You should read the following discussion of our financial condition and results of operations in conjunction with our financial statements and the related notes and other financial information included elsewhere in this Quarterly Report on Form 10-Q ("Form 10-Q") and the Form 10-K.
The following discussion and analysis also includes discussion of certain non-GAAP financial measures. For a description and reconciliation of the non-GAAP measures discussed in this section, see "Non-GAAP Financial Measures" below.
This Form 10-Q contains "forward-looking statements". These statements are made pursuant to the safe harbor provisions of the Private Securities Litigation Reform Act of 1995. Forward-looking statements are neither historical facts nor assurances of future performance. Instead, they are based on our current beliefs, expectations and assumptions regarding the future of our business, future plans and strategies and other future conditions. Such forward-looking statements may include, without limitation, statements about future opportunities for us and our products and services, our future operations, financial or operating results, anticipated business levels, future earnings, planned activities, anticipated growth, market opportunities, strategies, competitions and other expectations and targets for future periods. In some cases, you can identify forward-looking statements because they contain words such as "anticipate," "believe," "estimate," "expect," "intend," "may," "predict," "project," "target," "potential," "seek," "will," "would," "could," "should," continue," contemplate," "plan" and other words and terms of similar meaning. Forward-looking statements are subject to known and unknown risks and uncertainties, many of which may be beyond our control. We caution you that forward-looking statements are not guarantees of future performance or outcomes and that actual performance and outcomes may differ materially from those made in or suggested by the forward-looking statements contained in this Form 10-Q. In addition, even if our results of operations, financial condition and cash flows, and the development of the markets in which we operate, are consistent with the forward-looking statements contained in this Form 10-Q, those results or developments may not be indicative of results or developments in subsequent periods. New factors emerge from time to time that may cause our business not to develop as we expect, and it is not possible for us to predict all of them. Factors that could cause actual results and outcomes to differ from those reflected in forward-looking statements include, among others, the following: with respect to the Merger, the Merger not being completed or delayed and the business uncertainties and certain contractual restrictions we are subject to while the Merger is pending; our ability to retain our existing clients or attract new clients, and sell additional solutions and services to our clients; our dependence on a small number of clients for a substantial portion of our total revenue; limitations of our clients' growth prospects, and the failure of the size of the total addressable markets in which we compete or expect that we may compete in the future to grow at rates currently expected; our ability to achieve or maintain profitability; Federal reductions in Medicare Advantage funding; significant consolidation in the healthcare industry, and decisions by clients to perform internally some of the same solutions or services we offer; the limited operating history we have with certain of our solutions; a failure to deliver high-quality member management services to our clients' members; the competition we face from healthcare services and technology companies; risks related to acquisitions of other businesses or technologies and other significant transactions; increases in labor costs, including due to changing minimum wage laws, and an overall tightening of the labor market; the long and unpredictable sales and integration cycles for our solutions; an economic downturn or volatility, including as a result of the ongoing COVID-19 pandemic; our ability to achieve market acceptance of new or updated solutions and services; our reliance on third parties for certain components of our business; significant fluctuations in our quarterly results of operations due to seasonality; our ability to achieve or maintain adequate utilization and suitable billing rates for our consultants, and our ability to deliver our services to our clients; recent and future developments in the Medicare Advantage market or the healthcare industry generally, including with respect to changing laws and regulations; our ability to comply with applicable laws, regulations and standards relating to data privacy and security; security breaches or incidents, failures and other disruptions of the information technology systems used in our business operations and of the sensitive information we collect, process, transmit, use and store; disruptions in service, and other software and systems failures, affecting us and our vendors; our ability to obtain, maintain, protect and enforce our intellectual property and proprietary rights; our ability to operate our business without infringing, misappropriating or otherwise violating the intellectual property or proprietary rights of third parties; our substantial indebtedness, and the restrictions imposed by our indebtedness on our subsidiaries; identified material weaknesses in our internal control over financial reporting and a failure to remediate these material weaknesses, and the effectiveness of our internal control over financial reporting; and the significant influence our principal stockholder, TPG, has over us. For a further discussion of these and other factors that could impact our future results, performance or transactions, see Part I, Item 1A "Risk Factors" of our Form 10-K and our other filings with theSecurities and Exchange Commission ("SEC"). Given these uncertainties, you should not place undue reliance on these forward-looking statements. Moreover, we operate in a very competitive and rapidly changing environment, and new risks emerge from time to time. It is not possible for us to predict all risks, nor can we assess the impact of all factors on our business or the extent to which any factor, or combination of factors, may cause actual results to differ materially from those contained in any forward-looking statements we may make. In light of these risks, uncertainties and assumptions, the future events and trends discussed in this Form 10-Q may not occur and 35
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actual results could differ materially and adversely from those anticipated or implied in the forward-looking statements. In addition, statements that "we believe" and similar statements reflect our beliefs and opinions on the relevant subject. These statements are based upon information available to us as of the date of this Form 10-Q, and, while we believe such information forms a reasonable basis for such statements, such information may be limited or incomplete, and our statements should not be read to indicate that we have conducted an exhaustive inquiry into, or review of, all potentially available relevant information. We qualify all of the forward-looking statements in this Form 10-Q by these cautionary statements. Except as required by law, we undertake no obligation to publicly update any forward-looking statements, whether as a result of new information, future events or otherwise.
Overview
The Company is a leading healthcare platform that utilizes technology and processes to improve government-sponsored health plans, including Medicare Advantage ("MA") plans. We help health plans to grow membership and revenue as well as operate more effectively and efficiently. We are a trusted solutions-oriented partner to payors and deliver purpose-built technology and services to enhance our clients' mission-critical workflows. Our solutions address health plan needs, including product development and sales, member experience management, clinical management, core operations, business intelligence and analytics. Leveraging our technology and expert advisory services, we serve as a unified and integrated extension of our clients' core health plan operations. Our proprietary, modular technology and end-to-end solutions replace or supplement our clients' existing systems and processes, enabling us to help health plans attract and retain members, improve revenue accuracy, drive cost savings, facilitate regulatory compliance, and enhance operational effectiveness. OnFebruary 1, 2022 , Convey's indirect wholly-owned subsidiary,D-M-S Holdings Parent, LLC (f/k/aDragon Holdings Parent, LLC ), aDelaware limited liability company, acquired all of the issued and outstanding capital stock ofD-M-S Holdings, Inc. d/b/aHealthSmart International , aDelaware corporation ("HealthSmart"). HealthSmart provides a diverse portfolio of health, wellness and diagnostic products centered on home based care outcomes. The acquisition of HealthSmart supports Convey's vision to empower health plans to excel by delivering a more diverse healthcare product portfolio to their members while streamlining logistics, resulting in a better healthcare consumer experience. The acquisition will combine Convey's best-in-class supplemental benefits administration technology and services solution with HealthSmart's market leading abilities as a trusted supplier of quality consumer healthcare products. Convey will extend the solutions serving the MA supplemental benefits business through a broader set of consumer healthcare products and expertise that serves many of the top health plans in theU.S.
Since our inception, we have created and continuously refined our technology solutions to best serve government-sponsored health plans. Our clients are primarily MA plans, Medicare Part D plans, including Employer Group Waiver plans, and pharmacy benefit managers.
We foster long-term collaborative partnerships as evidenced by our average relationship with our top 10 clients of over eight years, and we serve as a partner to nine of the nation's top 10 MA payors by lives covered, in each case as ofDecember 31, 2021 . We believe that we have significant opportunity to grow within our existing client base as the majority of our clients currently subscribe to only a subset of our overall solutions and services. Moreover, we believe we have significant opportunity to grow by winning new clients in the MA market, by selling more products to our existing clients, by expanding into adjacent markets such as Medicaid and commercial insurance, and through complementary strategic acquisitions.
Our clients face significant and constantly evolving challenges managing their Medicare health plans:
•Increasingly Competitive Environment for Medicare Plans: Effective benefit design and sales are critical to retaining and growing members during the Medicare annual enrollment period. Once members are enrolled in a plan, effective member engagement and supplemental benefits administration are paramount to ensuring strong satisfaction and retention. Moreover, the proliferation of value-based reimbursement models such as MA requires effective member management and broad ecosystem coordination, which fall outside the core competencies of many health plans. •Compliance withCenters for Medicare and Medicaid Services ("CMS") Requirements: Constantly evolving CMS and client requirements result in hundreds of modifications per year that inhibit the operational effectiveness and capabilities of health plans. Our purpose-built government sector technology platform addresses these constantly evolving requirements. •Complex and Highly Regulated Medicare Market: Many health plans enter the government plan market by simply adapting their existing systems designed for the commercial insurance market. As a result, the technology they employ often lacks the sophistication and design needed to effectively maintain and administer benefits tailored for the complex and highly regulated Medicare market. 36
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Health plans increasingly recognize the need for specialized solutions like ours to help them overcome these challenges and drive superior performance. We believe our proprietary technology and processes facilitate member engagement, health plan growth, and operational efficiencies. We operate in two segments: Technology Enabled Solutions ("TES") in which we provide technology and support solutions to our clients, and Advisory Services ("Advisory") in which we provide project-based consulting services led by our long-tenured subject matter experts. We believe that our combination of technology and advisory solutions gives us a competitive advantage in the government-sponsored health plan market. Our Technology Enabled Solutions and Advisory teams collaborate effectively to combine a strong technology platform with deep domain expertise to deliver best-in-class solutions to our clients. Furthermore, we leverage the Advisory team's industry expertise to identify new opportunities as well as cross-sell our solutions within existing clients. We have a highly predictable and recurring revenue model with strong cash flow from operations. We typically charge a recurring subscription or per-member fee or a re-occurring utilization-based fee, which, coupled with our long-term contracts and strong client retention, has historically provided us with strong revenue visibility into estimated future revenue. Our Technology Enabled Solutions business historically has been highly predictable as most of our revenue in any given year is under contract or otherwise visible by the beginning of that year due to the contract structures we employ.
Initial Public Offering
OnJune 18, 2021 , we closed the initial public offering ("IPO") of our common stock through an underwritten sale of 13,333,334 shares of our common stock at a price of$14.00 per share. In the offering, we sold 11,666,667 shares and a selling stockholder sold 1,666,667 shares. The aggregate net proceeds to us from the offering, after deducting underwriting discounts and commissions and other offering expenses payable by us, were approximately$146.1 million . We used approximately$131.5 million of the net proceeds from the IPO to repay outstanding indebtedness under our First Lien Credit Agreement (as amended, the "Credit Agreement"). We did not receive any of the proceeds from the sale by the selling stockholder.
Plan of Merger, Going Private and Restructuring Charges
OnJune 20, 2022 , the Company,Commodore Parent 2022, LLC, aDelaware limited liability company ("Commodore"), and Commodore Merger Sub 2022, Inc., aDelaware corporation and a wholly owned subsidiary of Commodore ("Commodore Merger Sub"), entered into an Agreement and Plan of Merger (the "Merger Agreement"), pursuant to which, subject to the satisfaction or waiver of certain conditions and on the terms set forth therein, Commodore Merger Sub will merge (the " Merger") with and into the Company, with the Company continuing as the surviving corporation (the "Surviving Corporation"). Commodore and Commodore Merger Sub are affiliates ofTPG Cannes Aggregation, L.P. , an affiliate ofTPG Global, LLC and the holder of a majority of the outstanding shares of capital stock of the Company (the "TPG Stockholder"). A special committee of the board of directors of the Company (the "Board") comprised solely of members of the Board that are independent of TPG Stockholder and its respective affiliates, reviewed, evaluated and (i) determined by unanimous vote, that the Merger Agreement and the transactions contemplated thereby, including the Merger, are advisable, fair to, and in the best interests of, the Company and its stockholders (other than the TPG Stockholder and any of its respective affiliates or the Company's officers and directors) and (ii) recommended that the Board approve the transaction. Acting upon the recommendation of the special committee, the Board approved the transaction. Following the execution of the Merger Agreement, the TPG Stockholder, the holder of approximately 75% of the outstanding shares of common stock, executed a written consent adopting the Merger Agreement and approving the transactions contemplated thereby, including the Merger. No further approval of the stockholders of the Company is required to approve the Merger. The transaction is expected to close in the second half of 2022. Completion of the transaction is subject to customary closing conditions. Upon completion of the transaction, the Company will become a private company and the shares of common stock of the Company will no longer be publicly listed or traded on theNew York Stock Exchange . At the effective time of the Merger (the "Effective Time") each share of common stock of the Company, issued and outstanding immediately prior to the Effective Time, (other than Rollover Shares (as defined below), common stock owned by the Company, the TPG Stockholder and its respective affiliates and common stock with respect to which appraisal rights underDelaware law are properly exercised and not withdrawn) will be converted into the right to receive an amount in cash equal to$10.50 per share, payable to the holder thereof, without interest. Commodore and Commodore Merger Sub have secured commitments (which may be assigned to the Company) for debt financing consisting of an incremental term loan facility in an aggregate principal amount of up to$180.0 million to be provided by certain lenders to the Company under the Company's existing Credit Agreement (as defined above) on the terms and subject to the conditions set forth in the debt commitment letter. The obligations of such lenders to provide debt financing under the debt commitment letter are subject to a number of customary conditions. In addition, certain of the Company's directors and officers have entered into a rollover and support 37
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agreement with Commodore, pursuant to which, among other matters, such rollover investors have agreed that a certain portion of their shares of common stock (the "Rollover Shares") will be converted intoSurviving Corporation shares. Pursuant to the Merger Agreement, at the Effective Time, each outstanding option to purchase shares of common stock, restricted stock unit and performance-based restricted stock unit, will remain outstanding and continue to be subject to the same terms and conditions as immediately prior to the Effective Time, as set forth in the applicable Company equity plan and award agreement, with certain exceptions. Pursuant to rules adopted by theSEC under the Securities Exchange Act of 1934, as amended (the "Exchange Act"), the Company will prepare and file with theSEC , and thereafter mail to its stockholders, a Schedule 14C Information Statement where you can find additional information about the Merger.
As part of the assessment of the Merger and the going private transaction, the Company incurred legal and financial advisory fees which are recorded as transaction related costs.
In addition, the Company recorded severance costs as restructuring charges as a result of labor force reductions associated with the going private transaction, the closure of thePompano Beach, Florida distribution center and other labor force reductions initiatives. OnJune 22, 2022 , the Company filed a Workers Adjustment and Retraining Notification ("WARN") alerting state officials of job cuts driven by closure of thePompano Beach, Florida distribution center. The closure is to be effectiveAugust 31, 2022 . ThePompano Beach distribution center operations will be handled through a new distribution center inLas Vegas, Nevada . Restructuring charges are recorded as corporate costs and not allocated to the reportable segments. See Note 14. Transaction Related Costs and Restructuring Charges, to the notes accompanying our financial statements, for cost details. COVID-19 Pandemic COVID-19 was declared a global pandemic by theWorld Health Organization onMarch 11, 2020 . Governments at the national, state, and local level in theU.S. , and globally, have implemented varying measures in an effort to contain the virus, including social distancing, travel restrictions, border closures, limitations on public gatherings of people, work from home and supply chain logistical changes. While some of these actions have eased, escalating transmission rates (including variants of COVID-19), uneven vaccination and vaccination booster rates and further governmental guidance and orders may result in having to reimplement certain of these measures or implementing new and additional ones. The spread of COVID-19 has also caused significant volatility inUnited States and international markets and has had and continues to have widespread, rapidly evolving and unpredictable impacts on global society, economies, financial markets and business practices. Our operations have been impacted by COVID-19 sinceMarch 2020 . During March andApril 2020 , we obtained approval from our clients for a work-at-home model, though not all required our approval, and transitioned most of our employees to the home environment so that they could work more safely. COVID-19 created a hardship for many of our employees. We worked during 2020 to care for our employees by periodically implementing temporary premium pay and temporary paid sick leave programs which provided additional financial resources for our employees, as well as partial pay for those employeeswho contracted the virus or had to care for a family memberwho was affected. We also had provided compensation to employeeswho worked with us for more than six months so that they can take time off to be vaccinated. In addition, we increased cleaning protocols throughout our facilities. Certain of these measures have resulted in increased costs. Due to significant volatility to the markets, as well as business and supply chain disruptions, we incurred several additional expenses due to the COVID-19 pandemic, including the following: •Higher Pricing from Vendors and Higher Shipping Costs: We experienced higher costs to procure certain products included in the formulary available to Medicare members. The price increases were due to supply chain disruptions and product shortages caused by the COVID-19 pandemic. We quantified the pricing increase by comparing the pre-pandemic prices for high demand products directly attributable to the COVID-19 pandemic (e.g., masks and other similar high demand products) to the prices to procure such products during the pandemic. Further, we incurred additional costs due to expedited shipping fees as a result of new inventory management practices put into place due to supply chain disruptions and delays caused by COVID-19 in order to fulfill product demand.
•Sick Pay, Premium Pay and
•Work-at-Home Training: In response to the COVID-19 pandemic, we held work-at-home remote training. To accomplish this transition, hourly new hire employees were required to receive training regarding at-home information
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technology ("IT") and telephony equipment setup. We paid the hourly new hire employees four hours for these efforts at their regular hourly wage rate and applicable fringe benefit rate. •IT Expenses: Additional temporary IT resources were retained, and overtime hours were incurred, for existing IT resources, in order to implement the remote working environment designed in response to the COVID-19 pandemic. •Janitorial Costs: Due to the onset of the COVID-19 pandemic, we implemented an enhanced sanitation policy. The enhanced sanitation policy included special deep cleaning sessions in areas contacted by employeeswho had tested positive for COVID-19 and enhanced sanitation sessions through our facilities compared to the sanitation methods used prior to the COVID-19 pandemic. See "Non-GAAP Financial Measures" for amounts related to the additional expenses due to the COVID-19 pandemic (Cost of COVID-19). While we had previously expected that these costs would not be an adjustment in the calculation of Adjusted EBITDA after 2021, the COVID-19 pandemic has not subsided and during 2022, to a lesser extent, we have continued to incur higher product costs due to higher pricing from vendors for certain items (e.g., masks and other similar high demand products). We now expect that these expenses will not be an adjustment in the calculation of Adjusted EBITDA after 2022. The full extent to which the COVID-19 pandemic and the various responses to the COVID-19 pandemic continues to impact our business, operations or financial condition will depend on numerous evolving factors that we may not be able to accurately predict, including, but not limited to, the duration, severity and scope of the COVID-19 pandemic (including due to new variants); actions by governmental entities, businesses and individuals that have been and continue to be taken in response to the pandemic; the effect on our clients and demand by clients, clients and our clients' members for and ability to pay for our solutions and services; and disruptions or restrictions on our employees' ability to work and travel. The impact of these factors and others on our suppliers and clients could persist for some time after governments ease their restrictions and after the overall number of COVID-19 cases inthe United States decreases. We may continue to experience higher than usual costs as a result of COVID-19 for the foreseeable future.
Non-GAAP Financial Measures
We present our financial results in accordance with GAAP. However, we use certain non-GAAP financial measures to supplement financial information presented on a GAAP basis. We believe that excluding certain items from our GAAP results allows management to better understand our consolidated financial performance from period to period and better project our future consolidated financial performance as forecasts are developed at a level of detail different from that used to prepare GAAP-based financial measures. Moreover, we believe these non-GAAP financial measures provide investors with useful information to help them evaluate our operating results by facilitating an enhanced understanding of our operating performance and enabling them to make more meaningful period to period comparisons. In particular, we use EBITDA and Adjusted EBITDA to assess our financial performance and also for internal planning and forecasting purposes. We believe EBITDA and Adjusted EBITDA provide investors with useful information because such metrics offer a consistent and comparable overview of our operations across historical financial periods. In evaluating EBITDA and Adjusted EBITDA, you should be aware that in the future we may incur expenses similar to those eliminated in the presentation. Non-GAAP measures should be considered as a supplement to, and not as a substitute for, or superior to, the corresponding measures calculated in accordance with GAAP. There are limitations to the use of the non-GAAP financial measures presented in this Form 10-Q. For example, our non-GAAP financial measures may not be comparable to similarly titled measures of other companies. Other companies, including companies in our industry, may calculate non-GAAP financial measures differently than we do, limiting the usefulness of those measures for comparative purposes. The non-GAAP financial measures we present are not meant to be considered as indicators of performance in isolation from or as a substitute for measures prepared in accordance with GAAP, and should be read only in conjunction with financial information presented on a GAAP basis. Reconciliations of each of EBITDA and Adjusted EBITDA to the most directly comparable GAAP financial measure, net income (loss), are presented below. We encourage you to review our financial information in its entirety, not to rely on any single financial measure and to view the reconciliations in conjunction with the presentation of the non-GAAP financial measures for each of the periods presented. In future periods, we may exclude such items, may incur income and expenses similar to these excluded items, and include other expenses, costs, and non-recurring items. The tables below provide reconciliations of EBITDA and Adjusted EBITDA to net income (loss) on a consolidated basis for the periods indicated. We define EBITDA as net income (loss) adjusted for interest, net, income tax expense (benefit), and depreciation and amortization expense. We define Adjusted EBITDA as EBITDA further adjusted for certain items of a significant or unusual nature, including but not limited to, change in fair value of contingent consideration, COVID-19 cost impacts, non-cash stock compensation expense, transaction related costs and restructuring charges, acquisition bonus expense, loss on extinguishment of debt, director and officer prior act liability insurance policy, inventory step-up and other costs. Other includes costs such as 39
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management fees, management service agreement termination fee, and fees associated with obtaining the incremental term loans.
In addition, we measure the performance of our individual segments using Segment Adjusted EBITDA. Segment Adjusted EBITDA is the financial measure by which management allocates resources and analyzes the performance of the reportable segments. The main difference between Segment Adjusted EBITDA and Adjusted EBITDA is that Segment Adjusted EBITDA includes add backs for sales and use tax and board of directors fees.
The following table presents a reconciliation of net income (loss) to EBITDA and Adjusted EBITDA for the periods presented:
For the Three Months
Ended June For the Six Months Ended June
30, 30, (in thousands) 2022 2021 2022 2021 Net income (loss)$ (9,890) $ (13,143) $ (11,044) $ (14,077) Interest, net 4,188 6,394 7,908 11,861 Income tax expense (benefit) (2,683) (5,166) (3,359) (6,173) Depreciation and amortization expense 9,012 7,823 17,264 15,194 EBITDA 627 (4,092) 10,769 6,805 Change in fair value of contingent consideration - 96 - 96 Cost of COVID-19(1) - 1,127 274 2,311 Non-cash stock compensation expense(2) 2,866 1,083 4,130 2,073 Transaction related costs and restructuring charges(3) 5,754 1,556 6,395 2,642 Acquisition bonus expense 88 96 147 289 Loss on extinguishment of debt(4) - 5,015 - 5,015 Director and officer prior act liability insurance policy(5) - 7,861 - 7,861 Inventory step-up(6) 2,838 - 4,731 - Other(7) 5 2,464 1,052 3,978 Adjusted EBITDA$ 12,178 $ 15,206 $ 27,498 $ 31,070 ________________________ (1)Due to significant volatility to the markets, as well as business and supply chain disruptions, we incurred several additional expenses due to the COVID-19 pandemic, including: (i) higher pricing from vendors due to supply chain disruptions, product shortages and increases in shipping costs, (ii) higher employee costs due to premium pay and hazard pay for our employees and enhanced sick pay due to illness and quarantine protocols, (iii) COVID-19 training costs, (iv) overtime costs for IT personnel to setup eligible employees to work from home and temporary resources and (v) janitorial costs due to enhanced COVID-19 protocols. The expenses are included in cost of services and cost of products on our statements of operations and comprehensive income (loss). See "COVID-19 Pandemic" above for additional information related to these expenses. While we had previously expected that these costs would not be an adjustment in the calculation of Adjusted EBITDA after 2021, the COVID-19 pandemic has not subsided and during 2022, to a lesser extent, we have continued to incur higher product costs due to higher pricing from vendors for certain items (e.g., masks and other similar high demand products). We now expect that these expenses will not be an adjustment in the calculation of Adjusted EBITDA after 2022. (2)Represents non-cash stock-based compensation expense in connection with the stock awards that have been granted to employees and non-employees. The expense is included in selling, general and administrative expenses on our statements of operations and comprehensive income (loss).
(3)Transaction related costs and restructuring charges primarily consist of public company readiness costs, expenses for corporate development such as mergers and acquisitions activity, due diligence costs, going private costs and restructuring charges such as severance costs.
(4)The loss on extinguishment of debt was recognized for prepayment of outstanding indebtedness.
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(5)In connection with the IPO, we made a$7.9 million one-time payment on a 3-year director and officer prior act liability insurance policy. We deemed this policy to be a retroactive insurance policy and in accordance with ASC 720-20-25, "Retrospective Contracts", we expensed the premium of$7.9 million inJune 2021 .
(6)Incremental cost of products associated with the step-up of inventory recognized in purchase accounting for the HealthSmart acquisition.
(7)Other includes other individual adjustments related to fees associated with obtaining the incremental term loans, management fees and management service agreement termination fee. All costs are included in selling, general and administrative expenses on our statements of operations and comprehensive income (loss).
Components of Results of Operations
Revenue
We generate revenue from contracts with our clients within our two operating segments: Technology Enabled Solutions and Advisory Services.
Through our Technology Enabled Solutions segment, we primarily provide technology solutions and services to assist our clients with workflows across product development, member experience, clinical management, core operations, business intelligence, and analytics. Through our Advisory Services segment, we provide fixed or variable fee arrangements to assist clients in the design and management of government and commercial health plans. Our revenue includes both product revenue and service arrangements. Products revenue consists of technology enabled solutions for supplemental benefits to members through their Medicare Advantage plans. These include supplemental benefit products, administration, fulfillment, and shipment of eligible product, as well as catalog development and distribution. Revenue is derived from supplemental benefit membership, supplemental benefit dollars, member utilization of the benefits and, as a result of the HealthSmart acquisition, health, wellness and diagnostic products sold through the retail channel.
Services revenue consists of:
•Technology-based Medicare plan administration services including eligibility and enrollment processing, member services, premium billing and payment processing, reconciliation and other related services. Our solutions are primarily priced on recurring per member per month fees, annual software license fees, and transaction-based fees. •Value based payment assurance solutions, including payment tools and data analytics, that improve revenue accuracy and gaps in quality, clinical care, and compliance. Our value-based solutions are primarily priced on an annual subscription fee, shared savings or fee-based engagement. Advisory (consulting) services that support health plan operations and drive business model evolution. Our Advisory services are priced on a fixed-fee or time and materials basis.
Operating Expenses
Costs of products consist of the value of supplemental benefit products, the value of health, wellness and diagnostic products, shipping and handling costs to acquire and to deliver the product to our clients; personnel costs including salaries, wages, overtime, benefits; facility costs and overhead allocation covering information technology, telecommunications costs, and other costs specifically identified to the shipment of our products. Costs of services consist of all costs directly attributable to service revenue generation activities as outlined in contracts with our clients. Our largest components in costs of services are personnel costs, including salaries, wages, overtime, benefits, and discretionary bonus; facility costs and overhead allocation covering information technology, telecommunications costs, and other costs needed in the delivery of our services. Selling, general and administrative expenses ("SG&A") include corporate management and governance functions comprised of general management, legal, accounting, financial reporting, human resource, sales, marketing, and other costs not directly associated with revenue generation activities, including those involved with developing new service offerings. SG&A includes salaries, bonuses, and related benefits. SG&A also includes all general operating expenses, including, but not limited to, rent and occupancy costs for non-revenue generating activities, telecommunications costs, information technology infrastructure, and operations costs, including software licensing costs, advertising and marketing expenses, insurance expenses, professional services and consulting expenses. 41
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Depreciation and amortization includes depreciation expense of property and equipment, including leasehold improvements, computer equipment, furniture and fixtures and software and amortization expense of capitalized internal-use software and software development costs, customer relationships, acquired software and certain trade names.
Transaction related costs and restructuring charges include professional services incurred in connection with public company readiness costs, expenses for corporate development such as mergers and acquisitions activity, due diligence costs, going private costs and restructuring charges such as severance costs. Other Income (Expense)
Other Income (expense) is primarily composed of:
•Interest income. Interest income consists of interest on cash and cash equivalents.
•Interest expense. Interest expense consists of accrued interest and related payments on our outstanding term loans and revolving loans, as well as the amortization of debt issuance costs associated with our debt. Interest expense also includes interest on our sales tax accrual.
Results of Operations
Comparison of the Three Months Ended
The following table sets forth our results of operations for the periods indicated: For the Three Months Ended June 30, Change (in thousands, except for percentages) 2022 2021 $ % Net revenues: Services$ 43,828 $ 42,284 $ 1,544 4 % Products 45,954 32,964 12,990 39 % Net revenues 89,782 75,248 14,534 19 % Operating expenses: Cost of services 22,397 20,785 1,612 8 % Cost of products 36,909 22,299 14,610 66 % Selling, general and administrative 24,095 29,589 (5,494) (19) % Depreciation and amortization 9,012 7,823 1,189 15 % Transaction related costs and restructuring charges 5,754 1,556 4,198 270 % Change in fair value of contingent consideration - 96 (96) - % Total operating expenses 98,167 82,148 16,019 20 % Operating income (8,385) (6,900) (1,485) 22 % Other income (expense): Loss on extinguishment of debt - (5,015) 5,015 - % Interest expense (4,188) (6,394) 2,206 (35) % Total other expense, net (4,188) (11,409) 7,221 (63) % Income (loss) before income taxes (12,573) (18,309) 5,736 (31) % Income tax (expense) benefit 2,683 5,166 (2,483) (48) % Net income (loss)$ (9,890) $ (13,143) $ 3,253 (25) % Net Revenues Services Revenue Services revenue was$43.8 million and$42.3 million for the three months endedJune 30, 2022 , andJune 30, 2021 , respectively. The$1.5 million increase is driven by$3.2 million attributable to customer membership base increase and$5.0 million by net new consulting projects. This is offset by a decrease of$6.7 million in discontinued contracts. 42
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Products Revenue
Products revenue was$46.0 million and$33.0 million for the three months endedJune 30, 2022 , andJune 30, 2021 , respectively. The increase of$13.0 million is driven by$15.1 million attributable to the acquisition of HealthSmart and$8.4 million in new and existing client growth memberships. This is offset by a decrease of$10.5 million in discontinued contracts.
Operating Expenses
Cost of Services
Cost of services was$22.4 million and$20.8 million for the three months endedJune 30, 2022 , andJune 30, 2021 , respectively. The increase of$1.6 million is primarily attributable to higher staffing levels to handle increased support to our existing clients, wage increases and incentives paid to agents to handle increased call volumes. Cost of Products Cost of products was$36.9 million and$22.3 million for the three months endedJune 30, 2022 , andJune 30, 2021 , respectively. The increase of$14.6 million is driven by$10.5 million attributable to product costs associated with HealthSmart,$2.8 million of purchase accounting inventory step-up for HealthSmart,$0.8 million due to higher volume, and$0.5 million due to higher rates and increased shipping costs.
Selling, General and Administrative
Selling, general and administrative was$24.1 million and$29.6 million for the three months endedJune 30, 2022 , andJune 30, 2021 , respectively. The decrease of$5.5 million is driven by$10.2 million of non-recurring going public costs incurred in 2021; offset by$1.6 million attributable to the acquisition of HealthSmart,$1.8 million higher stock compensation expense, and$1.3 million driven by higher IT, accounting, HR, and operational costs, offset by lower expected management incentive bonus.
Depreciation and Amortization
Depreciation and amortization was
Transaction Related Costs and Restructuring Charges
Transaction related costs and restructuring charges were$5.8 million and$1.6 million for the three months endedJune 30, 2022 , andJune 30, 2021 , respectively. The increase of$4.2 million is primarily due to the costs associated with the company restructuring and costs incurred for the assessment of the Merger and going private transaction, offset by costs associated with readiness of last year's IPO. Other Income (Expense) Interest Expense Interest expense was$4.2 million and$6.4 million for the three months endedJune 30, 2022 , andJune 30, 2021 , respectively. The decrease of$2.2 million is mainly attributable to lower outstanding balances due to the pay down of the term loan from IPO proceeds; offset by the incremental term loan entered into to finance the HealthSmart acquisition. Furthermore, lower interest rates for both the term loan and the incremental term loan were also a factor.
Segment Information
Our reportable segments have been determined in accordance with Accounting Standards Codification Topic 280, Segment Reporting. We have two reportable segments: Technology Enabled Solutions and Advisory Services. We evaluate the performance of each of our two operating segments based on segment revenue and Segment Adjusted EBITDA. Segment Adjusted EBITDA represents each segment's earnings before interest, tax, depreciation and amortization and is further adjusted to exclude certain items of a significant or unusual nature, including but not limited to, COVID-19 cost impacts, sales and use tax, non-cash stock compensation expense, transaction related costs and restructuring charges, acquisition bonus expense, inventory step-up, loss on extinguishment of debt, director and officer prior act liability insurance 43
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policy and other costs. Other includes costs such as management and board of directors fees, management service agreement termination fees, and fees associated with obtaining the incremental term loans.
See Note 17. Segment Information, to the notes accompanying our financial statements.
The segment measurements provided to and evaluated by the chief operating decision maker group are described in the notes to our financial statements. These results should be considered in addition to, and not as a substitute for, results reported in accordance with GAAP. For the Three Months Ended
June
30, Change (in thousands, except for percentages) 2022 2021 $ % Revenue Technology Enabled Solutions$ 75,619 $ 61,366 $ 14,253 23 % Advisory Services 14,163 13,882 281 2 % Total$ 89,782 $ 75,248 $ 14,534 19 % Segment Adjusted EBITDA Technology Enabled Solutions$ 8,668 $ 15,877 $ (7,209) (45) % Advisory Services 5,897 5,264 633 12 % Total$ 14,565 $ 21,141 $ (6,576) (31) % Segment Revenues Technology Enabled Solutions revenue was$75.6 million and$61.4 million for the three months endedJune 30, 2022 , and 2021, respectively. The increase of$14.3 million was mainly attributable to: (i) revenue from the acquisition of HealthSmart, and (ii) existing client growth of membership base accounts. Advisory revenue was$14.2 million and$13.9 million for the three months endedJune 30, 2022 and 2021, respectively. The increase of$0.3 million was primarily driven by new projects within our existing client base.
Segment Adjusted EBITDA
Technology Enabled Solutions Segment Adjusted EBITDA was$8.7 million and$15.9 million for the three months endedJune 30, 2022 , and 2021, respectively. The decrease of$7.2 million was primarily attributable to higher staffing levels to handle increased support to our existing clients, wage increases, higher product costs, and increased shipping costs due to continued supply chain constraints and inflationary pressures. The decrease is offset by the contribution from the HealthSmart acquisition and higher volume.
Advisory Segment Adjusted EBITDA was
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Comparison of the Six Months Ended
The following table sets forth our results of operations for the periods indicated: For the Six Months Ended June 30, 2022 Change (in thousands, except for percentages) 2022 2021 $ % Net revenues: Services$ 90,308 $ 85,811 $ 4,497 5 % Products 96,182 72,069 24,113 33 % Net revenues 186,490 157,880 28,610 18 % Operating expenses: Cost of services 47,873 44,806 3,067 7 % Cost of products 74,145 48,826 25,319 52 % Selling, general and administrative 47,308 49,690 (2,382) (5) % Depreciation and amortization 17,264 15,194 2,070 14 % Transaction related costs and restructuring charges 6,395 2,642 3,753 142 % Change in fair value of contingent consideration - 96 (96) - % Total operating expenses 192,985 161,254 31,731 20 % Operating income (6,495) (3,374) (3,121) 93 % Other income (expense): Loss on extinguishment of debt - (5,015) 5,015 - % Interest expense (7,908) (11,861) 3,953 (33) % Total other expense, net (7,908) (16,876) 8,968 (53) % Income (loss) before income taxes (14,403) (20,250) 5,847 (29) % Income tax (expense) benefit 3,359 6,173 (2,814) (46) % Net income (loss)$ (11,044) $ (14,077) $ 3,033 (22) % Net Revenues Services Revenue Services revenue was$90.3 million and$85.8 million for the six months endedJune 30, 2022 , andJune 30, 2021 , respectively. The$4.5 million increase is driven by$4.6 million attributable to customer membership base increase and$0.2 million by net new consulting projects. This is offset by a decrease of$0.3 million in discontinued contracts.
Products Revenue
Products revenue was$96.2 million and$72.1 million for the six months endedJune 30, 2022 , andJune 30, 2021 , respectively. The increase of$24.1 million is driven by$22.3 million attributable to the acquisition of HealthSmart and$1.8 million for net new clients and existing client growth of memberships.
Operating Expenses
Cost of Services
Cost of services was$47.9 million and$44.8 million for the six months endedJune 30, 2022 , andJune 30, 2021 , respectively. The increase of$3.1 million is primarily attributable to higher staffing levels to handle increased support to our existing clients, wage increases, and incentives paid to agents to handle increased call volumes. Cost of Products Cost of products was$74.1 million and$48.8 million for the six months endedJune 30, 2022 , andJune 30, 2021 , respectively. The increase of$25.3 million is driven by$15.6 million attributable to product costs associated with HealthSmart,$4.7 million of purchase accounting inventory step-up for HealthSmart,$2.0 million due to higher volume, and$3.0 million due to higher rates and shipping costs due to supply chain constraints. 45
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Selling, General and Administrative
Selling, general and administrative was$47.3 million and$49.7 million for the six months endedJune 30, 2022 , andJune 30, 2021 , respectively. The decrease of$2.4 million is driven by non-recurring IPO costs incurred in 2021; offset by$2.6 million attributable to the acquisition of HealthSmart and$2.1 million driven by higher IT, accounting, HR, and operational costs, offset by lower expected management incentive bonus.
Depreciation and Amortization
Depreciation and amortization was$17.3 million and$15.2 million for the six months endedJune 30, 2022 , andJune 30, 2021 , respectively. The increase of$2.1 million in depreciation and amortization expense is due to the acquisition of HealthSmart and capitalization of software development programs.
Transaction Related Costs and Restructuring Charges
Transaction related costs and restructuring charges were$6.4 million and$2.6 million for the six months endedJune 30, 2022 , andJune 30, 2021 , respectively. The increase of$3.8 million is primarily due to the costs associated with the company restructuring and costs incurred for the assessment of the Merger and going private transaction, offset by costs associated with readiness of last year's IPO. Other Income (Expense) Interest Expense Interest expense was$7.9 million and$11.9 million for the six months endedJune 30, 2022 , andJune 30, 2021 , respectively. The decrease of$4.0 million is mainly attributable to lower outstanding balances due to the pay down of the term loan from IPO proceeds; offset by the incremental term loan entered into to finance the HealthSmart acquisition. Furthermore, lower interest rates for both the term loan and the incremental term loan were also a factor.
Segment Information
Our reportable segments have been determined in accordance with Accounting Standards Codification Topic 280, Segment Reporting. We have two reportable segments: Technology Enabled Solutions and Advisory Services. We evaluate the performance of each of our two operating segments based on segment revenue and Segment Adjusted EBITDA. Segment Adjusted EBITDA represents each segment's earnings before interest, tax, depreciation and amortization and is further adjusted to exclude certain items of a significant or unusual nature, including but not limited to, COVID-19 cost impacts, sales and use tax, non-cash stock compensation expense, transaction related costs and restructuring charges, acquisition bonus expense, inventory step-up, loss on extinguishment of debt, director and officer prior act liability insurance policy and other costs. Other includes costs such as management and board of directors fees, management service agreement termination fees, and fees associated with obtaining the incremental term loans.
See Note 17. Segment Information, to the notes accompanying our financial statements.
The segment measurements provided to and evaluated by the chief operating decision maker group are described in the notes to our financial statements. These results should be considered in addition to, and not as a substitute for, results reported in accordance with GAAP. For the Six Months Ended
June
30, Change (in thousands, except for percentages) 2022 2021 $ % Revenue Technology Enabled Solutions$ 158,785 $ 130,949 $ 27,836 21 % Advisory Services 27,705 26,931 774 3 % Total$ 186,490 $ 157,880 $ 28,610 18 % Segment Adjusted EBITDA Technology Enabled Solutions$ 21,038 $ 32,253 $ (11,215) (35) % Advisory Services 11,221 8,602 2,619 30 % Total$ 32,259 $ 40,855 $ (8,596) (21) % 46
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Segment Revenues
Technology Enabled Solutions revenue was$158.8 million and$130.9 million for the six months endedJune 30, 2022 , and 2021, respectively. The increase of$27.8 million was mainly attributable to: (i) revenue from the acquisition of HealthSmart, and (ii) existing client growth of membership base accounts. Advisory revenue was$27.7 million and$26.9 million for the six months endedJune 30, 2022 and 2021, respectively. The increase of$0.8 million was primarily driven by new projects within our existing client base.
Segment Adjusted EBITDA
Technology Enabled Solutions Segment Adjusted EBITDA was$21.0 million and$32.3 million for the six months endedJune 30, 2022 , and 2021, respectively. The decrease of$11.2 million was attributable to higher staffing levels to handle increased support to our existing clients, wage increases, higher product costs, and increased shipping costs due to continued supply chain constraints and inflationary pressures. The decrease is offset by the contribution from the HealthSmart acquisition and higher volume.
Advisory Segment Adjusted EBITDA was
Liquidity and Capital Resources
Overview
Our primary sources of liquidity are our existing cash and cash equivalents, cash provided by operating activities and borrowings available under our Credit Agreement. As ofJune 30, 2022 , we had unrestricted cash and cash equivalents of$19.7 million , and as ofJune 30, 2022 , our total indebtedness was$270.4 million . We are a holding company that transacts substantially all of our business through our operating subsidiaries. Consequently, our ability to pay dividends to stockholders, meet debt payment obligations, and pay taxes and operating expenses is largely dependent on dividends or other distributions from our subsidiaries, whose ability to pay such distributions to us is restricted, subject to certain exceptions, pursuant to the terms of the Credit Agreement. Covenants contained in the Credit Agreement may restrict our operating subsidiaries from issuing dividends and other distributions to us. Our principal liquidity needs have been, and we expect them to continue to be, working capital and general corporate needs, debt service, capital expenditures and potential acquisitions. Our capital expenditures for property and equipment to support growth in the business were$3.3 million and$4.2 million for the six months endedJune 30, 2022 , and 2021, respectively. Additional expenditures for software development were$2.3 million and$2.8 million for the six months endedJune 30, 2022 , and 2021, respectively. We believe that our primary sources of liquidity, including our cash and cash equivalents, cash provided by operating activities and borrowing capacity under our Credit Agreement, will be sufficient to meet our liquidity needs for at least the next 12 months. We anticipate that to the extent that we require additional liquidity, it will be funded through the incurrence of additional indebtedness, the issuance of additional equity, or a combination thereof. We cannot assure you that we will be able to obtain this additional liquidity on reasonable terms, or at all. Additionally, our liquidity and our ability to meet our obligations and fund our capital requirements are also dependent on our future financial performance, which is subject to general economic, financial, and other factors that are beyond our control.
Cash Flows Information
The following table presents a summary of cash flows for the periods presented: Six Months Six Months Ended June 30, Ended June 30, (in thousands) 2022 2021 Net cash used in operating activities$ (13,772) $ (21,073) Net cash used in investing activities$ (80,224) $ (6,251) Net cash provided by financing activities $
74,971
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Operating Activities
Net cash used in operating activities for the six months ended
Net loss was$11.0 million for the six months endedJune 30, 2022 , as compared to$14.1 million net loss for the six months endedJune 30, 2021 . The net loss for the six months endedJune 30, 2022 is attributable to: (i) costs incurred for the HealthSmart acquisition including a$4.7 million purchase accounting inventory step-up and$0.7 million of additional transaction related costs, (ii) going private costs of$4.1 million consisting of legal and financial advisory costs, (iii) restructuring charges of$1.1 million consisting of severance costs, and (iv) higher labor costs and higher freight costs driven by supply chain constraints. Non-cash items were$26.3 million for the six months endedJune 30, 2022 , as compared to$17.4 million for the six months endedJune 30, 2021 . The effect of changes in operating assets and liabilities was a cash decrease of$29.1 million for the six months endedJune 30, 2022 , as compared to a cash decrease of$24.4 million for the six months endedJune 30, 2021 . The most significant drivers contributing to this net decrease of$4.7 million relate to the following:
•An increase in accounts receivable when compared to the prior period; and
•Higher cash used on inventory purchases when compared to the prior period.
Investing Activities
Net cash used in investing activities for the six months endedJune 30, 2022 , was$80.2 million compared to$6.3 million for the six months endedJune 30, 2021 . During the six months endedJune 30, 2022 , net cash used in investing activities was primarily attributable to the HealthSmart acquisition.
Financing Activities
Net cash provided by financing activities for the six months ended
Contractual Obligations and Commitments
The following table summarizes our contractual obligations as ofJune 30, 2022 . The principal commitments consisted of obligations under outstanding operating leases for office facilities, finance leases related to copy machines, our long-term debt, and purchase commitments. The amount of the obligations presented in the following table summarizes as ofJune 30, 2022 , the commitments to settle contractual obligations in cash for the periods presented. Payments Due by Period Less than 1 More than (in thousands) Total year 1-3 Years 4-5 Years 5 years Operating leases for facilities 27,876 3,324 17,345 4,467 2,740 Finance leases 910 315 595 - - Long-term debt obligations(1) 270,436 390 2,340 267,706 - Purchase commitments 14,058 14,058 - - -
Total contractual obligations
________________________
(1)Includes the term loan under our Credit Agreement.
Off-Balance Sheet Arrangements
During the periods presented, we did not have any off-balance sheet
arrangements, as defined in Regulation S-K promulgated by the
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Critical Accounting Policies and Use of Estimates
The discussion and analysis of our financial condition and results of operations is based upon our consolidated financial statements, which have been prepared in accordance with GAAP. The preparation of our financial statements requires us to make judgments, estimates, and assumptions that affect the reported amounts of assets, liabilities, income, and expenses and related disclosures of contingent assets and liabilities. We base these estimates on our historical experience and various other assumptions that we believe to be reasonable under the circumstances. Actual results experienced may vary materially and adversely from our estimates. Revisions to estimates are recognized prospectively. During the six months endedJune 30, 2022 , there were no material changes to our critical accounting policies and use of estimates from those described under the heading "Management's Discussion and Analysis of Financial Condition and Results of Operations-Critical Accounting Policies and Use of Estimates" included in our Form 10-K for the year endedDecember 31, 2021 . The following discussion supplements our Critical Accounting Policies and Use of Estimates Policy forGoodwill as it relates to the interim goodwill impairment test performed as ofMarch 31, 2022 . As a result of the decline in our stock price for the three months endedMarch 31, 2022 , we performed an interim impairment test for goodwill for APA, SBA, VBPA and Advisory reporting units using the quantitative approach as ofMarch 31, 2022 . Since HealthSmart was recently acquired, no impairment test was performed on that reporting unit. Based on our evaluation performed, we determined the fair value of each of the reporting units exceeded its respective carrying amount, and therefore, we determined that goodwill was not impaired at any of our reporting units as ofMarch 31, 2022 . Our stock price increased during the three months endedJune 30, 2022 , and it was not considered an indicator of impairment as ofJune 30, 2022 . Evaluation of goodwill for impairment requires judgment, including the identification of reporting units, assignment of assets, liabilities and goodwill to reporting units and determination of the fair value of each reporting unit. We estimate the fair value of our reporting units using a combination of an income approach, utilizing a discounted cash flow analysis, and a market approach, using market multiples. Under the income approach, we estimate projected future cash flows, the timing of such cash flows and long-term growth rates, and determine the appropriate discount rate that reflects the risk inherent in the projected future cash flows. The discount rate used is based on a market participant weighted-average cost of capital and may be adjusted for the relevant risk associated with business-specific characteristics and the uncertainty related to the reporting unit's ability to execute on the projected future cash flows. Under the market approach, we estimate fair value based on market multiples of revenues and earnings derived from comparable publicly-traded companies with characteristics similar to the reporting unit. The estimates used to calculate the fair value of a reporting unit change from year to year based on operating results, market conditions and other factors. The assumptions and estimates used in determining the fair values of the reporting units contain uncertainties, and any changes to these assumptions and estimates could have a negative impact and result in a future impairment.
Recent Accounting Pronouncements
See Note 2 to our unaudited interim condensed consolidated financial statements included elsewhere in this Quarterly Report on Form 10-Q for more information.
Emerging Growth Company Status
Pursuant to the JOBS Act, an emerging growth company is provided the option to adopt new or revised accounting standards that may be issued by FASB or theSEC either (i) within the same periods as those otherwise applicable to non-emerging growth companies or (ii) within the same time periods as private companies. We intend to take advantage of the exemption for complying with new or revised accounting standards within the same time periods as private companies. Accordingly, the information contained herein may be different than the information you receive from other public companies. We also intend to take advantage of some of the reduced regulatory and reporting requirements of emerging growth companies pursuant to the JOBS Act so long as we qualify as an emerging growth company, including, but not limited to, not being required to comply with the auditor attestation requirements of Section 404(b) of the Sarbanes-Oxley Act, reduced disclosure obligations regarding executive compensation and exemptions from the requirements of holding non-binding advisory votes on executive compensation and golden parachute payments.
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