All right. Good morning, everyone. My name is Allen Lutz, Healthcare Tech and Distribution Analyst here at BofA. We are delighted to have the Progyny team here with us. We have CEO, Pete Anevski, and CFO, Mark Livingston. Thank you both for joining us. Really appreciate it. You know, Pete, I'll start with you. On the last earnings call, at least I felt this way, you sounded notably more constructive on the selling season and some of the momentum that you're seeing in the business, you know, around the new pipeline was building, substantially favorable versus a year ago. Just overall, it seemed like a very constructive call.
To kick things off here, would love to get a sense, just maybe taking a step back, what's informing, at least from our perspective, what seems like a little bit of increased confidence or, you know, some of the positive things you're seeing in the business so far in 2026?
Sure. Good morning, by the way. Thanks for joining us. A couple things, right? We talked about everything when we talk about it, we talk about it relative to this point last year. Our pipeline builds throughout the year. Our selling season culminates in commitments materially during middle of August through October. What we talked about was the progress that we're making in pipeline and pipeline build versus a year ago and also early commitments. That's not only for both of those, not only overall pipeline, but also average size of deal favorable versus prior year.
It's my first time using a mic here. you know, so as we talk about the RFP activity that you're seeing, you mentioned a comment on the call, just RFP activity from some of your standalone competitors has already outpaced what you saw across all of last year. Can you unpack that a little bit? you know, what are you seeing there in the RFP activity? Is there something going on in the broader competitive landscape? Just high level, you know, what's-- what are you seeing there from an RFP standpoint?
I'm not sure I can speculate as to what may be going on relative to our standalone competitors. I just wanted to make the observation around the increased RFP activity. Again, you know, vis-a-vis last year or prior years even, you know, much higher. I think if you look at our solution, and look at the sustainability of our solution and the demonstration of our solution, in client satisfaction that manifests itself in the form of 99% retention, you know, a 10-year history, that's really positive. We also talked about on the call is a good example of that.
We had a large client present with us and discuss their third-party consultant that they hired analyzing their claims data and their claims data warehouse, and over an eight-year period showed, you know, significant favorable results relative to doubling their pregnancy rate with IVF, relative to reducing their preterm birth and NICU rate, and a bunch of other really important stats vis-a-vis the favorable outcomes that we experience. I think they said it the best when they said, you know, they wish they could talk about all their benefits this way. It's the perfect trifecta of better member experience, significant cost avoidance, and increased clinical outcomes. That's exactly what they're looking for for all their benefits.
That makes a lot of sense. You talked about 99% client retention, and you mentioned all the differentiators right there. If we take a step back and we look at, not really the competitive landscape, but maybe the demand for fertility solutions, over the past couple years, clearly the trajectory of the market opportunity has evolved. We'd love to get a sense from your perspective, how fast do you think the fertility addressable market is growing, and how to think about how that's changed over maybe the past two or three years?
I think the market continues to grow, driven by the macro trend that we see where both fertility rates are declining overall, as well as the number of people giving birth in the U.S. are a higher proportion now that are over 30 versus under. 53% of women that gave birth based on the latest CDC data were over 30 versus under 30. Within that, even greater, you know, is the 35 and over. The average age of a woman going through IVF is 36 years old. 35 and over continues to grow at a compounded rate of, you know, above 2.5% over the last 10 or 11 years.
On an overall basis, the demand, driven by the macro trend is increasing. The overall industry continues to grow at a roughly, you know, 9%, 10% compounded rate per year. Will continue to do so and continue to do so, I think, even more given the fact that the trend of people waiting longer in life to start building their family hasn't stopped and is more pronounced. As it keeps being more pronounced, it's gonna drive that need even greater and greater.
That's great. The industry growing 9%, 10%, and also your revenue is starting to diversify in a few different ways. You talked about the Cigna partnership as one example on the last earnings call. You have a more mature Blues relationship as well. Can you talk about how material a contribution the health plan partners are today? Is it fair to assume, you know, what's the relative growth rate of health plan contributions relative to direct? Is it materially different? Just trying to get a sense of the trajectory of both of those parts of your business.
Here's the way to think about it. The distribution partners that we're signing up and doing business with are a continuing contributor to our overall growth. We historically have added around 1 million lives a year to our business, and that's not small. It's about 1% of the addressable market for us, not insignificant. The relationships are now getting deeper and stronger, and that's sort of the, you know, part of what we called out with our Cigna partnership. As a result, you know, we're starting to get This is our first full year with that partnership in terms of a sales year coming up right now. We're seeing more traction with that.
I believe that that will add incremental value in the form of pull through and overall lives added. We'll see how that plays out. It's those types of relationships that we're gonna continue to deepen with the payers around the country, the Blues regional payers, et cetera, and start to repeat that level of engagement with those partners to be able to help accelerate incremental lives. It'll also help as we continue to roll out. We're only at the first few months of go-to-market in our Progyny Select product. Those relationships will help in that area as well.
I'll get to the Progyny Select in a couple of questions. I guess before we get there, though, one of the things I thought was most interesting about the call is you talk about the selling season and how strong it was, more RFP activity relative to a year ago. Also two of your largest clients up for renewal have already committed to renew. You're seeing, at least from our perspective, the market seems to be coming, you know, more toward Progyny, and then your current customers also aren't looking elsewhere. There seem to be a confluence of tailwinds there that are really, really positive. When it comes to those two large clients that are up for renewal, I guess first they've already committed to renew. I just wanna verify that.
Can you talk about what industry those clients are in? You know, is there a typical timeline for when larger clients indicate their intent to renew during a year?
Yeah. I'll try and hit on all those. If I miss one, just let me know. I'll do the timeline first. Generally speaking, if they're gonna go through an RFP process or a market check, it begins about now, maybe, you know, 30 days ago, and lasts different periods, but through the summer, if you will, you know, middle of the summer, sometimes later in the summer, by the time they finalize their decision. It's as long as an RFP you were going through with a new prospective client, as it is with an existing client. It's just generally how long RFPs take. They're iterative in terms of their steps and the number of people they have involved, et cetera. As it relates to these two clients, yeah, they notified us.
They were scheduled. We had, you know, an indication from them that they were going to do a market check this year. They came to us already and let us know they're not going to do that, and they're continuing on with us, which is really positive. We're also having positive conversations with them around some expanded products that they don't have with us today. That's really positive. I forgot what the other question was.
The typical timeline for...
Yeah. Yeah. Sort of like I said, it starts about now, maybe 30 days ago. Let's call it beginning of April. It stretches out until, you know, July, August, you know, sometimes. September is probably late, depending on if they're larger, by August they would have made a decision.
Got it. You know, as it relates to Again, it seems like there's more RFP activity, but these two clients are staying. You mentioned a lot of different reasons why maybe that is the case around, you know, just sort of the benefits of Progyny and some of the outperformance versus traditional fertility services. Also, you're expanding the products that you're offering as well. As it comes to these two customers, is there anything specific you could point to other than them just being satisfied customers?
They've done last year, in different ways, they've done a form of a market check already, even if it wasn't a formal RFP. One of them explicitly said that to us, that that's why they're not. The other one just said they sort of related to the review they've done, they didn't feel the need to do a market check.
Got it.
Look, I think just adding to it, I think one of the things that you have to remember is we are in constant sort of contact with, you know, all of our customers on a quarterly basis. I think we give a tremendous amount of reporting to them about what's happening within their program, including cost as well as value. I think reinforcing that value message on a regular basis, you know, helps get them comfortable with the program that they have and I think helps obviously obviate the need to go out and do market checks when they already understand it quite clearly.
That makes sense. Going back to the Progyny Select, you know, really exciting market expansion for Progyny. Would love to get a sense of what you're seeing initially, when we should get kind of more I think the, you know, SMID businesses typically follow up in the fall or late summer? You correct me if I'm wrong there. You know, talk about the competitive landscape or lack of competitive landscape in that space. What are you seeing there and talk about a competitive landscape?
Sure. Relative to progress, we'll start there. We've been signing up distribution partners and are now in the process of what I call pull through, but essentially working with them, their producers and ultimately the brokers that are in their network that ultimately interact with these small businesses. These small businesses generally, you know, materially are January 1 plan years and generally go through their renewal process. It's a shorter cycle, they go through the renewal process for their medical plan, you know, in the, in the, I'll call it, you know, middle to back half of the fourth quarter in terms of commitment. We won't see the actual pull through in any meaningful way until then.
The progress around the partners that we're signing up and the effort that they're putting in to educate their network and their folks is positive to date. Relative to where we are early in Progyny Select go-to-market life cycle, if you will, you know, I'm pleased with the progress we're seeing so far. Relative to competition, there's no other plan out there that's filed from an insurance perspective, the ability to have a supplemental plan in the country as far as we can see. The attorneys go through, as you might imagine, the searches.
Unless you're in a mandated state and your health plan for your fully insured population is offering you something relative to that mandate, there isn't standalone supplemental plan competition for Progyny Select.
Shifting gears a little bit, as you think about the current state of the self-insured employer in general, utilization across both medical and pharmacy is high, and maybe a little bit higher than it's been historically. You know, as we think about the white space here and getting, you know, the not nows over the finish line, can you talk about how the conversation has evolved over the past couple years? What is the appetite in the current selling season for the white space? How does that compare to maybe the past couple years?
Under utilization first?
Yeah. Look, I, the one thing I just addressing on utilization, so, you know, a good healthy quarter this quarter, you know, generally in line with what we were expecting. We obviously came in, you know, close to the high end of our guide, so our expectations all sort of ran with that. Again, within the range of expectation over the last, you know, several years, anywhere from a 0.45 to a 0.49, we were at slightly towards the higher end of that. We're pleased that utilization and consumption has remained relatively consistent, certainly over the last five quarters or so. Helps us provide a good foundation for our guidance and what we're seeing currently and for the balance of the year. I think from white space, obviously, you can talk more about it, Pete.
We talked a little bit about greenfield, brownfield in Pete's earlier comments around the sales pipeline, but you can...
Demand continues to be positive for both white space and for both brownfield and greenfield in terms of the space. There's still a significant amount of companies and, you know, across a broad spectrum of industries that don't offer the benefit at all. Even the brownfield is a huge opportunity because a lot of those are limited in terms of what they're covering versus a comprehensive covered benefit like what you would do with Progyny, right? Both are huge opportunities for us and continue to be positive conversations. Sometimes even with the awareness that we've created now for the need for a fertility benefit over the last 10 years, sometimes there's still a little bit more of a conversation as to why you should be doing this.
When you hear noise in your, in your employee base for not having it, and we still have to do a little bit more education there, but it's not as much as it was in the past. But still a positive. Here's the reality. The companies that aren't covering it with the trend, the macro trend that I talked about before, you can only be able to ignore it for so long. The range of folks that we engage with our benefit are 30-42 years old. They're your millennial population. They're a large portion of your employee base, a really important portion of your employee base, and they have this need. To continue to ignore it, I think, is not possible.
It's just a matter of when you're gonna add the benefit yourself and also, you know, get educated on the reality that you're already paying for it in some way or a portion of it. There's a lot of cost avoidance on top of it that you're gonna be able to do and redistribute your money across more people needing the benefit versus paying for high cost claimants in the form of, you know, premature births or NICU births, and that kind of thing.
That's really helpful. One of the things we talked about in the past is GLP-1s and how that may impact how employers that currently don't provide fertility benefits might be thinking about expanding the benefits. Just to level set here, over the past three years, spending on GLP-1s from a self-insured employer perspective has exploded. I don't think anyone would dispute that. What we've seen, expectations in 2024 build into 2025, and I think in 2026, expectations for GLP-1 spend have been really high. What we've observed in the early part of 2026 is that a lot of that volume for GLP-1s is actually flowing outside of the employer benefit toward direct-to-consumer.
It's possible that employers are seeing a lower trend, at least in the beginning of the year, relative to their expectations. As you think about the 2027 selling season, clearly something is going on that's positive in terms of demand for fertility benefits. My question to you is, are you seeing some of these not nows or some of these employers who may be Are they telling you that, "Hey, our GLP-1 spend is falling below trend, so we're actually now able to commit to a fertility benefit, whereas we hadn't in the past"? I'm curious if that is something that's coming up in your conversations. Just any type of context around that would be helpful.
Yeah. Unfortunately, it's not as explicit as that. I wish it was. There's feels like a little less mind share around GLP-1s. A lot more focused on sort of how to contain that cost and different types of ways to implement your benefit in order to contain that. I think you're right. The proliferation of D2C in GLP-1s is going to cause more companies to decide whether or not how much of GLP-1s are they going to cover or not, because now they're affordable for people on a D2C basis and all across other areas.
Although nobody is saying last year or the year before, because of GLP-1s, we were holding off on fertility, the fact that there's less conversation just in general around that suggests there's less mind share vis-à-vis what it was recently, and possibly, you know, could be one of the reasons why there's more activity.
I think part of it too is the ROI, right? On the GLP-1, there's, you know, down the line ROI that you have to sort of buy into. I think we do a really good job of demonstrating, like, current ROI on your spend. Pete's already kind of referenced it in some of his comments. The leakage that employers already have, whether they're paying proportions of the fertility procedures, you know, matched to something else in their current plan, even if they're not offering it, or certainly the costs on the back end with, you know, preterm birth costs, NICU, et cetera. I think we come in with a really clean story around ROI, and I think by comparison, you know, it's sort of buy the future or buy the today.
I think if you're looking at a fertility benefit that can help control costs today, I think that's where we're resonating.
To kind of piggyback off that, you know, you've expanded to new products, menopause, postpartum and leave, benefit navigation. I think 20% of your current customers have added a new benefit, and 40% of new have added. Can you talk about the momentum or what you're most excited about when it comes to your new offerings that are now, you know, more than a year old?
Yeah, I think, it's important to have solutions that address a larger portion of your employer's population, right? Address specific needs that they're concerned with. In the case of a lot of these benefits, they're either, you know, addressing areas where you could help bend the cost curve in some of the trends that they're seeing, or just filling a need in terms of a gap relative to access to care. Or in the case of leave and benefit navigation, amplifying many good things that you're already doing for your employees, but them not realizing it with sort of more traditional tools, and utilizing tools that could help them better understand, better appreciate, better use all the things that you're offering to them.
All have different features that are positive for the overall experience of the employee and the good that the benefit managers are trying to do for those employees. I think the general excitement that they are all touching and addressing parts of family building and overall women's health is also really positive. They've been resonating really well. We have a lot of really good, healthy conversations with our existing clients and continue to talk about what we're doing, whether they have the benefit or not, and what's on our roadmap for those products or whether or not they're looking to add them. All really positive conversations vis-à-vis their roadmap in terms of what they want to do for their benefits and what we have to offer.
Going back to utilization for a minute, Mark, given 1Q came in so strong, can you talk about the key variables to get to the high end, and then what would need to happen to get to the low end? Just what's embedded in each, as far as your guidance is concerned around utilization?
Yeah. We're following a very similar guidance philosophy that we've been using here for the last, you know, five or six quarters or so. We anchor, you know, what we're seeing today, the activity, how we're seeing clients and their journeys progress from Q1 to Q2. You know, that's embedded within our Q2 guide, you know, closer towards the higher end of our guide, and therefore, that projects on to the higher end of the guide for the balance of the year. The lower end reflects incremental variability at a level that considers some of the variability that we had a couple of years ago. That way we've got a range that sort of incorporates some of the, you know, changes in human behavior and patterns that could happen through the year.
Again, what we're seeing today and the activity that we're seeing today would skew you a little bit closer towards the high end of the range than the lower end.
Okay, that's great. To move on to margins, you talked about planned investments to expand the platform's capabilities, member experience, et cetera. Can you just provide some examples of where these investments are going, and how to think about either the ROI or the improved member experience?
Sure. It's everything from the back-end platform, to be a more efficient company, that's today multi-product, where we started out as a single product company, right? Everything we built originally was built on the back of a single product platform. That creates some level of both tech debt as well as difficulty in adding capabilities from a timing perspective for engineering, right? That back-end platform investment is huge and will give us the ability to add capabilities and/or new products and get them to market a lot faster. That's one.
Two is that platform is built with both interoperability as well as with the ability to leverage AI, so that we can augment what all the care management folks are doing, whether they're on the provider side, as they do provider account management and interface with the network or whether they're on the member side as they're engaging, the Progyny advocates engaging or the, or the clinical educators engaging with the patients, they're gonna be able to do that in a much more efficient way and spend a lot more time on their medical journey and sort of what they're talking about there versus sort of, you know, like everything, removing administrative sort of tasks, I like to call it homework, from the members' plate, so that they can, you know, get through the journey a lot faster and a lot easier, right?
Those are the positive things. There is also a lot of investment in the digital assets that we are doing. Finally adding a suite of products to our global offering that address all the same areas that we do in the U.S., in order to make sure that for our customers that are global, multinational customers, that they can, if they want to, have the same type of offerings that address the same type of areas as they do in the U.S., 'cause that is a lot of times a complaint that they hear from their colleagues around the world.
From an ROI perspective, like our strategy is not to replace the level of human interaction that, you know, in particular our care advocates are having with our members. I think we see that as part of the value that we're providing. It's about empowering them and making them more efficient in their day-to-day job. For us it's, you know, to put it in sort of, you know, cold financial terms, it's about avoiding future hiring as we grow, as opposed to, you know, seeing some kind of step, you know, march change in how we're currently supporting our clients.
That's a good pivot to the next question around capital deployment. You know, as you think about the income statement and then, you know, the cash flow profile of the business, obviously you generate a lot of cash. How do you think about the opportunity for M&A? You know, historically, you know, you've done very, very small deals. Are there opportunities to do something larger, or are you kind of more committed to, you know, very, very small deals, and buying back shares? Just curious if the thinking around there has evolved at all.
Thinking hasn't evolved. The thinking is always around maximizing shareholder value. You're right, the acquisitions we've done are what I'll call smaller tuck-in acquisitions, meaningful and are adding value already despite their dollar size, if you will. We haven't identified anything of size that makes sense. Valuations continue to be nutty in certain areas, so we wouldn't do an irrational acquisition for the sake of doing it. We'll build de novo, we're perfectly fine with that. If something presents itself, we'll take a look at it. If we believe it's gonna add shareholder value, we believe it's either accretive or a clear path to being accretive, you know, we'll look at it, nothing has presented itself to date relative to that type of stuff.
We'll continue to do what we do, which is, you know, maximize shareholder value. If that means returning value to shareholders through things like buyback programs, that's what we'll do in the interim, with the excess cash that we're generating.
With the last minute or so, you know, as we talk about your business, you know, 99% retention rate, the industry's growing high single digits, you know, your selling season's going well, you know, yet the public market valuation, at least from our perspective, seems pretty disconnected, you know, with the growth that you've been putting up. I guess, what do you think investors are missing the most about the Progyny story here?
I think honestly, they're missing the big picture opportunity that Progyny has. The macro trends that continue to drive our business are growing, not declining. The opportunity relative to all the different areas that we're addressing is still in its early stages. We couldn't be better well positioned both from a technology standpoint, from a network and relationship standpoint, and continue to increase the size of the moat vis-à-vis competitors in terms with all of our investments. On top of that, we're adding new products that are continuing to increase our TAM. I think all of those things are really positive, and I couldn't feel better about where we are.
Sounds great. Looks like we are out of time. Pete, Mark, thank you so much for the time. Thank you everyone for joining us.
Thank you.
Thanks for having us.