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  "documentTitle": "Progyny, Inc. (PGNY)",
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  "authorName": "Spruce Point Capital Management",
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  "presentationDate": "2023-02-07 00:00:00",
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      "text": "PGNY claims that its Smart Cycle benefit structure ensures that patients can complete treatment cycles. We believe that is a mischaracterization, as Smart Cycles simply represent a “service maximum” as opposed to the traditional “dollar maximum”. It is easy to see that the average employer benefit will be insufficient to cover all patients’ needs.",
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      "text": "The notion that patients cannot exhaust their coverage mid-treatment is simply not accurate.",
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      "text": "Smart Cycle Bundles and Values",
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      "kind": "paragraph",
      "text": "The Reality: PGNY's Fertility Benefit Still Has Coverage Maximums That May Not Cover Full Treatment",
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      "text": "It is generally acknowledged that, for the 70-80% of women who will successfully get pregnant through IVF, it will require an average of just over 2 IVF cycles to achieve that result. In addition, reviewing PGNY client coverage amounts, most employers cover 2 to 3 PGNY Smart Cycles. Therefore, given the Smart Cycle allocations for ancillary services and alternative protocols, it is clearly possible that a patient might not be able to complete the average required 2 IVF cycles. In addition, reviewing disclosures from former PGNY patient advocates, one of their primary roles is to explain how to maximize the PGNY benefit given their individual treatment requirements, which can include encouraging patients to pay for certain expenses out-of-pocket in order to preserve Smart Cycle credit. The notion that patients cannot exhaust their coverage mid-treatment is simply not accurate.",
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      "text": "PGNY's Coverage Claim",
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      "text": "Comprehensive Coverage. We provide all individuals with access to comprehensive coverage. Our 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. — PGNY 2021 10-K",
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      "kind": "source-note",
      "text": "Source: PGNY website, PGNY 2021 10-K, VMWare Member Guide 2021",
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