Progyny, Inc. and its wholly owned subsidiaries (Progyny) operate as a benefits management company.
The company is specializing in fertility, family building and women's health benefits solutions in the United States. Its clients include many of the nation’s most prominent employers across a broad array of industries.
The company launched its fertility benefits solution in 2016 with its first five employer clients, and the company has grown its base of clients to more than 530 employers, each...
Progyny, Inc. and its wholly owned subsidiaries (Progyny) operate as a benefits management company.
The company is specializing in fertility, family building and women's health benefits solutions in the United States. Its clients include many of the nation’s most prominent employers across a broad array of industries.
The company launched its fertility benefits solution in 2016 with its first five employer clients, and the company has grown its base of clients to more than 530 employers, each with at least 1,000 covered lives. The company has contracts to provide coverage to approximately 6.7 million employees and their covered dependents (known in its industry as covered lives, and to whom the company refers to as its members). The company has retained substantially all its clients since the company launched its fertility benefits solution, and the company’s member satisfaction is evidenced by its most recent industry-leading Net Promoter Score, or NPS, of +79 for its fertility benefits solution and +84 for Progyny Rx, the company’s integrated pharmacy benefits solution, as of December 31, 2024.
The company is redefining fertility and family building benefits, proving that a comprehensive fertility solution can simultaneously benefit employers, members and providers. By empowering the company’s members with education, guidance and financial support, and enabling high-quality fertility specialists to use the latest science and technologies, its solution leads to the development of customized treatment plans that result in optimal clinical outcomes for the company’s members and cost savings for its clients.
In order to simplify the process for the company’s members, the company offers its proprietary Smart Cycle approach. Smart Cycles are designed by the company to include the medical services required for a member’s full course of treatment, including all necessary diagnostic testing and access to the latest technology. In conjunction with the Smart Cycle plan design, each member who utilizes the company’s benefit has a dedicated Patient Care Advocate, or PCA, who has fertility expertise and provides end-to-end concierge support, including logistical support (i.e., fertility specialist selection, appointment scheduling, treatment authorization and treatment payment), clinical guidance (i.e., treatment options, outcomes statistics and what to expect) and emotional support during the often challenging and unpredictable fertility journey. Additionally, all Progyny members have access to the company’s selective network of high-quality fertility specialists, who the company equips with a benefits design that enables them to pursue the best treatment pathways, providing the company’s members with tailored treatments that result in optimal clinical outcomes.
In addition to the company’s fertility benefits solution, the company offers an integrated pharmacy benefits solution, Progyny Rx, which can be added by the company’s clients. Progyny Rx provides the company’s members with access to the medications needed during their fertility treatment. As part of this solution, the company provides care management services, which include the company’s 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. The company also expanded its solutions to include a preconception, maternity and postpartum care offering, as well as a menopause and midlife care offering.
The company has demonstrated its ability to drive better outcomes for the company’s clients, members and provider clinics across multiple metrics. Provider clinics in the company’s network produce outcomes that surpass their own reported practice averages when treating Progyny members because of the company’s differentiated solution. Additionally, across the company’s membership, its outcomes compared to national averages have been consistently superior as of December 31, 2024.
Solutions
The company is redefining effective fertility and family building benefits through its purpose-built, data-driven and disruptive platform through which the company offers its fertility benefits and Progyny Rx solutions. The company’s comprehensive fertility solution has proven to be simultaneously beneficial for its clients, its members and its network of fertility specialists. Through the company’s differentiated approach to benefit plan design, patient education and support and active network management, its clients’ employees are able to pursue the most effective treatment from the best fertility specialists and achieve optimal outcomes in a cost-efficient manner, while the company’s clients and members achieve savings in upfront treatment costs, as well as reduced maternity and NICU expenses.
Fertility Benefits Solution
Differentiated Benefits Plan Design
The Smart Cycle is the company’s proprietary, easy-to-understand fertility benefits design. The company’s Smart Cycle plan design allows members equitable access to the treatment they need and is designed to drive superior outcomes and reduce both upfront treatment expenses and subsequent costs. Everything needed for a comprehensive fertility treatment is contained within a Smart Cycle treatment bundle, including all necessary diagnostic testing and access to the latest technology (e.g., in the case of IVF treatment, preimplantation genetic testing). The company’s client’s contract to purchase a cumulative Smart Cycle unit value per eligible member. These can range from one to unlimited cumulative Smart Cycles units.
The Smart Cycle structure allows the company’s members, together with the advice of their fertility specialists and the support of their PCAs, to select the Smart Cycle treatment bundles that align with their unique treatment needs and their intended family building pathway, without having to follow the ‘one size fits all’ protocols common to conventional health insurance carriers, and without the worry that their desired treatment approach will not be authorized or covered for the full treatment cycle. The company’s comprehensive Smart Cycles, which are its proprietary treatment bundles, are assessed regularly by the company’s Medical Advisory Board, and include access to the latest science and technologies, enabling its network of fertility specialists to utilize best practices. The company’s superior clinical outcomes driven by its Smart Cycle plan design include higher rates of pregnancy and live births, as well as lower miscarriage rates and fewer multiple births.
Personalized Concierge-Style Member Support Services
The company’s fertility benefits solution provides members with access to significant support services that are crucial to the success of the fertility and family building journey. Before the fertility treatment process begins, and throughout every step of the fertility journey, it delivers high-touch member support services through a dedicated PCA, who is paired to a member and interacts with them an average of 15 times over the course of their treatment. The company’s PCAs has deep fertility expertise and provide extensive clinical education, guidance and emotional support to its members. Additionally, the company has an in-house clinical staff, consist of professionals with substantial expertise in reproductive endocrinology, fertility nursing, clinical psychology and social work who design its PCA training curriculum and direct the company’s comprehensive member experience.
The company’s comprehensive member portal, accessible via any desktop or mobile device or via the mobile application, further supports the member experience by providing key educational resources and easy-to-access benefits information to its members. The company’s members can use the portal to securely message their PCA or access a curated library of videos, articles, podcasts and webinars on fertility and family building. The portal also offers digital solutions that help its members address the emotional effects that are often associated with infertility, including loss, self-blame, anxiety and depression. The company’s platform provides its members with best-in-class support services to help them navigate their fertility and family building journeys.
Selective Network of High-Quality Fertility Specialists
The company has utilized its deep industry knowledge, and the insights derived from the company’s data analytics platform to establish and actively manage a national network of leading fertility specialists in the United States. The company’s members receive access to its selective Center of Excellence network of high-quality providers that includes over 1,050 fertility specialists who practice at over 650 provider clinic locations throughout the United States and over 1,140 specialists in total when including reproductive urologists. The company’s network includes 45 of the top 50 fertility practice groups by volume in the United States according to 2022 CDC data, which was published in 2024 and is the most recent data available. Fertility specialists who are invited to join the company’s network must meet and maintain rigorous credentialing standards and quality thresholds that it sets for inclusion in its network to ensure that the company’s members receive the highest quality care. The company’s national network serves members in virtually every state, providing extensive geographic coverage to its national employers.
Progyny Rx, an Integrated Pharmacy Benefits Solution
Progyny Rx is the company’s integrated pharmacy benefits solution that can be added by clients that utilize its fertility benefits solution. This solution provides the company’s members with access to the medications needed during their treatment. As part of this solution, the company provides care management services, which include its 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. The company’s single treatment and medication authorization process reduces the administrative burden, creating an efficient pharmacy solution for its members and their fertility specialists. Progyny Rx reduces dispensing and delivery time to two days to eliminate the risk of missed treatment cycles. The company’s single medication authorization and delivery process ensures that its members will not miss or delay cycles. The company provides access to phone-based, clinical education and support seven days a week to ensure that its members understand any necessary medication storage requirements and administration techniques, including injection training. To further support members who require additional education, the company also offers a library of on-demand videos. Given the importance of the timely use of medication to the success of fertility treatments, and the complexity involved in administering the medications, it believes Progyny Rx provides a differentiated and effective pharmacy solution for the company’s clients and their employees.
Robust Data Collection Process
The company is the only fertility and family building benefits company to collect data in a timely manner directly from providers on adherence to treatment protocols and clinical outcomes, including single embryo transfer rates, pregnancy rates, miscarriage rates, live birth rates, multiple birth rates, practice patterns, treatment timelines and costs per birth. The company’s data is used to understand the utilization of its benefits, its provider clinics’ adherence to best practices and the outcomes produced by each clinic and across the company’s network. This data informs decisions across the company’s platform, from services covered to its fertility network standards. The insights from the company’s data also enable it to actively manage its fertility specialist network and ensure that the company’s fertility specialists are utilizing best practices and optimizing outcomes. The data collection process also includes extensive member surveys, which allows the company to understand and improve its member experience and satisfaction. Finally, the company’s data allows it to provide its clients with unique and detailed reports to provide full transparency into the utilization of their benefit program, their expenditures and the outcomes delivered, and value created. The company effectively utilizes its thorough data collection and analysis process and its unique and robust data set to continuously improve the client and member experience across the company’s platform.
Prestigious Medical Advisory Board
The company’s Medical Advisory Board consist of nationally recognized fertility specialists who are advancing fertility science and research. They are responsible for oversight of key clinical issues, including evaluating new fertility treatment diagnostics and procedures to ensure that its benefits design and overall program is comprehensive and designed to drive to the best outcomes. This review ensures that the company is evaluating and covering the latest and most effective fertility treatments and identifying opportunities to improve its plan design, member experience and fertility specialists network standards.
Full-Service Client Success
The company provides a dedicated client success team to help ensure that it is delivering superior service. The company’s client success managers support its clients’ day-to-day needs and resolve issues that arise. For example, to help the company’s clients ensure that their employees are fully aware of the Progyny program, its client success teams work with its clients to create co-branded materials to support health fairs, open enrollment events and other employee communications. The company’s client success team also reviews all program reports with its clients to reinforce the transparency it provides to clients into their expenditures and outcomes and to review and quantify the value created by the company’s solutions. The company’s client success services, including its detailed client reporting, play an important role in helping it maintain and strengthen the company’s client relationships.
Ease of Integration for its Clients
Once the company is selected by an employer to manage their fertility and family building benefit, its solution is easy to implement as part of their broader pre-tax medical benefits package. Integrating the company’s solution involves only a small commitment of its client's time (typically only six to ten hours over the course of six weeks). Underlying the ease of integration is the fact that the company has developed multiple integration solutions that allow it to integrate with any health plan or health insurance carrier, reducing significant time and expense for the company’s clients. The company’s ability to integrate its solution with its clients' health insurance plan allows its benefit to be offered to employees on a pre-tax basis, providing the company’s members with significant savings in comparison to a post-tax reimbursement. The company’s ability to integrate its benefits solutions with all the large national health insurance carriers is a differentiating factor within the industry.
Assistance Service Reimbursement Programs
The company also offers an assistance service program where certain services can be offered through a reimbursement program, including adoption, surrogacy, doula, and travel reimbursement when travel is required to receive medical services. The company then administers the expense reimbursement to employees up to this dollar amount. The company works with its clients to determine what expenses related to adoption or surrogacy or any other elected benefit will be covered under their plan, thereby alleviating their administrative burden.
Value Proposition
The company provides measurable value to its employer clients:
Substantial and Measurable Financial Value. The company’s superior clinical outcomes drive savings in both upfront fertility treatment costs (due to the company’s higher live birth rates), as well as subsequent maternity and NICU expenses for the company’s clients (due to its lower multiple birth rates).
Progyny Rx Savings. Progyny Rx delivers unit cost savings to the company’s clients based on a reduction in unnecessary quantities of medication dispensed.
Employee Productivity and Retention. The company’s solution addresses employee absenteeism, poor productivity, and the lack of employee retention driven by the stress of suffering from infertility (and undergoing fertility treatment), as well as the return-to-work issues related to multiple births. The company’s members are able to receive the most effective treatments more quickly and have access to high-touch member support services through the company’s PCAs, thereby reducing the physical and emotional rigors of infertility and its treatment.
Appeal to Existing and Prospective Employees. Better fertility benefits programs can be a key component to enhancing a company’s overall benefits program and an important tool in its recruiting efforts and in helping retain key talent. An appealing feature of the Progyny benefit from an employee retention perspective is that the benefit is both comprehensive and is accessible by all groups across an employee population. The level of employee satisfaction the company provides is important for any employer focused on employee retention.
The company provides meaningful value to its members:
Superior Clinical Outcomes. The company’s members experience healthier pregnancies (with significantly increased utilization of single embryo transfer) and superior rates of pregnancy and live births, as well as reduced rates of miscarriages and multiple births, saving valuable time and money and limiting personal and professional disruption.
Comprehensive Coverage. The company provides all individuals with access to comprehensive coverage. The company’s Smart Cycle design ensures that members always have coverage for a full treatment cycle as their access to treatment is not limited by a dollar maximum that could be exhausted mid-treatment. Additionally, members have access to the latest technologies and procedures, which are reviewed and approved by the company’s Medical Advisory Board.
Access for All Employees and Dependents. Smart Cycles are available to be utilized across all employee groups, including populations not typically covered.
Equitable Access to Care. The company’s Smart Cycle design ensures members receive fair and balanced access to care that is not dependent on where members live, how expensive a fertility specialist is or which specific treatments are required.
High-Touch Concierge Member Experience. The company provides its members with high-touch, end-to-end concierge support, including logistical assistance, clinical guidance and emotional support through the company’s PCAs and its in-house clinical staff.
Access to Selective, Premier Fertility Specialist Network. The company’s solution provides members with access to the nation’s leading fertility specialists, including over 1,050 fertility specialists who practice at over 650 provider clinic locations throughout the United States. The company’s network includes 45 of the top 50 fertility practice groups by volume in the United States according to 2022 CDC data.
Integrated Pharmacy Benefits Solution. Progyny Rx provides members with a simplified authorization process, timely medication delivery and member support from pharmacy clinicians seven days a week.
The company provides meaningful value to its fertility specialists:
Members Supported with a Comprehensive Benefit. The company’s solutions allow its members to arrive at their fertility specialist with a fully-covered course of treatment and the flexibility to utilize the latest approved technologies and best practices via the company’s comprehensive Smart Cycle benefits plan design. Members are also educated on the use of best practices and are supported by PCAs throughout their fertility journey.
Eliminate Step Therapy Protocols. The company’s network of fertility specialists have access to the latest science and technologies through the company’s innovative Smart Cycles, which free the company’s fertility specialists from having to follow the ineffective protocols common to conventional coverage and allow them to pursue the most effective treatments first, thereby saving time and money.
Simplified Administration. Once a Smart Cycle treatment is authorized, fertility specialists within the company’s network are able to prescribe the optimal treatment plan without any need for pre-certification or pre-authorization.
Superior Clinical Outcomes. Outcomes for Progyny members across the company’s fertility specialist network are superior to the average outcomes that the same provider clinics report to the CDC for all of their patients. Specifically, as shown in the table above, the in-network average live birth rate per attempted retrieval for Progyny members is 46.7%, as compared to the 36.8% average live birth rate per attempted retrieval for all patients at those same clinics. This results in the typical Progyny member undergoing 2.1 retrievals for a live birth as compared to the national average of 3.6 retrievals. This difference of more than one retrieval represents substantial cost avoidance for the company’s clients, as well as significantly less physical and emotional stress on the member.
Eliminating Financial Risk Associated With Collections. The company assumes full responsibility for the collection of all members’ deductibles and coinsurance, thereby eliminating the burden and cost of collection (and bad debt expense) for member payments that the company’s provider clinics otherwise would experience.
Data Sharing and Reporting. The company produces clinic scorecards quarterly with key performance indicators that allow fertility specialists to compare their results with peer averages.
Higher Volumes and Improved Financial Performance. Fertility specialists in the company’s network often experience an increase in patient volume, and because of the company’s comprehensive benefits design, an increase in the number of patients who progress from consultation to treatment.
Growth Strategy
The key elements of the company's strategy are to expand its client base; capitalize on embedded growth potential within its existing client base; expand Progyny benefits solutions within its existing client base; and new services and addressable markets to enhance the depth and breadth of its comprehensive family building offering.
Clients
The company has contracts to serve over 530 employers in the United States across more than 40 industries. The company’s clients, who are leaders across both high-growth and mature industries and range in size from at least 1,000 to 600,000 employees, represent approximately 6.7 million lives under contract.
The company has clients in the technology, consumer retail, e-commerce, industrial, healthcare, media, insurance, legal, food and beverage, financial services, life sciences, professional services, government services, union, energy, manufacturing, logistics, transportation, aerospace, real estate, nonprofit and hospitality sectors. The majority of the company’s clients have signed multi-year contracts or contracts that renew automatically on an annual basis.
The majority of the company’s client’s contract with it for a January 1st benefits plan start date, the company’s sales cycle follows the conventional healthcare benefits cycle, which largely concludes by the end of October of the prior year to allow for benefits education and annual open enrollment to occur. In the 2024 sales cycle, more clients, with benefits going live in 2025, has opted for comprehensive coverage, with substantially all its new clients electing Progyny Rx, multiple Smart Cycles and/or egg-freezing.
Sales and Marketing
The company sells its solutions through its sales organization, and, in many cases, the company leverages its relationships with top benefits consultants, channel partners and health plan partners to establish relationships with potential clients. The company’s sales team has broad experience in health benefits management and extensive long-term relationships with industry participants and benefits executives at large employers. The company’s sales team is organized principally by geography and account size and is responsible for identifying potential clients and managing the overall sales process. The success and effectiveness of the company’s sales team is evidenced by the addition of over 80 new clients in 2024, and the fact that a majority of its clients terminated their prior fertility benefit to switch to Progyny.
The company generates client leads, accelerate sales opportunities and build brand awareness through its marketing programs. The company’s marketing programs target human resource, benefits and finance executives in addition to healthcare professionals and senior business leaders. The company’s principal marketing programs include learning opportunities for potential members, demand generation, field marketing events, integrated marketing campaigns (including direct email and online advertising) and participation in industry events, trade shows and conferences. The company also benefits from strong referrals as several of its prominent clients have publicly endorsed Progyny and discussed the value they and their members receive.
Intellectual Property
As of December 31, 2024, the company had a number of registered trademarks, including Progyny (and design), Smart Cycle and UnPack It.
Seasonality
The company’s business experiences moderate seasonality in revenue with a slightly higher proportion of revenue during the second half of the year as compared with the first half. The majority of the company’s client’s contract with it for a January 1st benefits plan start date and that the average cost of treatments earlier in the overall treatment process is somewhat lower than the average cost as treatment progresses, the company’s revenue from treatment services tends to grow as the year continues, particularly for new clients.
Government Regulation
The company regulates, directly or indirectly through its client relationships, by various federal agencies, including, but not limited to, the Department of Health and Human Services, or HHS, the Department of Labor, or DOL, and the Federal Trade Commission, or FTC, as well as by various state governments and agencies.
The Employee Retirement Income Security Act of 1974, or ERISA, regulates certain aspects of employee health plans, including both insured and self-funded health plans sponsored by the company’s clients, with whom it has agreements to provide third-party administrator (TPA) services and, in most cases, pharmacy benefit manager (PBM) services through Progyny Rx.
As a provider of services to entities subject to the Health Insurance Portability and Accountability Act of 1996 (HIPAA), the company is directly subject to certain provisions of HIPAA in its capacity as a ‘Business Associate.’
History
The company was incorporated in Delaware in 2008. It was formerly known as Auxogyn, Inc. and changed its name to Progyny, Inc. in 2015.
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