	$ 31
Adjustments to undistributed earnings of participating securities		48
Diluted net income attributable to common stockholders	$ 4,057	$ 79
Weighted Average Number of Shares Outstanding, Diluted [Abstract]
Weighted-average shares used in computing basic loss per share attributable to common stockholders (in shares)	84,537,538	5,156,755
Effect of dilutive securities (in shares)	15,127,620	9,964,173
Weighted-average shares used in computing diluted net (loss) income per share attributable to common stockholders (in shares)	99,665,158	15,120,928
Earnings Per Share, Diluted [Abstract]
Diluted net income per share attributable to common stockholders (in dollars per share)	$ 0.04	$ 0.01

Net Earnings Per Share - Potentially Dilutive Securities (Details) - shares	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Total (in shares)	372,420	76,538,676
Redeemable convertible preferred stock
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Total (in shares)		65,428,088
Options to purchase common stock
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Total (in shares)	256,679	9,964,173
Restricted stock units
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Total (in shares)	115,741
Warrants to purchase common stock
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Total (in shares)		96,198
Warrants to purchase convertible preferred stock
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Total (in shares)		1,050,217