Biggest changeOther Income, Net Year Ended December 31, 2023 2022 % Change (dollars in thousands) Other income, net $ 8,507 $ 1,100 673 % Other income, net increased by $7.4 million for the year ended December 31, 2023 compared to the year ended December 31, 2022, primarily due to increases in investment and interest income. 64 Table of Contents Provision (Benefit) for Income Taxes Year Ended December 31, 2023 2022 % Change (dollars in thousands) Provision (benefit) for income taxes $ 8,654 $ (5,917) (246) % For the year ended December 31, 2023, we recorded a provision for income taxes of $8.7 million, as compared to a benefit for income taxes of $5.9 million for the year ended December 31, 2022, primarily due to higher operating profit as well as a decrease in tax benefits for equity compensation, including discrete tax benefits, in the current year period.
Biggest changeProvision for Income Taxes Year Ended December 31, 2024 2023 % Change (dollars in thousands) Provision for income taxes $ 28,866 $ 8,654 234 % For the year ended December 31, 2024, we recorded a provision for income taxes of $28.9 million, as compared to a provision for income taxes of $8.7 million for the year ended December 31, 2023, primarily due to a higher operating profit as well as a decrease in tax benefits for equity compensation. 56 Table of Contents Liquidity and Capital Resources As of December 31, 2024, we had $162.3 million of cash and cash equivalents and $65.6 million of marketable securities.
These expenses also include third-party consulting services and facilities costs. We anticipate that we will incur additional general and administrative expenses on an ongoing basis to support the growth of our business. Other Income, net Other income, net primarily includes interest income and expense, as well as investment income and losses.
These expenses also include third-party consulting services and facilities costs. We anticipate that we will incur additional general and administrative expenses on an ongoing basis to support the growth of our business. Interest and other income, net Interest and other income, net primarily includes interest income and expense, as well as investment income and losses.
Some of the limitations of Adjusted EBITDA include: (1) it does not properly reflect capital commitments to be paid in the future; (2) although depreciation and amortization are non-cash charges, the underlying assets may need to be replaced and Adjusted EBITDA does not reflect these capital expenditures; (3) it does not consider the impact of stock-based compensation expense; (4) it does not reflect other non-operating income and expenses, including other income (expense), net and interest income (expense), net; and (5) it does not reflect tax payments that may represent a reduction in cash available to us.
Some of the limitations of Adjusted EBITDA include: (1) it does not properly reflect capital commitments to be paid in the future; (2) although depreciation and amortization are non-cash charges, the underlying assets may need to be replaced and Adjusted EBITDA does not reflect these capital expenditures; (3) it does not consider the impact of stock-based compensation expense; (4) it does not reflect other non-operating income and expenses, including interest and other income, net; and (5) it does not reflect tax payments that may represent a reduction in cash available to us.
Financing Activities Net cash used in financing activities was $11.1 million for the year ended December 31, 2023, consisting of payments of $17.2 million for employee taxes related to equity awards, partially offset by $4.9 million in proceeds from stock option exercises and $1.3 million in proceeds from contributions to our employee stock purchase plan.
Net cash used in financing activities was $11.1 million for the year ended December 31, 2023, consisting of payments of $17.2 million for employee taxes related to the net settlement of equity awards, partially offset by $4.9 million in proceeds from stock option exercises and $1.3 million in proceeds from contributions to our employee stock purchase plan.
The preparation of these consolidated financial statements requires us to make estimates and assumptions that affect the amounts reported amounts of assets, liabilities, revenue and expenses, and related disclosures. We base our estimates on historical experience and on various other assumptions that we believe are reasonable under the circumstances. We evaluate our estimates and assumptions on an ongoing basis.
GAAP. The preparation of these consolidated financial statements requires us to make estimates and assumptions that affect the reported amounts of assets, liabilities, revenue and expenses, and related disclosures. We base our estimates on historical experience and on various other assumptions that we believe are reasonable under the circumstances. We evaluate our estimates and assumptions on an ongoing basis.
Revenue Model Our clients primarily contract with us to provide our fertility benefits solution and, where added on by our clients, our Progyny Rx solution. Our revenue has both a utilization-based component and a population-based component, as follows: • Utilization Component. Clients pay us for the fertility benefits and Progyny Rx solutions utilized by their employees.
Our clients primarily contract with us to provide our fertility benefits solution and, where added on by our clients, our Progyny Rx solution. Our revenue has both a utilization-based component and a population-based component, as follows: • Utilization Component. Clients pay us for the fertility benefits and Progyny Rx solutions utilized by their employees.
There are approximately 8,000 employers in the United States who have a minimum of 1,000 employees, who together with Taft-Hartley labor populations and federal government populations, represents approximately 106 million potential covered lives in total. Our current member base of approximately 6.4 million covered lives under contract represents a mid-single digit percent of our total market opportunity.
There are approximately 8,000 employers in the United States who have a minimum of 1,000 employees, who together with Taft-Hartley labor populations and federal government populations, represents approximately 106 million potential covered lives in total. Our current member base of approximately 6.7 million covered lives under contract represents a mid-single digit percent of our total market opportunity.
In February 2022, we entered into a lease agreement for additional space in our corporate offices in New York, New York, consisting of a 24,099 square foot office and a 21,262 square foot office, and also for continued occupancy of the 25,212 square foot office after the expiration of the current sublease.
In February 2022, we entered into a lease agreement commencing in February 2023 for additional space in our corporate offices in New York, New York, consisting of a 24,099 square foot office and a 21,262 square foot office, and also for continued occupancy of the 25,212 square foot office after the expiration of the current sublease.
Fertility Benefits Services Fertility benefits 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 expense, other related costs, and an allocation of our general overhead, depreciation and amortization) for those employees associated with 59 Table of Contents our care management service functions: Provider Account Management, PCA, Provider Relations and Claims Processing teams; and (3) related information technology support costs.
Fertility Benefits Services Fertility benefits 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 expense, 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.
We include accrued receivables within accounts receivable on our consolidated balance sheet. As of December 31, 2023 and 2022, accrued receivables were $45.8 million and $54.6 million, respectively. At the same time, we estimate cost of services and accrued claims payables based on the amount to be paid to the provider clinic and expected gross margin on fertility benefit services.
We include accrued receivables within accounts receivable on our consolidated balance sheet. As of December 31, 2024 and 2023, accrued receivables were $45.6 million and $45.8 million, respectively. At the same time, we estimate cost of services and accrued claims payables based on the amount to be paid to the provider clinic and expected gross margin on fertility benefit services.
Revenue is also accrued for authorized Smart Cycle services rendered based on member appointments scheduled with a fertility specialist in our network but for which no claim has yet been reported, net of expected changes and cancellations of services. Pharmacy Benefits Solution Revenue Pharmacy benefits solution revenue primarily represents utilization of Progyny Rx.
Revenue is also accrued for authorized Smart Cycle services rendered based on member appointments scheduled with a fertility specialist in our network but for which no claim has yet been reported, net of expected changes and cancellations of services. 50 Table of Contents Pharmacy Benefits Solution Revenue Pharmacy benefits solution revenue primarily represents utilization of Progyny Rx.
We estimate the fair value of each stock-based award on the measurement 67 Table of Contents date using either the Black-Scholes option-pricing model for stock options and stock purchased under the employee stock purchase plan or the closing market price of our common stock for restricted stock units, including those with performance-based vesting criteria.
We estimate the fair value of each stock-based award on the measurement date using either the Black-Scholes option-pricing model for stock options and stock purchased under the employee stock purchase plan or the closing market price of our common stock for restricted stock units, including those with performance-based vesting criteria.
Accrued claims payable of $30.3 million and $31.1 million as of December 31, 2023 and 2022, respectively, are included within accrued expenses and other current liabilities in the consolidated balance sheet. Our estimates are adjusted to actual at the time of billing and these adjustments have historically not been material.
Accrued claims payable of $32.1 million and $30.3 million as of December 31, 2024 and 2023, respectively, are included within accrued expenses and other current liabilities in the consolidated balance sheet. Our estimates are adjusted to actual at the time of billing and these adjustments have historically not been material.
Additionally, staffing levels and the related personnel costs, including stock-based compensation expense, and other costs necessary to deliver our care management services will continue to grow as we continue to add clients and their associated members. Operating Expenses Our operating expenses consist of sales and marketing and general and administrative expenses.
Additionally, staffing levels and the related 51 Table of Contents personnel costs, including stock-based compensation expense, and other costs necessary to deliver our care management services will continue to grow as we continue to add clients and their associated members. Operating Expenses Our operating expenses consist of sales and marketing and general and administrative expenses.
Changes in operating assets and liabilities resulted in cash used in operating activities from an increase in prepaid expenses and other current assets of $22.9 million and accounts receivable of $21.7 million, partially offset by cash provided by operating activities from increases in accounts payable of $16.2 million, accrued expenses and other current liabilities of $10.4 million and other noncurrent assets and liabilities of $0.6 million.
Changes in operating assets and liabilities resulted in cash used in operating activities from an increase in prepaid expenses and other current assets of $22.9 million and accounts receivable of $21.7 million, partially 57 Table of Contents offset by cash provided by operating activities from increases in accounts payable of $16.2 million, accrued expenses and other current liabilities of $10.4 million and other noncurrent assets and liabilities of $0.6 million.
A key driver of our revenue is the number of members we serve and the rate at which they utilize their fertility benefits. As our client base has grown, our membership has grown from approximately 110,000 members in 2016 when we launched our fertility benefits solution to 5.4 million members as of December 31, 2023.
A key driver of our revenue is the number of members we serve and the rate at which they utilize their fertility benefits. As our client base has grown, our membership has grown from approximately 110,000 members in 2016 when we launched our fertility benefits solution to 6.5 million members as of December 31, 2024.
As part of this solution, we provide care 56 Table of Contents management services, which include our formulary plan design, simplified authorization, assistance with prescription fulfillment and timely delivery of the medications by our network of specialty pharmacies, as well as medication administration training, pharmacy support services and continuing PCA support. Our Clients.
As part of this solution, we provide care management services, which include our formulary plan design, simplified authorization, assistance with prescription fulfillment and timely delivery of the medications by our network of specialty pharmacies, as well as medication administration training, pharmacy support services and continuing PCA support.
With respect to Progyny Rx, we bill the client for the fertility medication dispensed to their employees in connection with the authorized fertility treatments. Medication fees also include our formulary management, drug utilization review and cost containment services and other care management services. • Population-Based Component.
With respect to Progyny Rx, we bill the client for the fertility medication dispensed to their employees in connection with the authorized fertility treatments. Medication fees also include our 48 Table of Contents formulary management, drug utilization review and cost containment services and other care management services. • Population-Based Component.
We believe there is sufficient positive evidence to conclude that it is more likely than not that the net deferred tax assets were realizable as of December 31, 2023. The amount of deferred tax provided is calculated using tax rates enacted at the balance sheet date.
We believe there is sufficient positive evidence to conclude that it is more likely than not that substantially all the net deferred tax assets were realizable as of December 31, 2024. The amount of deferred tax provided is calculated using tax rates enacted at the balance sheet date.
Treasury securities for the period that is consistent with the expected term of the stock option. The dividend yield is assumed to be none as we have not paid dividends, nor do we anticipate paying dividends. The weighted-average estimated fair value of stock option awards granted in the year ended December 31, 2023 was $19.10.
Treasury securities for the period that is consistent with the expected term of the stock option. The dividend yield is assumed to be none as we have not paid dividends, nor do we anticipate paying dividends. The weighted-average estimated fair value of stock option awards granted in the year ended December 31, 2024 was $16.60.
Provision (Benefit) for Income Taxes We are subject to income taxes in the United States. Income tax expense consists of taxes currently payable and changes in deferred tax assets and liabilities calculated according to local tax rules.
Provision for Income Taxes We are subject to income taxes in the United States and in certain foreign jurisdictions. Income tax expense consists of taxes currently payable and changes in deferred tax assets and liabilities calculated according to local tax rules.
GAAP. 61 Table of Contents Year Ended December 31, 2023 2022 Consolidated Statements of Operations Data, as a percentage of revenue: Revenue 100.0 % 100.0 % Cost of services 78.1 % 78.7 % Gross profit 21.9 % 21.3 % Operating expenses: Sales and marketing 5.5 % 5.8 % General and administrative 10.8 % 12.5 % Total operating expenses 16.2 % 18.3 % Income from operations 5.7 % 3.0 % Other income, net 0.8 % 0.1 % Income before income taxes 6.5 % 3.1 % Provision (benefit) for income taxes 0.8 % (0.8) % Net income 5.7 % 3.9 % Adjusted EBITDA 17.2 % 16.0 % Note: percentages shown in the table may not foot due to rounding.
GAAP. 53 Table of Contents Year Ended December 31, 2024 2023 Consolidated Statements of Operations Data, as a percentage of revenue: Revenue 100.0 % 100.0 % Cost of services 78.3 % 78.1 % Gross profit 21.7 % 21.9 % Operating expenses: Sales and marketing 5.5 % 5.5 % General and administrative 10.4 % 10.8 % Total operating expenses 15.9 % 16.2 % Income from operations 5.8 % 5.7 % Interest and other income, net 1.3 % 0.8 % Income before income taxes 7.1 % 6.5 % Provision for income taxes 2.5 % 0.8 % Net income 4.6 % 5.7 % Adjusted EBITDA 17.0 % 17.2 % Note: percentages shown in the table may not foot due to rounding.
PEPM fees represented 1% of our total revenue for the years ended December 31, 2023 and 2022, respectively. Our revenue in a given year is determined by the level and mix of the utilization of our fertility benefits and Progyny Rx solutions by our members as well as the number of members enrolled in our clients’ benefits plans.
PEPM fees represented 1% of our total revenue for the years ended December 31, 2024 and 2023, respectively. Our revenue in a given year is determined by the utilization, including rate of consumption and mix, of our fertility benefits and Progyny Rx solutions by our members as well as the number of members enrolled in our clients’ benefits plans.
Clients can also add adoption and surrogacy reimbursement programs as part of this solution. Pharmacy Benefits Solution. We went live with our integrated pharmacy benefits solution in 2018. Progyny Rx can only be purchased by clients that purchase our fertility benefits solution. Progyny Rx provides our members with access to the medications needed during their fertility treatment.
Clients can also add adoption and surrogacy reimbursement programs as part of this solution. Pharmacy Benefits Solution. Progyny Rx can only be purchased by clients that purchase our fertility benefits solution. Progyny Rx provides our members with access to the medications needed during their fertility treatment.
For the 21,262 square foot office, we will pay the base rent of approximately $1.3 million starting in the fourth quarter of 2025 for five years and approximately $1.4 million per year thereafter through the fourth quarter of 2035, the expected expiration date.
For the 21,262 square foot office, we will pay the base rent of approximately $1.3 million starting in the second quarter of 2026 for five years and approximately $1.4 million per year thereafter through the second quarter of 2036, the expected expiration date.
Share Repurchase Program In February 2024, our Board of Directors authorized a share repurchase program of up to $100 million in shares of common stock.
Share Repurchase Programs In February 2024, our Board of Directors authorized a share repurchase program of up to $100 million in shares of common stock. In May 2024, our Board of Directors authorized an additional share repurchase program of up to $100 million in shares of common stock.
As of December 31, 2023, we had $165.1 million and $91.0 million of unrecognized compensation costs related to unvested options and restricted stock units, respectively, which are expected to be expensed and vest over a weighted-average remaining period of approximately 2.5 years and 2.6 years, respectively.
As of December 31, 2024, we had $118.3 million and $99.5 million of unrecognized compensation costs related to unvested options and restricted stock units, respectively, which are expected to be expensed and vest over a weighted-average remaining period of approximately 2.0 years and 2.6 years, respectively.
The impact of tax law changes is recognized in periods when the change is enacted. 68 Table of Contents As of December 31, 2023 and 2022, we had $73.1 million and $77.9 million of net deferred tax assets, respectively. There was a valuation allowance of $0.5 million and $0.3 million as of December 31, 2023 and 2022, respectively.
The impact of tax law changes is recognized in periods when the change is enacted. As of December 31, 2024 and 2023, we had $84.9 million and $73.1 million of net deferred tax assets, respectively. There was a valuation allowance of $1.8 million and $0.5 million as of December 31, 2024 and 2023, respectively. 60 Table of Contents
For our current 25,212 square foot office, we will pay the base rent of approximately $1.6 million per year beginning in June 2029 through the fourth quarter of 2035, the expected expiration date. Critical Accounting Estimates Our consolidated financial statements and accompanying notes have been prepared in accordance with U.S. GAAP.
For our current 25,212 square foot office, we will pay the base rent of approximately $1.6 million per year beginning in June 2029, which is the lease commencement date, through the second quarter of 2036, the expected expiration date. 58 Table of Contents Critical Accounting Estimates Our consolidated financial statements and accompanying notes have been prepared in accordance with U.S.
Moreover, our future capital requirements will depend on many factors, including sales of our solutions and client renewals, the timing and the amount of cash received from clients, the expansion of our sales and marketing activities and the continuing market adoption of our solutions.
Moreover, our future capital requirements will depend on many factors, including sales of our solutions and client renewals, the timing and the amount of cash received from clients, the amount of capital investment necessary to support our benefits offerings and growth strategy, the expansion of our sales and marketing activities and the continuing market adoption of our solutions.
Cost of Services Year Ended December 31, 2023 2022 % Change (dollars in thousands) Cost of services $ 849,799 $ 619,588 37 % Cost of services increased by $230.2 million, or 37%, for the year ended December 31, 2023 compared to the year ended December 31, 2022 primarily due to an increase in medical treatment and pharmacy prescription costs associated with fertility treatments delivered.
Cost of Services Year Ended December 31, 2024 2023 % Change (dollars in thousands) Cost of services $ 913,858 $ 849,799 8 % Cost of services increased by $64.1 million, or 8%, for the year ended December 31, 2024 compared to the year ended December 31, 2023 primarily due to an increase in medical treatment and pharmacy prescription costs associated with fertility treatments delivered.
This increase was primarily due to an $11.3 million increase in personnel-related costs attributable to an increase in stock-based compensation expense of $5.9 million, incremental headcount and an increase in sales commissions, as well as a $2.5 million increase in other related sales and marketing expenses.
This increase was primarily due to a $3.5 million increase in personnel-related costs attributable to an increase in stock-based compensation expense, as well as a $1.0 million increase in other related sales and marketing expenses.
For the years ended December 31, 2023 and 2022, stock-based compensation expense was $122.6 million and $100.7 million, respectively.
For the years ended December 31, 2024 and 2023, stock-based compensation expense was $128.1 million and $122.6 million, respectively.
The following assumptions were used to calculate the fair value of stock options granted to employees: Year Ended December 31, 2023 2022 Expected volatility 52.0% - 54.0% 49.3% - 53.3% Expected term (years) 5.50 - 6.11 4.61 - 6.11 Risk‑free interest rate 3.5% - 4.8% 1.4% - 4.4% Expected dividend yield — — Our outstanding stock-based awards as of December 31, 2023 are subject to service-based or performance-based vesting.
Changes in these inputs could result in a significant change in the fair value of stock options. 59 Table of Contents The following assumptions were used to calculate the fair value of stock options granted to employees: Year Ended December 31, 2024 2023 Expected volatility 53.0% - 55.0% 52.0% - 54.0% Expected term (years) 5.25 - 6.11 5.50 - 6.11 Risk‑free interest rate 3.5% - 4.6% 3.5% - 4.8% Expected dividend yield — — Our outstanding stock-based awards as of December 31, 2024 are subject to service-based or performance-based vesting.
General and Administrative Expense Year Ended December 31, 2023 2022 % Change (dollars in thousands) General and administrative $ 117,127 $ 98,327 19 % General and administrative expense increased by $18.8 million, or 19%, for the year ended December 31, 2023 compared to the year ended December 31, 2022.
General and Administrative Expense Year Ended December 31, 2024 2023 % Change (dollars in thousands) General and administrative $ 121,960 $ 117,127 4 % General and administrative expense increased by $4.8 million, or 4%, for the year ended December 31, 2024 compared to the year ended December 31, 2023.
Changes in operating assets and liabilities resulted in cash used in operating activities from an increase in accounts receivable of $119.3 million and other noncurrent assets and liabilities of $1.1 million, partially offset by cash provided by operating activities from increases in accounts payable of $47.7 million and accrued expenses and other current liabilities of $13.1 million and decreases in prepaid expenses and other current assets of $0.1 million.
Changes in operating assets and liabilities resulted in cash used in operating activities from a decrease in accounts payable of $30.3 million, and an increase in accounts receivable of $9.9 million, partially offset by cash provided by operating activities from increases in accrued expenses and other current liabilities of $9.9 million and other noncurrent assets and liabilities of $0.4 million, and a decrease in prepaid expenses and other current assets of $18.0 million.
Three Months Ended December 31, Year Ended December 31, 2023 2022 2023 2022 Assisted Reproductive Treatment (ART) Cycles (1) 15,066 12,196 58,013 42,598 Utilization - All Members (2) 0.54% 0.51% 1.33% 1.23% Utilization - Female Only (2) 0.48% 0.46% 1.09% 1.03% Average Members 5,442,000 4,559,000 5,383,000 4,349,000 (1) Represents the number of ART cycles performed, including IVF with a fresh embryo transfer, IVF freeze all cycles/embryo banking, frozen embryo transfers and egg freezing.
Three Months Ended December 31, Year Ended December 31, 2024 2023 2024 2023 Assisted Reproductive Treatment (ART) Cycles (1) 15,839 15,066 61,114 58,013 Utilization - All Members (2) 0.55% 0.54% 1.31% 1.33% Utilization - Female Only (2) 0.48% 0.48% 1.07% 1.09% Average Members (3) 6,471,000 5,442,000 6,404,000 5,383,000 (1) Represents the number of ART cycles performed, including IVF with a fresh embryo transfer, IVF freeze all cycles/embryo banking, frozen embryo transfers and egg freezing.
Net cash provided by operating activities was $80.4 million for the year ended December 31, 2022, primarily consisting of net income of $30.4 million adjusted for certain non-cash items, which included $100.7 million of stock-based compensation expense, $13.8 million of bad debt expense, $6.6 million of deferred tax benefits, and $1.6 million of depreciation and amortization.
Net cash provided by operating activities was $188.8 million for the year ended December 31, 2023, primarily consisting of net income of $62.0 million adjusted for certain non-cash items, which included $122.6 million of stock-based compensation expense, $19.9 million of bad debt expense, $3.7 million of deferred tax expense, and $2.3 million of depreciation and amortization.
Net cash used in financing activities was $7.9 million for the year ended December 31, 2022, consisting of payments of $12.1 million for employee taxes related to equity awards, partially offset by $3.1 million in proceeds from stock option exercises and $1.2 million in proceeds from contributions to our employee stock purchase plan.
Financing Activities Net cash used in financing activities was $309.9 million for the year ended December 31, 2024, consisting of $300.3 million of repurchases of common stock under the 2024 Share Repurchase Programs, inclusive of $0.4 million in trading fees and payments of $12.0 million for employee taxes related to the net settlement of equity awards, partially offset by $1.1 million in proceeds from stock option exercises and $1.3 million in proceeds from contributions to our employee stock purchase plan.
This increase is primarily due to a $166.2 million, or 33% increase, in revenue from our fertility benefits solution and a $135.5 million or 49% increase in revenue from our Progyny Rx solution. The increase in revenue from our fertility benefits solution was primarily due to the increase in the number of clients and covered lives.
This increase is primarily due to a $53.2 million, or 8% increase, in revenue from our fertility benefits solution and a $25.4 million or 6% increase in revenue from our Progyny Rx solution. The increase in revenue from our fertility benefits solution and Progyny Rx solution were primarily due to the increase in the number of clients and covered lives.
Operating Expenses Sales and Marketing Expense Year Ended December 31, 2023 2022 % Change (dollars in thousands) Sales and marketing $ 59,488 $ 45,657 30 % Sales and marketing expense increased by $13.8 million, or 30%, for the year ended December 31, 2023 compared to the year ended December 31, 2022.
Operating Expenses Sales and Marketing Expense Year Ended December 31, 2024 2023 % Change (dollars in thousands) Sales and marketing $ 63,948 $ 59,488 7 % Sales and marketing expense increased by $4.5 million, or 7%, for the year ended December 31, 2024 compared to the year ended December 31, 2023.
Our cash and cash equivalents and working capital are affected by the timing of payments to third party providers and collections from clients and have increased as our revenue has increased.
We have financed our operations primarily through sales of our solutions and the net proceeds we have received from sales of equity securities. Our cash and cash equivalents and working capital are affected by the timing of payments to third party providers and collections from clients and have increased as our revenue has increased.
We are expanding our client base within each industry and have an industry-specific strategy that enables us to most effectively target our addressable market. Because our clients within an industry compete with each other for employees, we believe our solutions are increasingly viewed as an important way for them to differentiate from, or remain competitive with, one another.
Because our clients within an industry compete with each other for employees, we believe our solutions are increasingly viewed as an important way for them to differentiate from, or remain competitive with, one another.
For the 24,099 square foot office, we will pay the base rent of approximately $1.4 million per year starting in April 2024 for five years and approximately $1.5 million per year thereafter through the fourth quarter of 2035, the expected expiration date.
For the 24,099 square foot office, we pay base rent of approximately $1.4 million per year through the end of the fifth year and approximately $1.5 million per year thereafter through the second quarter of 2036, the expected expiration date.
A discussion of the fiscal year ended December 31, 2022 compared to the year ended December 31, 2021 has been reported previously in our Annual Report on Form 10-K for the year ended December 31, 2022 filed with the SEC on March 1, 2023 (File No. 001-39100) under the heading “ Management’s Discussion and Analysis of Financial Condition and Results of Operations – Comparison of Years Ended December 31, 2022 and 2021 .” Overview We believe in a world where everyone can realize dreams of family and ideal health.
A discussion of the fiscal year ended December 31, 2023 compared to the year ended December 31, 2022 has been reported previously in our Annual Report on Form 10-K for the year ended December 31, 2023 filed with the SEC on February 29, 2024 (File No. 001-39100) under the heading “ Management's Discussion and Analysis of Financial Condition and Results of Operations - Comparison of Years Ended December 31, 2023 and 2022. ” Executive Overview We are a benefits management company specializing in fertility, family building, and women's health benefits solutions in the United States.
For the purposes of calculating utilization rates in any given period, the results reflect the number of unique members utilizing the benefit for that period. Individual periods cannot be combined as member treatments may span multiple periods . Impact of COVID-19 on our Business The COVID-19 pandemic significantly impacted various markets around the world, including the United States.
For the purposes of calculating utilization rates in any given period, the results reflect the number of unique members utilizing the benefit for that period. Individual periods cannot be combined as member treatments may span multiple periods .
Results of Operations The following tables set forth our results of operations for the periods presented and as a percentage of revenue for those periods: Year Ended December 31, 2023 2022 (in thousands) Consolidated Statements of Operations Data: Revenue $ 1,088,598 $ 786,913 Cost of services (1) 849,799 619,588 Gross profit 238,799 167,325 Operating expenses: Sales and marketing (1) 59,488 45,657 General and administrative (1) 117,127 98,327 Total operating expenses 176,615 143,984 Income from operations 62,184 23,341 Other income, net 8,507 1,100 Income before income taxes 70,691 24,441 Provision (benefit) for income taxes 8,654 (5,917) Net income $ 62,037 $ 30,358 Adjusted EBITDA (2) $ 187,076 $ 125,690 (1) Includes stock-based compensation expense as follows: Year Ended December 31, 2023 2022 Cost of services $ 34,490 $ 25,918 Sales and marketing 27,015 21,135 General and administrative 61,106 53,695 Total stock‑based compensation expense $ 122,611 $ 100,748 (2) Adjusted EBITDA is a non-GAAP financial measure that we define as net income, adjusted to exclude depreciation and amortization, stock-based compensation expense, other income, net, interest income, net, and provision (benefit) for income taxes.
Results of Operations The following tables set forth our results of operations for the periods presented and as a percentage of revenue for those periods: 52 Table of Contents Year Ended December 31, 2024 2023 (in thousands) Consolidated Statements of Operations Data: Revenue $ 1,167,221 $ 1,088,598 Cost of services (1) 913,858 849,799 Gross profit 253,363 238,799 Operating expenses: Sales and marketing (1) 63,948 59,488 General and administrative (1) 121,960 117,127 Total operating expenses 185,908 176,615 Income from operations 67,455 62,184 Interest and other income, net 15,747 8,507 Income before income taxes 83,202 70,691 Provision for income taxes 28,866 8,654 Net income $ 54,336 $ 62,037 Adjusted EBITDA (2) $ 198,760 $ 187,076 (1) Includes stock-based compensation expense as follows: Year Ended December 31, 2024 2023 Cost of services $ 36,799 $ 34,490 Sales and marketing 30,490 27,015 General and administrative 60,841 61,106 Total stock‑based compensation expense $ 128,130 $ 122,611 (2) Adjusted EBITDA is a non-GAAP financial measure that we define as net income, adjusted to exclude depreciation and amortization, stock-based compensation expense, interest and other income, net, and provision for income taxes.
In the event that we require additional financing, we may not be able to raise such financing on terms acceptable to us or at all.
In addition, we may enter into arrangements to acquire or invest in complementary businesses, products, and technologies. We may, in the future, be required to seek additional equity or debt financing. In the event that we require additional financing, we may not be able to raise such financing on terms acceptable to us or at all.
Investing Activities Net cash used in investing activities was $200.5 million and $43.9 million for the years ended December 31, 2023 and 2022, respectively, which primarily consisted of net investments in marketable securities of $196.9 million and $40.6 million, respectively.
For the year ended December 31, 2023, net cash used in investing activities was $200.5 million, which primarily consisted of net investments in marketable securities of $196.9 million. The remainder of the activity for the year ended December 31, 2024 consisted of purchases of computers, software, including capitalized software development costs, and furniture and fixtures.
Deferred income taxes are recorded for the expected tax consequences of temporary differences between the tax basis of assets and liabilities for financial reporting purposes and amounts recognized for income tax purposes.
Deferred income taxes are recorded for the expected tax consequences of temporary differences between the tax basis of assets and liabilities for financial reporting purposes and amounts recognized for income tax purposes. As of each reporting date, management considers new evidence, both positive and negative, that could affect its view of the future realization of deferred tax assets.
The following table presents a reconciliation of Adjusted EBITDA to net income for each of the periods indicated: Year Ended December 31, 2023 2022 (in thousands) Net income $ 62,037 $ 30,358 Add: Depreciation and amortization 2,281 1,601 Stock‑based compensation expense 122,611 100,748 Other income, net (5,203) (286) Interest income, net (3,304) (814) Provision (benefit) for income taxes 8,654 (5,917) Adjusted EBITDA $ 187,076 $ 125,690 Comparison of Years Ended December 31, 2023 and 2022 Revenue Year Ended December 31, 2023 2022 % Change (dollars in thousands) Revenue $ 1,088,598 $ 786,913 38 % Revenue increased by $301.7 million, or 38%, for the year ended December 31, 2023 compared to the year ended December 31, 2022.
GAAP, for each of the periods indicated: 54 Table of Contents Year Ended December 31, 2024 2023 (in thousands) Net income $ 54,336 $ 62,037 Add: Depreciation and amortization 3,175 2,281 Stock‑based compensation expense 128,130 122,611 Interest and other income, net (15,747) (8,507) Provision for income taxes 28,866 8,654 Adjusted EBITDA $ 198,760 $ 187,076 Comparison of Years Ended December 31, 2024 and 2023 Revenue Year Ended December 31, 2024 2023 % Change (dollars in thousands) Revenue $ 1,167,221 $ 1,088,598 7 % Revenue increased by $78.6 million, or 7%, for the year ended December 31, 2024 compared to the year ended December 31, 2023.
These changes are a result of the impact of revenue growth and our operating results as well as the timing of cash collection and payments to third parties.
These changes are a result of the impact of revenue growth and our operating results as well as the timing of cash collections and payments to third parties, including $40.4 million of cash paid for income taxes, net of refunds for the year ended December 31, 2024.
There can be no assurance as to the number of shares to be repurchased by us, if any. Operating Lease Commitments In September 2019, we commenced a sublease agreement for our corporate offices in New York, New York. The sublease is for a 25,212 square foot office and will expire in May 2029.
As of the year ended December 31, 2024, the share repurchase programs were completed, and no amounts remained available for repurchase under the programs. Operating Lease Commitments In September 2019, we commenced a sublease agreement for our corporate offices in New York, New York. The sublease is for a 25,212 square foot office and will expire in May 2029.
GAAP results. 62 Table of Contents We calculate Adjusted EBITDA as net income, adjusted to exclude depreciation and amortization, stock-based compensation expense, other income, net, interest income, net, and provision (benefit) for income taxes.
Because of these limitations, when evaluating our performance, you should consider Adjusted EBITDA alongside other financial performance measures, including our net income, gross margin, and other U.S. GAAP results. We calculate Adjusted EBITDA as net income, adjusted to exclude depreciation and amortization, stock-based compensation expense, interest and other income, net, and provision for income taxes.
If we are unable to raise additional capital or generate cash flows necessary to expand our operations and invest in continued innovation, we may not be able to compete successfully, which would harm our business, operations and financial condition. 65 Table of Contents The following table summarizes our cash flows from operations for the periods presented: Year Ended December 31, 2023 2022 (in thousands) Cash provided by operating activities $ 188,814 $ 80,395 Cash used in investing activities (200,525) (43,866) Cash used in financing activities (11,072) (7,864) Effect of exchange rate changes on cash and cash equivalents 1 — Net (decrease) increase in cash and cash equivalents $ (22,782) $ 28,665 Operating Activities Net cash provided by operating activities was $188.8 million for the year ended December 31, 2023, primarily consisting of net income of $62.0 million adjusted for certain non-cash items, which included $122.6 million of stock-based compensation expense, $19.9 million of bad debt expense, $3.7 million of deferred tax expense, and $2.3 million of depreciation and amortization.
The following table summarizes our cash flows from operations for the periods presented: Year Ended December 31, 2024 2023 (in thousands) Cash provided by operating activities $ 179,105 $ 188,814 Cash provided by (used in) investing activities 195,792 (200,525) Cash used in financing activities (309,880) (11,072) Effect of exchange rate changes on cash and cash equivalents $ 1 $ 1 Net increase (decrease) in cash and cash equivalents $ 65,018 $ (22,782) Operating Activities Net cash provided by operating activities was $179.1 million for the year ended December 31, 2024, primarily consisting of net income of $54.3 million adjusted for certain non-cash items, which included $128.1 million of stock-based compensation expense, $16.4 million of bad debt expense, $10.5 million of deferred tax benefit, $3.2 million of depreciation and amortization, $2.1 million of net accretion of discounts on marketable securities, and $1.4 million loss on disposal of property and equipment.
In particular, we are focused on expanding the number of clients with more than 2,500 covered lives.
In particular, we are focused on expanding the number of clients with more than 2,500 covered lives. As of December 31, 2024 and 2023, we served 473 and 392 clients, representing 6,472,000 and 5,418,000 members, respectively.
This increase in cost of services was also attributable to an increase in personnel-related costs primarily due to incremental headcount as well as an $8.6 million increase in stock-based compensation expense. 63 Table of Contents Gross Profit and Gross Margin Year Ended December 31, 2023 2022 % Change (dollars in thousands) Gross profit $ 238,799 $ 167,325 43 % Gross margin 21.9 % 21.3 % Gross profit increased by $71.5 million, or 43%, for the year ended December 31, 2023 compared to the year ended December 31, 2022.
Gross Profit and Gross Margin Year Ended December 31, 2024 2023 % Change (dollars in thousands) Gross profit $ 253,363 $ 238,799 6 % Gross margin 21.7 % 21.9 % Gross profit increased by $14.6 million, or 6%, for the year ended December 31, 2024 compared to the year ended December 31, 2023. 55 Table of Contents Gross margin decreased 20 basis points for the year ended December 31, 2024 compared to year ended December 31, 2023, primarily due to an increase in personnel-related costs in the delivery of our care management services.
As of each reporting date, management considers new 60 Table of Contents evidence, both positive and negative, that could affect its view of the future realization of deferred tax assets. We believe there is sufficient positive evidence to conclude that it is more likely than not that the net deferred tax assets are realizable.
We believe there is sufficient positive evidence to conclude that it is more likely than not that substantially all the net deferred tax assets are realizable.
This increase was primarily due to a $9.7 million increase in personnel-related costs including an increase in stock-based compensation expense of $7.4 million, a $6.1 million increase in bad debt expense driven by our revenue growth, as well as a $3.0 million increase in other related general and administrative expenses.
This increase was primarily due to a $6.0 million increase in personnel-related costs attributable to incremental head count, and a $2.3 million increase in other related general and administrative expenses, partially offset by a $3.5 million decrease in bad debt expense.
As of December 31, 2023 and 2022, we served 392 and 288 clients, respectively, representing 5,418,000 and 4,585,000 members, respectively. 57 Table of Contents Importantly, as we have continued to grow, we have meaningfully diversified our client base across more than 40 different industries currently from just two industries when we launched our fertility benefits solution in 2016.
Importantly, as we have continued to grow, we have meaningfully diversified our client base across more than 40 different industries currently from just two industries when we launched our fertility benefits solution in 2016. We are expanding our client base within each industry and have an industry-specific strategy that enables us to most effectively target our addressable market.
Components of Results of Operations Revenue Revenue includes fertility benefits solution revenue, pharmacy benefits solution revenue and PEPM fees. Fertility Benefits Solution Revenue Fertility benefits solution revenue primarily represents utilization of our fertility benefits solution.
(3) Includes approximately 300,000 members from a single client who are not reflected in utilization as a result of the client's chosen benefit design. Components of Results of Operations Revenue Revenue includes fertility benefits solution revenue, pharmacy benefits solution revenue and PEPM fees. Fertility Benefits Solution Revenue Fertility benefits solution revenue primarily represents utilization of our fertility benefits solution.
As of December 31, 2023 2022 Client Tier (Members) Clients Members Clients Members Up to 2,500 112 217,000 76 145,000 2,501 - 10,000 180 934,000 130 678,000 10,001 - 50,000 79 1,588,000 64 1,275,000 Greater than 50,000 21 2,679,000 18 2,487,000 Total 392 5,418,000 288 4,585,000 Benefits Utilization.
We count each organization we contract with as a single client including divisions, segments or subsidiaries of larger organizations to the extent we contract separately with them. 49 Table of Contents As of December 31, 2024 2023 Client Tier (Members) Clients Members Clients Members Up to 2,500 130 261,000 112 217,000 2,501 - 10,000 222 1,151,000 180 934,000 10,001 - 50,000 98 1,935,000 79 1,588,000 Greater than 50,000 23 3,125,000 21 2,679,000 Total 473 6,472,000 392 5,418,000 Benefits Utilization.