0001558370-21-010678 | 10-Q | XBRL Viewer

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Document and Entity Information - $ / shares	6 Months Ended
Document and Entity Information - $ / shares	Jun. 30, 2021	Jul. 31, 2021
Cover [Abstract]
Entity Central Index Key	0001551306
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Jun. 30, 2021
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,
Trading Symbol	PGNY
Security Exchange Name	NASDAQ
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		89,393,728
Entity Listing, Par Value Per Share	$ 0.0001
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2021
Document Fiscal Period Focus	Q2
Amendment Flag	false

Consolidated Balance Sheets - USD ($) $ in Thousands	Jun. 30, 2021	Dec. 31, 2020
Current assets:
Cash and cash equivalents	$ 48,747	$ 70,305
Marketable securities	45,221	38,994
Accounts receivable, net of $14,105 and $9,502 of allowance at June 30, 2021 and December 31, 2020, respectively	140,767	75,664
Prepaid expenses and other current assets	3,756	5,259
Total current assets	238,491	190,222
Property and equipment, net	3,931	3,400
Operating lease right-of-use assets	8,241	8,668
Goodwill	11,880	11,880
Intangible assets, net	848	1,213
Deferred tax assets	48,148	37,971
Other noncurrent assets	536	573
Total assets	312,075	253,927
Current liabilities:
Accounts payable	54,678	43,514
Accrued expenses and other current liabilities	44,107	34,272
Total current liabilities	98,785	77,786
Operating lease noncurrent liabilities	7,873	8,318
Other noncurrent liabilities	876	876
Total liabilities	107,534	86,980
Commitments and Contingencies (Note 7)
STOCKHOLDERS' EQUITY
Common stock, $0.0001 par value; 1,000,000,000 shares authorized at June 30, 2021 and December 31, 2020; 89,360,084 and 87,054,329 shares issued and outstanding at June 30, 2021 and December 31, 2020, respectively	9	9
Additional paid-in capital	240,111	236,139
Treasury stock, at cost, $0.0001 par value; 615,980 shares at June 30, 2021 and December 31, 2020	(1,009)	(1,009)
Accumulated deficit	(34,300)	(68,193)
Accumulated other comprehensive income (loss)	(270)	1
Total stockholders' equity	204,541	166,947
Total liabilities and stockholders' equity	$ 312,075	$ 253,927

Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Thousands	Jun. 30, 2021	Dec. 31, 2020
Allowances for accounts receivable
Allowances for accounts receivable	$ 14,105	$ 9,502
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)	89,360,084	87,054,329
Common stock, shares outstanding (in shares)	89,360,084	87,054,329
Treasury stock
Treasury stock, shares outstanding (in shares)	615,980	615,980

Consolidated Statements of Operations - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2021	Jun. 30, 2020	Jun. 30, 2021	Jun. 30, 2020
Statements of Operations
Revenue	$ 128,651	$ 64,605	$ 250,784	$ 145,629
Revenue, type	Service	Service	Service	Service
Cost of services	$ 99,030	$ 52,650	$ 192,256	$ 117,072
Cost of services, type	Service	Service	Service	Service
Gross profit	$ 29,621	$ 11,955	$ 58,528	$ 28,557
Operating expenses:
Sales and marketing	4,028	3,608	8,042	6,875
General and administrative	13,937	9,419	27,023	19,323
Total operating expenses	17,965	13,027	35,065	26,198
Income (loss) from operations	11,656	(1,072)	23,463	2,359
Other income:
Other income	12	3	19	167
Interest income, net	252	5	234	155
Total other income, net	264	8	253	322
Income (loss) before income taxes	11,920	(1,064)	23,716	2,681
Benefit (provision) for income taxes	6,807		10,177	(116)
Net income (loss)	18,727	(1,064)	33,893	2,565
Net income (loss) attributable to common stockholders	$ 18,727	$ (1,064)	$ 33,893	$ 2,565
Net income (loss) per share attributable to common stockholders:
Basic (in dollars per share)	$ 0.21	$ (0.01)	$ 0.39	$ 0.03
Diluted (in dollars per share)	$ 0.19	$ (0.01)	$ 0.34	$ 0.03
Weighted-average shares used in computing net income (loss) per share:
Basic (in shares)	88,165,158	85,281,151	87,783,894	84,909,692
Diluted (in shares)	99,808,085	85,281,151	99,977,518	98,887,190

Consolidated Statement of Comprehensive Income (Loss) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2021	Jun. 30, 2020	Jun. 30, 2021	Jun. 30, 2020
Statement of Comprehensive Income
Net income (loss)	$ 18,727	$ (1,064)	$ 33,893	$ 2,565
Other comprehensive income:
Unrealized gain (loss) on marketable securities	(220)	5	(271)	5
Total other comprehensive income (loss)	(220)	5	(271)	5
Total comprehensive income (loss)	$ 18,507	$ (1,059)	$ 33,622	$ 2,570

- Definition

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

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+ Details

Consolidated Statements of Changes in Stockholders' Equity - USD ($) $ in Thousands	Common Stock	Treasury Stock	Additional Paid in Capital	Accumulated Deficit Cumulative Effect, Period of Adoption, Adjustment	Accumulated Deficit	Other Comprehensive Income	Cumulative Effect, Period of Adoption, Adjustment	Total
Balance at beginning of period at Dec. 31, 2019	$ 8	$ (1,009)	$ 228,755	$ (1,169)	$ (113,483)		$ (1,169)	$ 114,271
Balance at beginning of period (in shares) at Dec. 31, 2019	84,188,202
Increase (Decrease) in Stockholders' Equity
Issuance of employee equity awards, net of shares withheld	$ 1		(2,668)					(2,667)
Issuance of employee equity awards, net of shares withheld (in shares)	1,589,855
Stock-based compensation			5,590					5,590
Reduction in initial public offering costs			115					115
Other comprehensive income						$ 5		5
Net income					2,565			2,565
Balance at end of period at Jun. 30, 2020	$ 9	(1,009)	231,792		(112,087)	5		118,710
Balance at end of period (in shares) at Jun. 30, 2020	85,778,057
Balance at beginning of period at Mar. 31, 2020	$ 8	(1,009)	231,516		(111,023)			119,492
Balance at beginning of period (in shares) at Mar. 31, 2020	84,845,828
Increase (Decrease) in Stockholders' Equity
Issuance of employee equity awards, net of shares withheld	$ 1		(3,265)					(3,264)
Issuance of employee equity awards, net of shares withheld (in shares)	932,229
Stock-based compensation			3,541					3,541
Other comprehensive income						5		5
Net income					(1,064)			(1,064)
Balance at end of period at Jun. 30, 2020	$ 9	(1,009)	231,792		(112,087)	5		118,710
Balance at end of period (in shares) at Jun. 30, 2020	85,778,057
Balance at beginning of period at Dec. 31, 2020	$ 9	(1,009)	236,139		(68,193)	1		$ 166,947
Balance at beginning of period (in shares) at Dec. 31, 2020	87,054,329							87,054,329
Increase (Decrease) in Stockholders' Equity
Issuance of employee equity awards, net of shares withheld			(7,591)					$ (7,591)
Issuance of employee equity awards, net of shares withheld (in shares)	1,480,764
Stock-based compensation			11,563					11,563
Warrant exercise			0					0
Warrant exercise (in shares)	824,991
Other comprehensive income						(271)		(271)
Net income					33,893			33,893
Balance at end of period at Jun. 30, 2021	$ 9	(1,009)	240,111		(34,300)	(270)		$ 204,541
Balance at end of period (in shares) at Jun. 30, 2021	89,360,084							89,360,084
Balance at beginning of period at Mar. 31, 2021	$ 9	(1,009)	238,695		(53,027)	(50)		$ 184,618
Balance at beginning of period (in shares) at Mar. 31, 2021	87,732,302
Increase (Decrease) in Stockholders' Equity
Issuance of employee equity awards, net of shares withheld			(5,113)					(5,113)
Issuance of employee equity awards, net of shares withheld (in shares)	802,791
Stock-based compensation			6,529					6,529
Warrant exercise			0					0
Warrant exercise (in shares)	824,991
Other comprehensive income						(220)		(220)
Net income					18,727			18,727
Balance at end of period at Jun. 30, 2021	$ 9	$ (1,009)	$ 240,111		$ (34,300)	$ (270)		$ 204,541
Balance at end of period (in shares) at Jun. 30, 2021	89,360,084							89,360,084

Consolidated Statements of Cash Flows - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2021	Jun. 30, 2020
OPERATING ACTIVITIES
Net income	$ 33,893	$ 2,565
Adjustments to reconcile net income (loss) to net cash provided by operating activities:
Deferred tax (benefit) expense	(10,177)	116
Non-cash interest expense	38	37
Depreciation and amortization	718	980
Stock-based compensation expense	11,551	5,590
Bad debt expense	4,805	2,149
Changes in operating assets and liabilities:
Accounts receivable	(69,908)	(20,400)
Prepaid expenses and current other assets	1,491	1,670
Accounts payable	11,091	12,833
Accrued expenses and other current liabilities	9,537	8,470
Other noncurrent assets and liabilities	20	327
Net cash (used in) provided by operating activities	(6,941)	14,337
INVESTING ACTIVITIES
Purchase of property and equipment, net	(799)	(791)
Purchases of marketable securities	(83,481)	(41,979)
Sale of marketable securities	76,984
Net cash (used in) investing activities	(7,296)	(42,770)
FINANCING ACTIVITIES
Payment of initial public offering costs		(791)
Proceeds from exercise of stock options	1,191	1,429
Payment of employee taxes related to equity awards	(9,291)	(4,096)
Proceeds from contributions to employee stock purchase plan	779	901
Net cash (used in) financing activities	(7,321)	(2,557)
Net (decrease) in cash and cash equivalents	(21,558)	(30,990)
Cash and cash equivalents, beginning of period	70,305	80,382
Cash and cash equivalents, end of period	48,747	49,392
SUPPLEMENTAL DISCLOSURE OF NON-CASH INVESTING AND FINANCING ACTIVITIES
Additions of property and equipment, net included in accounts payable and accrued expenses	$ 98	$ 89

Business and Basis of Presentation

6 Months Ended

Jun. 30, 2021

Organization, Consolidation and Presentation of Financial Statements [Abstract]

Business and Basis of Presentation

1. Business and Basis of Presentation

Description of Business

Progyny, Inc. (together with its subsidiary 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.

Emerging Growth Company Status

Prior to December 31, 2020, the Company was 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 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 was (i) no longer an emerging growth company or (ii) affirmatively and irrevocably opted out of the extended transition period provided in the JOBS Act. Based on the market value of the Company’s common stock as of June 30, 2020, the Company ceased to qualify as an emerging growth company as of December 31, 2020. As a result, the Company no longer was able to use the extended transition period for complying with new or revised accounting standards available to emerging growth companies and was required to adopt new or revised accounting standards as of the effective dates for public companies. Refer to Note 2 – Significant Accounting Policies below for a discussion of new accounting pronouncements adopted in the fourth quarter of 2020 with an effective date of January 1, 2020.

Basis of Presentation

The accompanying interim unaudited consolidated financial statements include the accounts of Progyny, Inc. and its wholly owned subsidiary, Progyny Fertility Purchasing, LLC. The interim unaudited consolidated 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 consolidated financial statements have been prepared on a basis consistent with the annual consolidated financial statements and, in the opinion of

management, include all adjustments necessary to fairly state our financial position as of June 30, 2021, the results of our operations for the three and six months ended June 30, 2021 and 2020 and the results of our cash flows for the six months ended June 30, 2021 and 2020. Therefore, these unaudited consolidated financial statements should be read in conjunction with the audited consolidated financial statements and related footnotes included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2020, filed with the SEC on March 1, 2021.

The results for the three and six months ended June 30, 2021 are not necessarily indicative of the operating results expected for the year ending December 31, 2021 or any other future period. Additionally, there are many uncertainties regarding the ongoing coronavirus (“COVID-19”) pandemic, and the Company is closely monitoring the impact of the pandemic on all aspects of its business, including how it has impacted and may continue to impact its customers and 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 and variants, the actions taken to contain it or treat its impact, vaccine roll-out and 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 consolidated 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. Such estimates include, but are not limited to, the determination of revenue recognition including accrued receivables, accrued claims payable, allowance for doubtful accounts, stock-based compensation, lease liabilities, and accounting for income taxes. 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.

Significant Accounting Policies

6 Months Ended

Jun. 30, 2021

Accounting Policies [Abstract]

Significant Accounting Policies

2. Significant Accounting Policies

There have 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, 2020.

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 estimates of service level agreement refunds, have not historically resulted in significant adjustments to the transaction price.

Clients are typically 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 pharmacies. 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 June 30, 2021 and December 31, 2020.

Accrued Receivables 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 end of each period, which includes assumptions regarding the lag between authorization date and service date as well as estimates for changes and cancellations of services. 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 June 30, 2021 and December 31, 2020, accrued receivables were $40.5 million and $28.2 million. Accrued receivables are included within accounts receivable in the balance sheet.

Accrued claims payable of $30.8 million and $22.8 million as of June 30, 2021 and December 31, 2020, respectively, 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 June 30, 2021 and December 31, 2020, unbilled receivables, which represent claims received and approved but unbilled at the end of the reporting period, were $25.6 million and $16.4 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. The Company estimates the allowance for doubtful accounts based on the lifetime expected credit losses for the client and member receivable pools, respectively. Under this current expected credit losses model, the Company determines the allowance for doubtful accounts based on factors such as the age of the receivable balance, historical experience, current economic conditions, and reasonable and supportable forecasts of future economic conditions. An allowance for credit losses is applied at the time the asset is recognized. Expected credit losses are recorded as general and administrative expenses on the statements of operations. The following table provides a summary of the activity in this allowance (in thousands):



Six Months Ended June 30, 2021	Balance at Beginning of Period		Charged to Costs and Expenses		Write-offs		Balance at End of Period
Allowance for doubtful accounts	$	9,502	$	4,805	$	(202)	$	14,105

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, Provider Relations and Claims Processing 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, Provider Relations and Claim Processing 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 pharmacies, 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 pharmacies. The Company’s contractual arrangements with pharmacy program partners provide for the Company to receive a discount (or rebate) from established list prices paid subsequent to dispensing when products are purchased indirectly from pharmacy program partners (such as 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 20 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 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. The Company adopted this standard as of January 1, 2021. The adoption of this standard did not have a material impact on the Company’s consolidated financial statements.

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. The Company adopted this standard on January 1, 2020, using the modified retrospective transition method, which applies the provisions of the standard at the effective date without adjusting the comparative periods presented. In addition, the Company elected the package of practical expedients permitted under the transition guidance within the new standard, which allowed the Company not to reassess (i) whether any expired or existing contracts contained leases, (ii) the lease classification for any expired or existing leases, and (iii) initial direct costs for existing leases. The Company also elected to not reassess lease terms for existing leases using hindsight and to account for each separate lease and non-lease component as a single lease component. As a result of the adoption of the new leasing guidance, the Company recorded right-of-use assets and lease liabilities of $9.5 million and $9.9 million, respectively. The right-of-use assets are classified within operating lease right-of-use assets on the Company’s consolidated balance sheet. Lease liabilities are classified within accrued expenses and other current liabilities and operating lease noncurrent liabilities on the Company’s consolidated balance sheet. The adoption of the standard did not materially impact the Company’s statement of operations or statement of cash flows for the year ended December 31, 2020. See Note 5 – Leases for further details.

In June 2016, the FASB issued ASU 2016-13, Financial Instruments – Credit Losses (Topic 326) 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. The adoption of the new standard impacted the Company’s methodology for calculating and estimating the allowance for doubtful accounts. In the fourth quarter of 2020, the Company adopted this standard as of January 1, 2020 using the modified retrospective transition method, which resulted in a cumulative-effect adjustment to accumulated deficit of $1.2 million. As disclosed in Note 17 – Unaudited Quarterly Results of Operations Data in the Company’s Annual Report on Form 10-K, quarterly financial information for interim periods of 2020 has been recast, which includes a $(0.7) million and $(0.3) million impact to the previously disclosed general and administrative expense for the three and six month periods ended June 30, 2020, respectively.

In August 2018, the FASB issued final guidance requiring a customer in a cloud computing arrangement that is a service contract to follow the internal use software guidance in Accounting Standards Codification (“ASC”) 350-402 Intangibles—Goodwill and Other—Internal Use Software (Subtopic 350-40) to determine which implementation costs to capitalize as assets. The Company adopted this standard on January 1, 2020. The adoption of the new standard did not have a material effect on the Company’s consolidated financial statements.

Accounting Pronouncements Issued but Not Yet Adopted

In May 2021, the FASB issued ASU No. 2021-04 (“ASU 2021-04”) “Earnings Per Share (Topic 260), Debt-Modifications and Extinguishments (Subtopic 470-50), Compensation- Stock Compensation (Topic 718), and Derivatives and Hedging-Contracts in Entity’s Own Equity (Subtopic 815- 40)” which provides guidance on modifications or exchanges of a freestanding equity-classified written call options that are not within the scope of another Topic, such as warrants. The new standard will be effective for the Company for the fiscal year beginning January 1, 2022 and should be applied prospectively to modifications or exchanges occurring on or after this date. The Company currently does not expect the adoption of the new standard to have a material effect on its consolidated financial statements, however, this impact will depend on the terms of written call options, such as warrants, or financings issued or modified in the future.

Revenue

6 Months Ended

Jun. 30, 2021

Revenue from Contract with Customer [Abstract]

Revenue

3. Revenue

Disaggregated revenue

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


	Three Months Ended				Six Months Ended
	June 30,				June 30,
	2021		2020		2021		2020

Fertility benefit services revenue	$	92,266	$	46,271	$	181,120	$	105,704
Pharmacy benefit services revenue		36,385		18,334		69,664		39,925
Total revenue	$	128,651	$	64,605	$	250,784	$	145,629

- Definition

The entire disclosure of revenue from contract with customer to transfer good or service and to transfer nonfinancial asset. Includes, but is not limited to, disaggregation of revenue, credit loss recognized from contract with customer, judgment and change in judgment related to contract with customer, and asset recognized from cost incurred to obtain or fulfill contract with customer. Excludes insurance and lease contracts.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-URI http://asc.fasb.org/topic&trid=49130388

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-SubTopic 10
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-Paragraph 10
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Reference 3: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
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-Paragraph 13
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Reference 4: http://www.xbrl.org/2003/role/disclosureRef
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Reference 5: http://www.xbrl.org/2003/role/disclosureRef
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Reference 6: http://www.xbrl.org/2003/role/disclosureRef
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-Subparagraph (e)
-URI http://asc.fasb.org/extlink&oid=123351226&loc=SL49130554-203045

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
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-Topic 606
-SubTopic 10
-Section 50
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-Subparagraph (a)
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Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
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-Section 50
-Paragraph 12
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Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-SubTopic 10
-Section 50
-Paragraph 15
-URI http://asc.fasb.org/extlink&oid=123351226&loc=SL49130558-203045

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
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-Section 50
-Paragraph 12
-Subparagraph (c)
-URI http://asc.fasb.org/extlink&oid=123351226&loc=SL49130554-203045

+ Details

Fair Value of Financial Instruments

6 Months Ended

Jun. 30, 2021

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 June 30, 2021 and December 31, 2020, the Company had $51.5 million and $66.3 million, respectively, in financial assets held in money market accounts and $45.2 million and $39.0 million, respectively, held in marketable securities, including U.S. treasury bills. All 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 June 30, 2021 and December 31, 2020, 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

Leases

6 Months Ended

Jun. 30, 2021

Leases [Abstract]

Leases

5. Leases

In September 2019, the Company’s lease agreement for its corporate headquarters commenced and will expire in May 2029. Pursuant to the lease, the Company will pay the base rent of approximately $1.3 million per annum through the end of the fifth lease year and approximately $1.4 million per annum thereafter through the expiration date.

The Company recognizes lease expense on a straight-line basis over the lease term. Lease expense was $0.3 million for the operating lease for the three months ended June 30, 2021 and June 30, 2020. For the six months ended June 30, 2021 and June 30, 2020, lease expense for the operating lease was $0.6 million and $0.7 million, respectively.

Cash outflows from operating activities attributable to the operating lease for the six months ended June 30, 2021 and June 30, 2020 was $0.6 million and $0.2 million, respectively.

Information related to our leases is as follows (in thousands):


	Balance Sheet Location	June 30, 2021		December 31, 2020
Operating Leases
Right-of-use asset	Operating lease right-of-use assets	$	8,241	$	8,668
Short-term lease liabilities	Accrued expenses and other current liabilities	$	1,231	$	1,231
Long-term lease liabilities	Operating lease noncurrent liabilities	$	7,873	$	8,318

Other information
Weighted average remaining lease term, operating lease			7.9 years		8.4 years
Weighted average discount rate, operating lease			4.29%		4.29%

Future minimum facility lease payments as of June 30, 2021, were as follows:


	Operating Lease Payments as of June 30, 2021
Year Ending December 31:
2021	$	642
2022		1,286
2023		1,286
2024		1,326
2025		1,407
Thereafter		4,807
Total undiscounted lease payments	$	10,754
Less: imputed interest		1,650
Present value of lease liabilities	$	9,104
Less: current portion of operating lease liabilities		1,231
Operating lease noncurrent liabilities	$	7,873

Debt

6 Months Ended

Jun. 30, 2021

Debt Disclosure [Abstract]

Debt

6. 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, which was amended in April 2019, January 2020, June 2020, and February 2021 (as amended, the “SVB Line of Credit”). Eligible accounts receivable was defined in the loan agreement as accounts billed with aging 90 days or less and excluded accounts receivable due for member copayments, coinsurance, and deductibles. The SVB Line of Credit matured in June 2021.

The Company was 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 revolving line. The Company made the first installment payment of $75,000 in June 2019 and accrued this cost. When the Company held unrestricted cash balances greater than $5.0 million, interest accrued at a floating rate per annum equal to the greater of prime rate or 4.75%. If the unrestricted cash balance was less than $5.0 million, interest accrued at a floating rate per annum equal to the greater of prime rate plus 0.5% or 4.75%, with interest payable monthly. Interest was paid based upon the borrowed funds.

The SVB Line of Credit contained customary affirmative covenants, financial covenants, as well as negative covenants that, among other things, restricted 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 required the Company to achieve a specified minimum quarterly revenue as defined by the SVB Line of Credit.

During the six months ended June 30, 2021 and as of December 31, 2020, the Company did not draw down on the SVB Line of Credit. During the six months ended June 30, 2021 and 2020, the Company recorded interest expense on the SVB Line of Credit of $38,000.

- Definition

The entire disclosure for information about short-term and long-term debt arrangements, which includes amounts of borrowings under each line of credit, note payable, commercial paper issue, bonds indenture, debenture issue, own-share lending arrangements and any other contractual agreement to repay funds, and about the underlying arrangements, rationale for a classification as long-term, including repayment terms, interest rates, collateral provided, restrictions on use of assets and activities, whether or not in compliance with debt covenants, and other matters important to users of the financial statements, such as the effects of refinancing and noncompliance with debt covenants.

+ References

Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-URI http://asc.fasb.org/topic&trid=2208564

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
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Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
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+ Details

Commitments and Contingencies

6 Months Ended

Jun. 30, 2021

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 was seeking $25.0 million in damages, fees, interest and cost. Final arbitration arguments were held on October 20, 2020. To expeditiously resolve the matter, the parties ultimately proposed a settlement to the Arbitration Panel on November 16, 2020. In December 2020, the Company finalized and settled the arbitration for $5.75 million without admission of liability to avoid further legal costs.

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.

Stock-based Compensation

6 Months Ended

Jun. 30, 2021

Share-based Payment Arrangement [Abstract]

Stock-based Compensation

8. Stock-based Compensation

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


	Three Months Ended				Six Months Ended
	June 30				June 30
	2021		2020		2021		2020
Cost of services	$	1,461	$	815	$	2,748	$	1,151
Selling and marketing		798		887		1,479		1,124
General and administrative		4,258		1,839		7,324		3,314
Total stock-based compensation expense	$	6,517	$	3,541	$	11,551	$	5,590

Income Taxes

6 Months Ended

Jun. 30, 2021

Income Tax Disclosure [Abstract]

Income Taxes

9. Income Taxes

For the six months ended June 30, 2021 and 2020, 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 six months ended June 30, 2021, the Company recorded a benefit for taxes of $10.2 million primarily due to equity compensation activity that occurred during the period. During the six months ended June 30, 2020, the Company recorded a provision for taxes of $0.1 million.

- Definition

The entire disclosure for income taxes. Disclosures may include net deferred tax liability or asset recognized in an enterprise's statement of financial position, net change during the year in the total valuation allowance, approximate tax effect of each type of temporary difference and carryforward that gives rise to a significant portion of deferred tax liabilities and deferred tax assets, utilization of a tax carryback, and tax uncertainties information.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
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+ Details

Net Income Per Share

6 Months Ended

Jun. 30, 2021

Earnings Per Share [Abstract]

Net Income Per Share

10. Net Income 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.

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 potential dilutive common shares assuming dilutive effect of outstanding common stock options, restricted stock units, common stock warrants, and shares issuable under the employee stock purchase plan. In periods when the Company has incurred a net loss, diluted net loss per share attributable to common stockholders is the same as basic net loss per share attributable to common stockholders because dilutive common shares are not assumed to have been issued if their effect is anti-dilutive.

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


	Three Months Ended				Six Months Ended
	June 30				June 30
	2021		2020		2021		2020

Basic net income (loss) per common share:
Numerator:
Net income (loss)	$	18,727	$	(1,064)	$	33,893	$	2,565

Denominator:
Weighted-average shares used in computing basic net income (loss) per share attributable to common stockholders		88,165,158		85,281,151		87,783,894		84,909,692
Basic net income (loss) per share attributable to common stockholders	$	0.21	$	(0.01)	$	0.39	$	0.03

Diluted net income (loss) per common share:
Numerator:
Net income (loss) attributable to common stockholders	$	18,727	$	(1,064)	$	33,893	$	2,565
Diluted net income (loss) attributable to common stockholders	$	18,727	$	(1,064)	$	33,893	$	2,565

Denominator:
Weighted-average shares used in computing basic net income (loss) per share attributable to common stockholder		88,165,158		85,281,151		87,783,894		84,909,692
Effect of dilutive securities		11,642,927		—		12,193,624		13,977,498
Weighted-average shares used in computing diluted net income (loss) per share attributable to common stockholders		99,808,085		85,281,151		99,977,518		98,887,190
Diluted net income (loss) per share attributable to common stockholders	$	0.19	$	(0.01)	$	0.34	$	0.03

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


	Three Months Ended		Six Months Ended
	June 30,		June 30,
	2021	2020	2021	2020
Options to purchase common stock	1,016,843	12,287,845	705,906	411,299
Shares issuable under ESPP	—	46,171	—	—
Restricted stock units	7,068	133,381	3,554	85,269
Total	1,023,913	12,467,397	709,460	496,568

Significant Accounting Policies (Policies)

6 Months Ended

Jun. 30, 2021

Accounting Policies [Abstract]

Basis of Presentation

Use of Estimates

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 June 30, 2021 and December 31, 2020.

Accrued Receivables and Accrued Claims Payable

As of June 30, 2021 and December 31, 2020, accrued receivables were $40.5 million and $28.2 million. Accrued receivables are included within accounts receivable in the balance sheet.

Accounts Receivable and Allowance for Doubtful Accounts



Six Months Ended June 30, 2021	Balance at Beginning of Period		Charged to Costs and Expenses		Write-offs		Balance at End of Period
Allowance for doubtful accounts	$	9,502	$	4,805	$	(202)	$	14,105

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

- Definition

Disclosure of accounting policy for revenue from contract with customer.

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+ Details

Significant Accounting Policies (Tables)

6 Months Ended

Jun. 30, 2021

Accounting Policies [Abstract]

Schedule of accounts receivable and allowance for doubtful accounts



Six Months Ended June 30, 2021	Balance at Beginning of Period		Charged to Costs and Expenses		Write-offs		Balance at End of Period
Allowance for doubtful accounts	$	9,502	$	4,805	$	(202)	$	14,105

Revenue (Tables)

6 Months Ended

Jun. 30, 2021

Revenue from Contract with Customer [Abstract]

Schedule of disaggregation of revenue


	Three Months Ended				Six Months Ended
	June 30,				June 30,
	2021		2020		2021		2020

Fertility benefit services revenue	$	92,266	$	46,271	$	181,120	$	105,704
Pharmacy benefit services revenue		36,385		18,334		69,664		39,925
Total revenue	$	128,651	$	64,605	$	250,784	$	145,629

Leases (Tables)

6 Months Ended

Jun. 30, 2021

Leases [Abstract]

Schedule of lease information


	Balance Sheet Location	June 30, 2021		December 31, 2020
Operating Leases
Right-of-use asset	Operating lease right-of-use assets	$	8,241	$	8,668
Short-term lease liabilities	Accrued expenses and other current liabilities	$	1,231	$	1,231
Long-term lease liabilities	Operating lease noncurrent liabilities	$	7,873	$	8,318

Other information
Weighted average remaining lease term, operating lease			7.9 years		8.4 years
Weighted average discount rate, operating lease			4.29%		4.29%

Schedule of future minimum facility lease payments


	Operating Lease Payments as of June 30, 2021
Year Ending December 31:
2021	$	642
2022		1,286
2023		1,286
2024		1,326
2025		1,407
Thereafter		4,807
Total undiscounted lease payments	$	10,754
Less: imputed interest		1,650
Present value of lease liabilities	$	9,104
Less: current portion of operating lease liabilities		1,231
Operating lease noncurrent liabilities	$	7,873

Stock-based Compensation (Tables)

6 Months Ended

Jun. 30, 2021

Share-based Payment Arrangement [Abstract]

Summary of stock based compensation expense for employees


	Three Months Ended				Six Months Ended
	June 30				June 30
	2021		2020		2021		2020
Cost of services	$	1,461	$	815	$	2,748	$	1,151
Selling and marketing		798		887		1,479		1,124
General and administrative		4,258		1,839		7,324		3,314
Total stock-based compensation expense	$	6,517	$	3,541	$	11,551	$	5,590

Net Income Per Share (Tables)

6 Months Ended

Jun. 30, 2021

Earnings Per Share [Abstract]

Reconciliation of net income loss available to common stockholders


	Three Months Ended				Six Months Ended
	June 30				June 30
	2021		2020		2021		2020

Basic net income (loss) per common share:
Numerator:
Net income (loss)	$	18,727	$	(1,064)	$	33,893	$	2,565

Denominator:
Weighted-average shares used in computing basic net income (loss) per share attributable to common stockholders		88,165,158		85,281,151		87,783,894		84,909,692
Basic net income (loss) per share attributable to common stockholders	$	0.21	$	(0.01)	$	0.39	$	0.03

Diluted net income (loss) per common share:
Numerator:
Net income (loss) attributable to common stockholders	$	18,727	$	(1,064)	$	33,893	$	2,565
Diluted net income (loss) attributable to common stockholders	$	18,727	$	(1,064)	$	33,893	$	2,565

Denominator:
Weighted-average shares used in computing basic net income (loss) per share attributable to common stockholder		88,165,158		85,281,151		87,783,894		84,909,692
Effect of dilutive securities		11,642,927		—		12,193,624		13,977,498
Weighted-average shares used in computing diluted net income (loss) per share attributable to common stockholders		99,808,085		85,281,151		99,977,518		98,887,190
Diluted net income (loss) per share attributable to common stockholders	$	0.19	$	(0.01)	$	0.34	$	0.03

Antidilutive securities excluded from computation of earnings per share


	Three Months Ended		Six Months Ended
	June 30,		June 30,
	2021	2020	2021	2020
Options to purchase common stock	1,016,843	12,287,845	705,906	411,299
Shares issuable under ESPP	—	46,171	—	—
Restricted stock units	7,068	133,381	3,554	85,269
Total	1,023,913	12,467,397	709,460	496,568

Business and Basis of Presentation (Details) - segment	3 Months Ended		6 Months Ended
Business and Basis of Presentation (Details) - segment	Jun. 30, 2021	Jun. 30, 2020	Jun. 30, 2021	Jun. 30, 2020
Segment Reporting, Disclosure of Entity's Reportable Segments [Abstract]
Number of operating segments	1	1	1	1

Significant Accounting Policies - Revenue Recognition (Details)	6 Months Ended
	Jun. 30, 2021
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	Jun. 30, 2021	Dec. 31, 2020
Accounting Policies [Abstract]
Accrued receivables	$ 40.5	$ 28.2
Accrued claims payable	30.8	22.8
Unbilled receivables	$ 25.6	$ 16.4

Significant Accounting Policies - Accounts and Receivable and Allowance for Doubtful Accounts (Details) - Allowance for doubtful accounts $ in Thousands	6 Months Ended
	Jun. 30, 2021 USD ($)
SEC Schedule, 12-09, Movement in Valuation Allowances and Reserves [Roll Forward]
Balance at Beginning of Period	$ 9,502
Charged to Costs and Expenses	4,805
Write-offs	(202)
Balance at End of Period	$ 14,105

Significant Accounting Policies - Cost of Services (Details)	6 Months Ended
	Jun. 30, 2021
Accounting Policies [Abstract]
Contract Term, Clinics, Low End of Range	1 year
Contract Term, Clinics, High End of Range	2 years

Significant Accounting Policies - Accounting Pronouncements (Details)	6 Months Ended
	Jun. 30, 2021
Accounting Standards Update 2019-12
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, 2021
Accounting Standards Update 2016-02
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, 2020
Change in Accounting Principle, Accounting Standards Update, Transition Option Elected	us-gaap:AccountingStandardsUpdate201602CumulativeEffectPeriodOfAdoptionMember
Accounting Standards Update 2016-13
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, 2020
Accounting Standards Update 2018-15
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, 2020

- Definition

Indicates (true false) whether accounting standards update was adopted.

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+ Details

Significant Accounting Policies - ASU 2016-02 (Details) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2021	Dec. 31, 2020	Jan. 01, 2020
Accounting Policies [Abstract]
Lease, Practical Expedients, Package	true
Lease, Practical Expedient, Use of Hindsight	true
Assets and Liabilities, Lessee [Abstract]
Operating lease right-of-use assets	$ 8,241	$ 8,668	$ 9,500
Operating Lease, Liability [Abstract]
Operating lease, liability	$ 9,104		$ 9,900

Significant Accounting Policies - ASU 2016-03 (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2021	Jun. 30, 2020	Jun. 30, 2021	Jun. 30, 2020	Dec. 31, 2020	Dec. 31, 2019
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Accumulated deficit	$ (34,300)		$ (34,300)		$ (68,193)
General and administrative	$ 13,937	$ 9,419	$ 27,023	$ 19,323
Accounting Standards Update 2016-13 \| Revision of Prior Period, Accounting Standards Update, Adjustment
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
General and administrative		$ (700)		$ (300)
Accounting Standards Update 2016-13 \| Cumulative Effect, Period of Adoption, Adjustment
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Accumulated deficit						$ (1,200)

- Definition

The cumulative amount of the reporting entity's undistributed earnings or deficit.

+ References + Details

Revenue (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
Revenue (Details) - USD ($) $ in Thousands	Jun. 30, 2021	Jun. 30, 2020	Jun. 30, 2021	Jun. 30, 2020
Revenues [Abstract]
Revenue	$ 128,651	$ 64,605	$ 250,784	$ 145,629
Fertility benefit services revenue
Revenues [Abstract]
Revenue	92,266	46,271	181,120	105,704
Pharmacy benefit services revenue
Revenues [Abstract]
Revenue	$ 36,385	$ 18,334	$ 69,664	$ 39,925

- Definition

Amount, including tax collected from customer, of revenue from satisfaction of performance obligation by transferring promised good or service to customer. Tax collected from customer is tax assessed by governmental authority that is both imposed on and concurrent with specific revenue-producing transaction, including, but not limited to, sales, use, value-added and excise.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
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+ Details

Fair Value of Financial Instruments - Assets (Details) - USD ($) $ in Thousands	Jun. 30, 2021	Dec. 31, 2020
Level 2
Assets, Fair Value Disclosure [Abstract]
Assets, Fair Value Disclosure	$ 0
Level 3
Assets, Fair Value Disclosure [Abstract]
Assets, Fair Value Disclosure		$ 0
Recurring \| Level 1
Investments, Fair Value Disclosure [Abstract]
Debt Securities, Available-for-sale	45,200	39,000
Recurring \| Level 1 \| Money Market Funds
Assets, Fair Value Disclosure [Abstract]
Cash and Cash Equivalents, Fair Value Disclosure	$ 51,500	$ 66,300

Fair Value of Financial Instruments - Liabilities (Details) - USD ($) $ in Thousands	Jun. 30, 2021	Dec. 31, 2020
Level 2
Liabilities, Fair Value Disclosure [Abstract]
Financial and Nonfinancial Liabilities, Fair Value Disclosure		$ 0
Level 3
Liabilities, Fair Value Disclosure [Abstract]
Financial and Nonfinancial Liabilities, Fair Value Disclosure	$ 0

Leases - Corporate Headquarters Lease (Details) $ in Millions	Jun. 30, 2021 USD ($)
Lessee, Operating Lease, Description [Abstract]
Operating lease, base rent per annum, through year five	$ 1.3
Operating lease, base rent per annum, after year five	$ 1.4

Leases - Lease Expense (Details) - USD ($) $ in Millions	3 Months Ended		6 Months Ended
Leases - Lease Expense (Details) - USD ($) $ in Millions	Jun. 30, 2021	Jun. 30, 2020	Jun. 30, 2021	Jun. 30, 2020
Income and Expenses, Lessee [Abstract]
Lease expense	$ 0.3	$ 0.3	$ 0.6	$ 0.7

Leases - Cash Outflows (Details) - USD ($) $ in Millions	6 Months Ended
Leases - Cash Outflows (Details) - USD ($) $ in Millions	Jun. 30, 2021	Jun. 30, 2020
Cash Flow, Operating Activities, Lessee [Abstract]
Cash outflows from operating activities attributable to operating leases	$ 0.6	$ 0.2

Leases - Assets and Liabilities (Details) - USD ($) $ in Thousands	Jun. 30, 2021	Dec. 31, 2020	Jan. 01, 2020
Assets and Liabilities, Lessee [Abstract]
Right-of-use assets	$ 8,241	$ 8,668	$ 9,500
Operating Lease, Liability [Abstract]
Short-term lease liabilities	$ 1,231	$ 1,231
Operating Lease, Liability, Current, Statement of Financial Position	Accrued expenses and other current liabilities	Accrued expenses and other current liabilities
Long-term lease liabilities	$ 7,873	$ 8,318

Leases - Other Information (Details)	Jun. 30, 2021	Dec. 31, 2020
Lessee Disclosure [Abstract]
Weighted average remaining lease term, operating lease	7 years 10 months 24 days	8 years 4 months 24 days
Weighted average discount rate, operating lease	4.29%	4.29%

Leases - Future Minimum Lease Payments (Details) $ in Thousands	Jun. 30, 2021 USD ($)
Lessee, Operating Lease, Liability, Payment, Due [Abstract]
2021	$ 642
2022	1,286
2023	1,286
2024	1,326
2025	1,407
Thereafter	4,807
Total undiscounted lease payments	$ 10,754

Leases - Gross Difference (Details) - USD ($) $ in Thousands	Jun. 30, 2021	Dec. 31, 2020	Jan. 01, 2020
Operating Lease Liabilities, Gross Difference, Amount [Abstract]
Total undiscounted lease payments	$ 10,754
Less: imputed interest	1,650
Present value of lease liabilities	9,104		$ 9,900
Less: current portion of operating lease liabilities	1,231	$ 1,231
Operating lease noncurrent liabilities	$ 7,873	$ 8,318

Debt (Details) - Line of Credit - Silicon Valley Bank Revolving Line of Credit $ in Thousands	1 Months Ended	6 Months Ended
	Jun. 30, 2018 USD ($) installment	Jun. 30, 2021 USD ($)	Jun. 30, 2020 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
Interest expense		$ 38	$ 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%

Commitments and Contingencies (Details) - Second Amended Demand for Arbitration, Vendor - USD ($) $ in Thousands		1 Months Ended
	Apr. 03, 2019	Dec. 31, 2020
Loss Contingency, Information about Litigation Matters [Abstract]
Damages sought	$ 25,000
Litigation Settlement [Abstract]
Arbitration settlement amount		$ 5,750

Stock-based Compensation (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
Stock-based Compensation (Details) - USD ($) $ in Thousands	Jun. 30, 2021	Jun. 30, 2020	Jun. 30, 2021	Jun. 30, 2020
Share-based Payment Arrangement, Additional Disclosure [Abstract]
Stock-based compensation expense	$ 6,517	$ 3,541	$ 11,551	$ 5,590
Cost of services
Share-based Payment Arrangement, Additional Disclosure [Abstract]
Stock-based compensation expense	1,461	815	2,748	1,151
Selling and marketing
Share-based Payment Arrangement, Additional Disclosure [Abstract]
Stock-based compensation expense	798	887	1,479	1,124
General and administrative
Share-based Payment Arrangement, Additional Disclosure [Abstract]
Stock-based compensation expense	$ 4,258	$ 1,839	$ 7,324	$ 3,314

Income Taxes (Details) - USD ($) $ in Thousands	3 Months Ended	6 Months Ended
Income Taxes (Details) - USD ($) $ in Thousands	Jun. 30, 2021	Jun. 30, 2021	Jun. 30, 2020
Income Tax Expense (Benefit), Continuing Operations [Abstract]
(Benefit) provision for income taxes	$ (6,807)	$ (10,177)	$ 116

- Definition

Amount of current income tax expense (benefit) and deferred income tax expense (benefit) pertaining to continuing operations.

+ References + Details

Net Income Per Share - Reconciliation (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2021	Jun. 30, 2020	Jun. 30, 2021	Jun. 30, 2020
Net Income (Loss) Available to Common Stockholders, Basic [Abstract]
Net income (loss)	$ 18,727	$ (1,064)	$ 33,893	$ 2,565
Weighted Average Number of Shares Outstanding, Basic [Abstract]
Weighted-average shares used in computing basic net income (loss) per share attributable to common stockholders (in shares)	88,165,158	85,281,151	87,783,894	84,909,692
Earnings Per Share, Basic [Abstract]
Basic net income (loss) per share attributable to common stockholders (in dollars per share)	$ 0.21	$ (0.01)	$ 0.39	$ 0.03
Net Income (Loss) Available to Common Stockholders, Diluted [Abstract]
Net income (loss) attributable to common stockholders	$ 18,727	$ (1,064)	$ 33,893	$ 2,565
Diluted net income (loss) attributable to common stockholders	$ 18,727	$ (1,064)	$ 33,893	$ 2,565
Weighted Average Number of Shares Outstanding, Diluted [Abstract]
Weighted-average shares used in computing basic net income (loss) per share attributable to common stockholders (in shares)	88,165,158	85,281,151	87,783,894	84,909,692
Effect of dilutive securities (in shares)	11,642,927		12,193,624	13,977,498
Weighted-average shares used in computing diluted net income (loss) per share attributable to common stockholders (in shares)	99,808,085	85,281,151	99,977,518	98,887,190
Earnings Per Share, Diluted [Abstract]
Diluted net income (loss) per share attributable to common stockholders (in dollars per share)	$ 0.19	$ (0.01)	$ 0.34	$ 0.03

Net Income Per Share - Potentially Dilutive Securities (Details) - shares	3 Months Ended		6 Months Ended
	Jun. 30, 2021	Jun. 30, 2020	Jun. 30, 2021	Jun. 30, 2020
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Total (in shares)	1,023,913	12,467,397	709,460	496,568
Stock Options
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Total (in shares)	1,016,843	12,287,845	705,906	411,299
Employee stock
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Total (in shares)		46,171
Restricted Stock Units
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Total (in shares)	7,068	133,381	3,554	85,269