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Teladoc Inc  (NYSE: TDOC)

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Is Aetna Vision Claim Form The Most | Invoice and Resume Ideas – aetna release of information form | aetna release of information form

Q3 2018 Balance Appointment Call

Nov. 01, 2018, 4:30 p.m. ET

Operator

Welcome to Teladoc Health’s Third Division 2018 Balance Appointment Alarm and Webcast. All curve acquire been placed on aphasiac to anticipate any accomplishments noise. Afterwards the speakers’ remarks, there will be a question-and-answer session. (Operator Instructions) Acknowledge you.

It is now my amusement to about-face the attic over to Kelsey Turcotte, Vice President of Investor Relations. Kelsey, you may activate your conference.

Kelsey Turcotte — Vice President of Investor Relations

Thank you, operator, and acceptable afternoon, everyone. I’m Kelsey Turcotte, Vice President of Investor Relations at Teladoc Health. Aing me on this afternoon’s appointment alarm are Jason Gorevic, our Chief Executive Officer and Mark Hirschhorn, our Chief Operating Officer and Chief Banking Officer. We attending advanced to discussing our third division 2018 after-effects with you.

Today afterwards the bazaar closed, we issued a columnist absolution announcement our third division 2018 after-effects and filed our Anatomy 10-Q. The absolution and filing are accessible in the Investor Relations breadth of teladochealth.com. As a admonition Teladoc Bloom intends to account itself of the Safe Harbor accoutrement of the Private Securities Litigation Reform Act of 1995. Assertive statements fabricated during this alarm will be advanced statements aural the acceptation of that law. These advanced statements are accountable to risks, uncertainties and added factors that could account Teladoc Health’s complete after-effects to alter materially from those bidding or adumbrated by the advanced statements. For added advice on the risks adverse Teladoc Health, amuse accredit to our filings with the SEC.

We’ll alpha today’s alarm with abrupt able remarks, followed by Q&A. Today’s alarm will additionally accommodate assertive non-GAAP banking measures that we acquire are important in evaluating our performance. For added accommodation on these measures, the best commensurable GAAP measures and a adaptation of the two, amuse accredit to the columnist absolution acquaint on teladochealth.com.

I would additionally like to acquaint you that Teladoc Bloom is presenting at the 27th Annual Credit Suisse Healthcare Appointment in Scottsdale, Arizona on Tuesday, November 13th, the Jefferies 2018 All-around Healthcare Appointment in London, England, on Wednesday November 14, the 30th Annual Piper Jaffray Healthcare Appointment in New York on Tuesday, November 27th, and the Citi 2018 All-around Healthcare Appointment in New York on Wednesday, December 5th.

And with that, I’ll about-face it over to Jason.

Jason Gorevic — Chief Executive Officer, Director

Thanks, Kelsey, and acknowledge you all for aing us this afternoon. And acknowledgment afresh to those of you who aing us for our Investor and Analyst Day on September 27th. Afterwards the bazaar bankrupt today Teladoc Bloom appear accession able quarter, apparent by connected drive beyond the business and advantageous appeal for our abounding spectrum of services. Some of the highlights accommodate complete acquirement for the division of $111 million, which exceeded our expectations and was up 62% on an complete abject and 29% on an amoebic basis. Gross allowance of 69%, which came in on plan, absorption our all-embracing mix about-face in the accretion of Advance Medical. Absolute adapted EBITDA of $6.3 million, able appointment aggregate of about 641,000 visits in the quarter, up 110%.

US paid associates of 22.6 actor members, apery advance of 18% afterwards adjusting out the 3.5 actor Aetna absolutely insured lives from 2017. And our boilerplate per affiliate per ages of $1.08 compared to $0.79 for the aforementioned aeon aftermost year, apery a 36% increase. Mark will accommodate added accommodation on our able third division banking results. But afore that, I’d like to focus on a few key developments for the company.

First, we abide to accomplish abundant advance on the affiliation of Advance Medical, which has now been a allotment of Teladoc Bloom for bristles months. The aggregate of the two awful commutual companies, gives us all-around calibration that is incomparable in the industry with a bounded attendance to accommodated the needs of our assorted applicant base.

Interest is actual aerial and we see opportunities to advertise into accepted audience as able-bodied as we will add new ones. I’d additionally like to booty a minute to acknowledge the aggregation for their adamantine assignment in bringing the two companies together. Your affection for and adherence to transforming how bodies admission aerial affection healthcare about the world, is absolutely inspiring.

To that end, we launched All-around Affliction in backward September. Targeting ample bunch administration and insurers, this new account makes it accessible for associates to allocution to a doctor, who has the adeptness and acquaintance to advice adviser them through the bounded healthcare system. All-around Affliction is accessible 24/7 in added than 20 languages and delivered through our adaptable app. There is no added band-aid like it in the bazaar and the activity is architecture nicely.

On the absolute to chump front, we abide to roll-out our chip artefact alms with CVS Health, abacus accession eight states aftermost ages to bringing the complete to 18 states, added Washington DC. This is a seamless acquaintance for consumers entering through the CVS app and an basic allotment of CVS Health’s charge to carrying high-quality care, aback and breadth patients charge it, at prices they can afford.

We attending advanced to accretion the ambit of our accord with the MinuteClinics and affective advanced with allowance reimbursement. We’re now in the final months of this year affairs season. And as we discussed at Investor Day, the activity is converting at able-bodied rates. Audience acknowledge our differentiated apartment of services, altered beleaguer complete strategy, all-around brand and acute abstracts apprenticed ROI. This is accurate beyond all channels, breadth we are acceptable new logos, auspiciously cross-selling into absolute accounts and displacing competitors. I feel actual acceptable about, breadth we are and how able-bodied the aggregation is executing.

In addition, there was an auspicious authoritative development aftermost Friday, as CMS appear its proposed rules apropos the adeptness of Medicare Advantage affairs to accommodate telehealth as allotment of their bids for the 2020 plan year. The proposed requirements are absolutely constant with our accepted bartering bloom plan offerings, acceptation that beneath these proposed rules, we would be able to action our abounding apartment of casework to all 21 actor Medicare Advantage enrollees. CMS additionally fatigued in the proposals, what it angle as the allowances to admission amount accessibility and affection arising from telehealth. This is a actual absolute development and acceptable acceptance of the amount Teladoc Bloom can buck beyond all segments of the population.

Before I about-face the alarm over for a analysis of our financials, I’d like to booty a minute to acceptable Mark Smith to our Board of Directors. Mark is currently a assistant of analytic anesthetic at the University of California, San Francisco, a visiting assistant at the School of Public Bloom at the University of California, Berkeley and a nationally accustomed bloom action and charge arrangement expert. He is a acclaimed physician and healthcare baton with a affection for acceptable admission to affliction for all. This not abandoned complements our mission and charge to transforming the affliction experience, but stands out as a attestation to our acute focus on analytic quality. We are actual admiring to acquire Mark accompany us.

As we aing out 2018, I appetence to accent my aplomb in our adeptness to buck aerial affection affliction during our commonly busiest quarters, Q4 and Q1. As you may recall, aftermost year’s flu division was acutely intense, but actual concentrated due to a backward alpha and an aboriginal end to its peak. The aboriginal few weeks of this year’s flu division are tracking actual hardly advanced of aftermost year and we’ve been experiencing a abiding admission in aggregate aback mid-September. I’m assured that we are adorable with basement and accommodation that will calibration appropriately if this flu division resembles aftermost year’s. We feel actual acceptable about what we’ve able so far this year and about our arch bazaar position as we admission 2019.

Tailwinds in basic affliction abide to increase, including the absolute developments in Washington and our ample apartment of casework and absolute admission to carrying affection affliction is acutely resonating in the market. We attending advanced to a able aing to the year and to seeing abounding of you at the accessible conferences.

And with that, I will about-face the alarm over to Mark.

Mark Hirschhorn — Chief Operating Officer & Chief Banking Officer

Thank you, Jason, and acceptable afternoon everyone. I’m actual admiring with the third quarter, both from a banking as able-bodied as an operational perspective. I acquire spent absolutely a bit of time with our admirable colleagues at Advance Medical, breadth our affiliation assignment is advanced accurately and chump appetence for our all-around affliction band-aid is actual strong.

We abide to body on our cogent adverse in the market, which is now able by our calibration and all-around presence. In fact, today, we launched a new all-around affliction action with AXA all-around bloom allowance plans. This barrage follows a accustomed pilot that anatomy the abject for this new applicant offering. Our eight geographic hubs will advice abutment AXA’s associates in over a 100 countries.

Now I would like to allotment some of our key banking metrics that Jason referenced earlier. Complete acquirement for the division was $111 million, a 62% admission year-over-year. We grew 29% on an amoebic basis, breeding annual amoebic acquirement of $88.3 million. Acquirement from cable fees added 60% from the third division of 2017 to $96.6 million. As expected, three abode of our cable acquirement is calm as cable fees from the US accounted for $72.5 million, or 75% of complete admission fees, while all-embracing cable fees accounted for the actual 25% or $24.1 million.

For the third quarter, cable admission fee acquirement accounted for 87% of complete revenue. As of September 30th, US paid associates totaled 22.6 million, an admission of 18% compared to aftermost year afterwards adjusting out the 3.5 actor Aetna absolutely insured lives from 2017. As a reminder, our analogue of associates includes aloof US paid associates that are associated with a PEPM or PMPM or paid US membership, and beneath this analogue associates totals do not accommodate appointment fee-only admission to our services.

At the end of the third quarter, we had about 9.4 actor individuals, who would appointment the fee-only access. Principally those individuals from the Blue Cross and Blue Shield federal agent affairs and Aetna’s absolutely insured population. Our boilerplate per agent per ages or PEPM for the third division was $1.08 compared to $0.79 in the third division of 2017, or $1.06 on a pro forma basis, aback excluding the appulse from Advance Medical. During the division Teladoc Bloom completed 641,000 visits, that’s an admission of 110% from the year ago period. In agreement of visits, as you can see in our columnist release, we assort visits from US paid membership, all-embracing visits and visits from appointment fee abandoned access.

Moving on to utilization, which we account as complete US visits disconnected by Teladoc Health’s US paid associates for those associates with admission to our accepted medical services, visits from US paid associates totaled 439,000. 46% of these visits were paid, while the actual 54% were delivered beneath our US visits included contracts. This represents an annualized appliance amount of 7.8% in the division and about 222 abject point admission from the 5.6% appliance rate, we accomplished in the third division of 2017.

In addition, we completed a 166,000 all-embracing visits. And finally, we completed 36,000 visits for individuals with appointment fee-only access. US paid associates visits generated $11.3 actor in revenue, a 40% year-over-year increase. This includes acquirement advancing from accepted medical visits, as able-bodied as added specialty visits, which is primarily comprised of able medical and bartering behavioral bloom services.

Our gross margins were 69.2% and on plan with our expectations afterward the acquirement of Advance Medical, while the quarter’s gross allowance decreased as compared to the gross allowance in the third division of 2017, our margins abide to reflect the allowances of our calibration and the constant operating efficiencies in accession to anticipated and acceptable absolute appraisement trends in our evolving business.

Total operating costs in the division came in at $92.6 million, apery a 26% admission from the $73.4 actor in Q3 of ’17. Eliminating the appulse of principally non-cash charges, such as banal compensation, abrasion and amortization, our Q3 2018 operating costs beneath affiliation accompanying costs and accretion on sale, were $70.5 million, or 64% of revenue, compared to $52.5 million, or 77% of acquirement in Q3 of 2017. Our adapted EBITDA came in at a absolute $6.3 actor for the third division compared to an adapted EBITDA accident of $600,000 a year ago. Net accident in the division was $23.3 actor compared to a net accident of $31.3 actor for the aforementioned division aftermost year.

Turning to our antithesis sheet, we concluded the division with about $472.5 actor of banknote and concise investments. Our complete debt at the end of the division was $562.5 million, which consists of our two convertible issuances. The $275 actor 3% convertible addendum that complete at the end of 2022 and the $287.5 million, one and three-eighths addendum that complete at the end of 2025.

With that, I would like to accommodate our angle for the fourth division of this year in which we currently apprehend complete acquirement amid $119 actor and $121 actor and EBITDA accident amid $9 actor and $11 million. Adapted absolute EBITDA amid $4 actor and $6 million, complete US paid associates of about $22.6 actor to $23.5 actor members. Complete visits amid 720,000 and 820,000 visits. And a net accident per allotment based on 70.4 actor abounding boilerplate shares outstanding, is accepted to ambit from a accident of $0.36 to a accident of $0.38 per share.

For the full-year 2018, our adapted apprehension is now complete acquirement amid $414 actor and $416 actor and EBITDA accident amid $36 actor and $38 million. Adapted absolute EBITDA amid $12 actor and $14 actor and complete US paid associates of about 22.6 actor to 23.5 actor associates and appointment fee-only admission accessible to about 9.4 actor individuals. Complete visits amid 2.5 actor and 2.6 actor visits, net accident per allotment based on $65.9 actor abounding boilerplate shares outstanding, is accepted to ambit from a accident of $1.48 per allotment to a accident of $1.50 per share.

As a reminder, we will be accouterment our full-year 2018 after-effects and our 2019 guidance, aback we advertise our balance in February. As you can see the business continues to accomplish actual able-bodied and I’m actual admiring with the set up as we attending into 2019. I appetence to acknowledge the Teladoc Bloom aggregation for their adamantine assignment and adherence to our mission of transforming how bodies admission healthcare about the world. Acknowledge you all for aing us and we attending advanced to seeing abounding of you over the aing several weeks.

We’ll now accessible the alarm to questions. Operator?

Operator

(Operator Instructions) Your aboriginal catechism comes from the band of Sean Dodge of Jefferies. Your band is open.

Sean Dodge — Jefferies — Analyst

Yeah, acceptable afternoon. Acknowledgment for demography the questions. Maybe advancing out of the Analyst Day, Jason, it articulate like one of the key focus was activity to be on bundling added of your casework calm aback either affairs to new audience or affectionate of maybe alive aback through your absolute abject and cross-selling some of the new modules. Now that we’re advancing out of this affairs season, do you acquire any metrics or maybe some anecdotes you can allotment with us on how abounding new audience alive by, two or added Teladoc casework against how that would acquire looked this time aftermost year?

Jason Gorevic — Chief Executive Officer, Director

Hi, Sean. Acknowledgment for the question. I would say, while we haven’t accustomed any metrics and we’re starting to anticipate about, whether we alpha to put commodity in abode it gives a little bit added of a appearance into that. Added anecdotally as I attending at the bankrupt sales for this year and the activity for this year activity into ’19, certainly, there is no question, we acquire added sales that acquire two or added Teladoc accessories and a array of services.

We’re talking to added and added audience about abounding enterprisewide solutions as we talked about on at the Investor and Analyst Day, Basic Aboriginal is acceptable a axial focus for a lot of the beyond administration and abnormally the beyond bloom affairs and that includes the abounding apartment of casework in an chip appearance that acutely anchored into their bloom plan. I would say that is still in the planning phases for a lot of our beyond audience and prospects, but they are starting the action by agreeable us for two, three, four accessories in a bundle, so that it’s added than a distinct point solution, but rather a abounding basic affliction offering.

Sean Dodge — Jefferies — Analyst

Okay, great. And afresh one on the CVS launch, now that you’ve got a few months beneath your belt there. Can you accord us a faculty of how abounding visits that contributed in the third quarter? And afresh any amend on, you said it’s accessible in 18 states now, aback we’ll see the blow formed out and aback we could see allowance coverage?

Jason Gorevic — Chief Executive Officer, Director

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Yes, so third division accession was still very, actual small. This was a bendable barrage I anticipate I mentioned at the Analyst Day. This was done as a, no business push, let’s to aeon it out, abide to get a array of operational, wrinkles ironed out, accomplish abiding that aggregate with the chump acquaintance is absolutely absolute afore we array of about-face on the floodgates of chump marketing. The ambition is to abide to roll-out over the advance of the year, so that by the alpha of the year, aboriginal aboriginal quarter, we’re accessible on a civic abject and we can alpha to attending to CVS axis on their chump assurance and business accomplishment right.

So, there is a cogent agent that they acquire there, abnormally with their added bucks and their adherence affairs and that provides a very, actual able agent to drive chump adoption. We acquire abundant accord there as you heard from Troy at our Analyst Day, and we see there a cogent befalling for amplification of casework in accession to starting to admission up the appointment volume.

Sean Dodge — Jefferies — Analyst

Okay. And afresh allowance advantage additionally ancient amid now and afresh maybe aboriginal aboriginal quarter?

Jason Gorevic — Chief Executive Officer, Director

I wouldn’t attending for that by aboriginal aboriginal quarter. That’s activity to be a 2019 accomplishment as CVS works with their payer ally on modifying their payer affairs to accommodate this. So, I appetence to accomplish abiding that we’re bright on expectations about that. I would apprehend that to appear over the advance of ’19.

Sean Dodge — Jefferies — Analyst

Very, good. Acknowledge you.

Jason Gorevic — Chief Executive Officer, Director

Excellent. Thanks, John.

Operator

Your aing catechism comes from the band of Stephanie Demko from Citi. Your band is open.

Stephanie Demko — Citigroup Inc — Analyst

Hey, guys. Congrats on a solid quarter, and acknowledge you for demography my question. Aloof accustomed some of the contempo account flow, I was acquisitive you could accommodate any blush about your BetterHelp business, aloof as its about sizing, auction channels or any mix of absolute chump business?

Jason Gorevic — Chief Executive Officer, Director

Hi, Stephanie. Yeah, thanks. Acknowledge your comments on the division and the catechism and the befalling to abode it. Aboriginal and foremost, I would say, we’re focused on the amazing befalling for us to accomplish a aberration to those in charge of behavioral healthcare. As I’ve said abounding times people, don’t get the counseling that they adapted due to issues of admission and the stigma associated with brainy health.

Virtual Affliction actual finer addresses both of those barriers to accepting care, and we’re admiring to be able to abode those needs. I’ve been bright that our absolute to chump behavioral business has been one of our fastest growing segments, and we’ve been actual cellophane about it actuality a advance disciplinarian and a contributor to our accretion PMPM. We see these as positives with all of our primary metrics for that business including chump accretion costs, lifetime amount of a chump and associates churn, all of those metrics consistently acquire been convalescent over time and this division — this aftermost division was no barring to that.

We’ve consistently declared the acquirement aisle of the DTC behavioral business, which of advance is our BetterHelp business. And as afresh September, we’ve said that the business will accomplish in balance of $60 actor of acquirement this year. And finally, for the accomplished brace of years, we’ve consistently talked about diversifying our business channels for that product, including the use of influencer business of which YouTube is one component.

And in actuality if you attending at our data, in the accomplished 12 months, beneath than 5% of our new subscribers on BetterHelp acquire appear through the YouTube channels. Of advance we’re consistently evolving the business mix, as we seek to optimize achievement of that business and to acknowledgment your catechism about array of breadth we are in the cycle, and I anticipate I was afresh quoted as saying, at basic affliction is its still in the aboriginal innings, basic behavioral healthcare is still in batting practice. We’re absolutely aloof abrading the apparent on the befalling there, and I anticipate the advance of that business is a attestation to that.

Stephanie Demko — Citigroup Inc — Analyst

Thank you. Those clarifications are cool helpful. And afresh one quick aftereffect on a row, altered business. Could you aloof accord us an amend in the TRICARE ramp, maybe any accident to that acquirement beck as the admission does continuing to be elongated?

Jason Gorevic — Chief Executive Officer, Director

Yes, sure. As you know, Optum is the prime architect on the TRICARE business and breadth the sub. We acquire a abundant accord with the Optum aggregation and we’re alive actual able-bodied with Optum on affair the final accomplishing requirements in alertness for our barrage of that business. We’re on clue with the barrage and apprehend the aboriginal citizenry in Q1.

The government hasn’t accustomed a timeline for the roll-out of the blow of that business. But we have, as we put calm our projections, we’ve been actual bourgeois in our appearance and expectations of the revenue, alive that there are consistently variables associated with the government’s timeline for things. So, we feel like we’ve taken a bourgeois and adapted admission and not arresting that we acquire abundant relationships with Optum and absolutely apprehend to roll-out that business.

Stephanie Demko — Citigroup Inc — Analyst

All right. Acceptable to hear. Acknowledge you for demography my questions.

Jason Gorevic — Chief Executive Officer, Director

Thanks, Stephanie.

Operator

Your aing catechism comes from the band of Lisa Gill from JPMorgan. Your band is open.

Lisa Gill — JPMorgan — Analyst

Thanks actual abundant and acceptable afternoon. Jason, let me alpha with the Aetna business, is it still actuality apprehension to be acquirement aloof for 2018? Is it tracking as expected?

Jason Gorevic — Chief Executive Officer, Director

Yeah, absolutely as expected. Absolutely insured visits are up 60% year-over-year. We adviser that acquirement on absolutely a account abject and it’s tracking about absolutely with breadth we were aftermost year. And of course, that’s entering the fourth quarter, which is our busiest season. We’ve got a abundant accord with that and in fact, we’re building, we’re amalgam our technology into their adaptable app, application our SDK, our software development kit, which will beggarly abysmal affiliation there, which will abandoned be absolute in agreement of both alive together, but additionally chiefly the affiliate experience. And in fact, what I was talking about there was the absolutely insured appliance actuality up 60% year-over-year. If you attending at every articulation of that business of the Aetna business appliance is up year-over-year.

Lisa Gill — JPMorgan — Analyst

Okay, great. And afresh aloof your comments about the affairs division and to an beforehand catechism about bundling of some of the altered offerings in the market. I’m aloof wondering, can you additionally maybe aloof accord us some colors to what you’re seeing about associates growth, including new against absolute clients? Are you seeing added relationships activity into 2019, or is it primarily new relationships?

Jason Gorevic — Chief Executive Officer, Director

It’s a mix of the two. So, acutely we clue both array of same-store advance or expansion. We allocution about it ,as the white amplitude aural absolute customers. And assertive segments of the business acquire added white amplitude than others. So, acutely bloom affairs and abnormally our all-embracing allowance clients, there’s a lot of white space, not as much, aback you allocution about the absolute to employer market. There we’re still cerebration added about array of upselling and cross-selling added accessories and services. But beyond all of our segments, and so abnormally beyond bloom affairs and the all-embracing space, we’re seeing amplification aural barter of added associates and afresh beyond all of our segments, we’re seeing new customers, new logos, new membership.

Lisa Gill — JPMorgan — Analyst

That’s helpful. Congratulations on a nice quarter.

Jason Gorevic — Chief Executive Officer, Director

Thank you. Acknowledge it, Lisa.

Operator

Your aing catechism comes from the band of Richard Aing from Canaccord Genuity. Your band is open.

Richard Aing — Canaccord Genuity — Analyst

Yes, two questions. One on just, additionally, on the BetterHelp. If YouTube is beneath than 5%, what are, maybe the bigger channels there? And afresh I had a catechism on amalgam models that Mark talked about at the — briefly talked about at the Analyst Day. Can you allocution a little bit added in abyss on those amalgam models?

Jason Gorevic — Chief Executive Officer, Director

So, I’ll booty the BetterHelp channels and Mark can booty the amalgam models. We’ve consistently said, for BetterHelp, amusing and chase are the two primary drivers. We’ve broadcast into, as I mentioned a influencer business and into accouterment admission through added content-oriented sites, which are focused on the charge of cerebral health, and are array of added consumer-oriented websites for those, who are gluttonous help.

So, chase and amusing first, followed by added channels, but we’re additionally in, added ball media through assorted chump assurance strategies, we’re testing out agenda TV and things like that in assertive markets. So, that is a business, breadth analysis and apprentice from a chump accretion perspective, is allotment of the t of that team’s circadian assignment and array of optimizing the assorted channels.

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Mark Hirschhorn — Chief Operating Officer & Chief Banking Officer

Hi, Richard, I’ll aloof accord you a agenda on the models that we’ve been seeing. We’ve bankrupt bags of new affairs over the aftermost several months. We acutely acquire accession array of six weeks to aing hundreds additional, best of it, not the all-inclusive majority are all the acceptable per member, per ages added a appointment fee. Additionally those that are at the college end of the per member, per ages with the appointment fee included, there acquire been actual few appointment fee-only proposals and affairs executed. But we abide to absolutely see a advance through the end of the year of those companies that are attractive to assurance up and acquire our casework accessible to them on January 1 barrage date.

Richard Aing — Canaccord Genuity — Analyst

Okay, acknowledge you.

Operator

Your aing catechism comes from the band of Charles Rhyee from Cowen. Your band is open.

Charles Rhyee — Cowen and Aggregation — Analyst

Hey guys, acknowledgment for demography the question. You know, Mark, maybe I capital to ask you, aloof chase up absolutely bound on that, on Richard’s catechism is, any affectionate of advance from audience into maybe a authentic PMPM abandoned affectionate of contract, breadth the visits are included? Are you seeing any affectionate of uptick in that affectionate of arrangement format?

Mark Hirschhorn — Chief Operating Officer & Chief Banking Officer

Well, I would — I would advance that the fastest breadth of advance for new applicant wins has been in that baby and medium-sized business with the visits included archetypal that college PMPM.

Charles Rhyee — Cowen and Aggregation — Analyst

Okay. And what is almost that PMPM appear out to be? If we attending at array of what you’re averaging currently is it like 1 to 5 range, or breadth is that affectionate of boilerplate out to typically?

Mark Hirschhorn — Chief Operating Officer & Chief Banking Officer

I would advance you commonly in the $3 added range, it’s a cogent assorted on what that boilerplate dollar and changes over the absolute population.

Charles Rhyee — Cowen and Aggregation — Analyst

Okay. And afresh the catechism I absolutely capital to ask was about the appointment advice for the aing quarter. It’s 7.20 to 8.20 and we attending at the beggarly of the range, and I acknowledge that you’re giving us the all-embracing appointment cardinal here. I assumption aloof to breach that bottomward a little bit, should we acquire that all-embracing visits to acquire the aforementioned affectionate of melancholia arrangement in the fourth quarter, as it does in the US?

Jason Gorevic — Chief Executive Officer, Director

Yeah, that’s what we’re assuming. So, that’s correct.

Charles Rhyee — Cowen and Aggregation — Analyst

Okay.

Jason Gorevic — Chief Executive Officer, Director

This would be the aboriginal time acutely we acquire such a cogent accession from international. But the ambit is wide, we’d be bourgeois to advance contrarily the actuality is, is that they do in actuality trend in a actual agnate appearance as a aftereffect of either a actual able or a balmy flu season. You know, we’re done with the aboriginal ages of the quarter, it was a nice — it was a nice month. Trending looks like we’re activity to have, as Jason noted, commodity agnate to, or if not stronger than aftermost year.

Charles Rhyee — Cowen and Aggregation — Analyst

So, afresh there is, is it — the accession that we’re attractive at is absolutely added flu abased than anything?

Jason Gorevic — Chief Executive Officer, Director

That’s correct.

Charles Rhyee — Cowen and Aggregation — Analyst

Okay. All right. And afresh just, sorry, lastly, on the Aetna side, you talked about is actuality array of acquirement aloof here. We did 2.5 actor in appointment fee-only revenue, acutely the Aetna ancillary has the bigger appointment fee business amount here, or is it that we’re assured a bigger fasten in the fourth quarter, because if we were affectionate of attractive at array of affectionate of abetment into it, it looks like we’re alive by my math, maybe $7 actor or $8 million, is that array of the adapted ambit for the abounding year, or is it –?

Mark Hirschhorn — Chief Operating Officer & Chief Banking Officer

Yeah. You’re in the adapted ballpark.

Charles Rhyee — Cowen and Aggregation — Analyst

Okay, great. Acknowledgment guys.

Mark Hirschhorn — Chief Operating Officer & Chief Banking Officer

Yeah, and that would be constant with breadth we were.

Charles Rhyee — Cowen and Aggregation — Analyst

Okay, perfect. Acknowledgment a lot.

Mark Hirschhorn — Chief Operating Officer & Chief Banking Officer

Sure.

Operator

Your aing catechism comes from the band of Ryan Daniels from William Blair. Your band is open.

Ryan Daniels — William Blair — Analyst

Yeah guys. Acknowledgment for demography the question. Jason, one for you, it sounds like the Advance Medical affiliation is off to a actual acceptable start, acceptable acknowledgment from customers. But I’m analytical as you’ve affectionate of gotten to apperceive the alignment added if there’s been any surprises either way, absolute or abrogating from antecedent expectations? And afresh cardinal two is a aftereffect to that. Are there any best practices that you’ve revealed, that you anticipate can be affectionate of brought over to the US operations and advance your accepted barter that could account the alignment activity forward.

Jason Gorevic — Chief Executive Officer, Director

Yeah. Thanks, Ryan. The Advance affiliation has been absurd really, alive absolutely able-bodied with that administration team. In actuality Peter McClennen Over there adapted now with the aggregation alive on planning for aing year, added affiliation discussions and starting to assignment on applicant efforts.

The aggregation from Advance Medical has been out to see all of our material, all-embracing clients, abnormally in Europe. I’ll be over there in November, aloof in a brace of weeks, breadth I’ll see a cardinal of our European clients. I anticipate the bigger array of affable abruptness is the appetence for artefact amplification aural our absolute clients, abnormally the Teladoc clients, array of bequest Teladoc audience in Europe above-mentioned to the Advance acquisition. We’re additionally seeing a very, actual acceptable acknowledgment to the all-around affliction artefact launch, which was acutely a aftereffect of the Advance Medical acquisition, and we’re seeing that as able response, both alfresco the US as able-bodied as from US multinationals.

With account to best practices, I anticipate that the two things are, one about the All-around Affliction artefact was commodity that, absolutely bluntly we didn’t have, we had done and the befalling to accompany that to bazaar was acutely be an befalling for us to advantage their best practices. And afresh the added affair is around, we acquire a aggregation alive through array of comparing the able medical casework processes to amount out the best-of-breed processes as able-bodied as analyze means to accomplish efficiencies. And so I anticipate that that’s activity to buck bake-apple over the advance of the aing brace of quarters.

Ryan Daniels — William Blair — Analyst

That’s great. Acknowledge you. And then, we’ve talked about some of the affectionate of bottom acquirement business segments were behavioral and et cetera. But I’m analytical how the provider bazaar is abstraction up, abnormally accustomed some of their contempo drive with CMS afore with payments for some of the Medicare Advantage plans, et cetera. Are you seeing that additionally aces up in the pipeline?

Jason Gorevic — Chief Executive Officer, Director

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Yes, the provider bazaar continues to abound at a absolutely able blow for us. We, aloof array of on a allotment basis, that’s apparently cardinal one or cardinal one in our, in our advance areas. Acutely it’s off of a baby base. I would say the two things that are absorbing in that amplitude are; cardinal one, we acquire audience attractive for added casework from us as they aggrandize the use cases for basic care, which is consistently encouraging. And we acquire absolutely acceptable examples of hospital clients, who are very, actual committed to basic affliction and are starting to see the absolute amount and apprehend the account of those services. We abide to acquire a able-bodied activity there. That’s a very, actual alive aggregation and our win amount continues to be actual strong.

Ryan Daniels — William Blair — Analyst

Okay, great, thanks. I’ll hop aback in the queue. Congrats on — performance.

Jason Gorevic — Chief Executive Officer, Director

Thanks Ryan. Acknowledge you.

Operator

Your aing catechism comes from the band of Mohan Naidu of Oppenheimer. Your band is open.

Mohan Naidu — Oppenheimer & Co. — Analyst

Thanks for demography my questions. Jason, on utilization, accustomed the absorption you’re accepting so far. Can you animadversion on the expectations on appliance amplification is the 100 abject point advance year-over-year is still the adapted baseline?

Jason Gorevic — Chief Executive Officer, Director

Yeah. I anticipate that’s right. I anticipate at the Analyst Day we talked about it’s arctic of a 100 abject points, but as that — as our angle on that continues to improve. But yeah, you’re absolutely acceptable at attractive at that as a baseline.

Mohan Naidu — Oppenheimer & Co. — Analyst

Okay. And on, brace of quick follow-ups. One on TRICARE. Aloof to be clear, there is no change in arrangement adapted now, it’s a aloof accomplishing advancing adapted now and the agenda to be online in Q1, is that correct?

Jason Gorevic — Chief Executive Officer, Director

That’s correct.

Mohan Naidu — Oppenheimer & Co. — Analyst

Okay. Aftermost catechism on the inpatient side, I acquire not heard abundant on that in today’s call. Aloof appetence to see what’s activity on in that bazaar and any updates on bazaar altitude there?

Jason Gorevic — Chief Executive Officer, Director

Can you aloof analyze what you beggarly on the inpatient side?

Mohan Naidu — Oppenheimer & Co. — Analyst

The hospital artefact that you guys sell, how is that bazaar advancing along?

Jason Gorevic — Chief Executive Officer, Director

Yeah. So, that’s advancing forth absolutely well. We see audience allurement for added casework from us. We see the activity as actuality absolutely robust, and we see added use cases for our technology and our audience allurement for us to do some development, so that they can apply our technology and added use cases.

Mohan Naidu — Oppenheimer & Co. — Analyst

That’s great. Acknowledgment a lot, Jason.

Jason Gorevic — Chief Executive Officer, Director

Excellent. Thanks, Mohan

Operator

Your aing catechism comes from the band of Sandy Draper from SunTrust. Your band is open.

Sandy Draper — SunTrust — Analyst

Thanks actual much. So, apologize about hopefully you can apprehend me OK. My articulation is a little shaky. If you acquire apparently to alarm a doctor — if you could, I anticipate I heard it on the animadversion Mark you said pro forma PEPM including Advance Medical would be a little bit higher, I anticipate that was correct. I’m aloof curious. So, about it sounds like I’d say at the college PEPM is that because about Advanced Medical had a broader acceptance beyond assorted services, or is it aloof bodies were disposed to buy added of an all-in all inclusive. Aloof aggravating to accept that and you can aloof say, if the acknowledgment is, I misheard it afresh acutely there’s a altered answer? Thanks.

Jason Gorevic — Chief Executive Officer, Director

No, you heard it correctly, Sandy, the actuality is that Advance Medical’s the primary basic of their acquirement is international. The befalling internationally, Europe, and Asia, Latin America tends to be far greater than that in aloof the U.S. abandoned because of not abandoned faster adoption, but there is beneath antagonism and there’s a greater appetence to acquirement an all across-the-board product.

Sandy Draper — SunTrust — Analyst

Got it. That’s helpful. That’s my abandoned question. Thanks.

Jason Gorevic — Chief Executive Officer, Director

Thank you, Sandy.

Operator

Your aing catechism comes from the band of Ana Gupte from Leerink Partners. Your band is open.

Ana Gupte — Leerink Ally — Analyst

Hey, thanks. Acceptable evening. So, the aftereffect on that aphorism that came out with CMS and Medicare Advantage for 2020. It could be a actual big befalling from, breadth we sit accoutrement managed affliction as well, maybe 25 actor complete seniors. How are you cerebration about, what the abeyant is for adoption, appliance and the likelihood that you get bazaar allotment from the nationals? And afresh on the bloom systems, whether they will use added of their own civil platform, although they assignment with you and on your networks as well? And what are you accomplishing to plan for that opportunity?

Jason Gorevic — Chief Executive Officer, Director

Yeah, acknowledgment Ana. We’re very, actual admiring with the proposed regs advancing out of CMS about to Medicare Advantage. They absolutely accommodate themselves to us rolling out our abounding artefact portfolio into the Medicare Advantage affairs and Medicare Advantage markets aloof like we acquire into the bartering markets. The regs absolutely abutment that. The added affair that was actual auspicious is the able endorsement from CMS of basic affliction and the appulse that it can acquire on access, affection of affliction and cost. And so absolutely couldn’t be added admiring with the administration that has gone.

The bazaar opportunity, there’s about 21 actor associates beyond the country, who are in Medicare Advantage affairs that tends to be a growing cardinal over time, if you attending at the Medicare Advantage associates over the last, as you able-bodied know, apparently bigger than I do, over the aftermost 5 to 10 years. It’s consistently developed in that population.

And so we are accepting alive conversations with a cardinal of our absolute customers, of course, we’re arctic of 35 bloom affairs as audience and abounding of those audience acquire MA populations. So, we’re talking to a lot of them about a basic affliction in their MA accessories for 2020 and we’re additionally now starting to be in discussions with affairs about their MA populations.

With account to the hospital systems, we absolutely don’t see too abounding hospitals systems activity to acquaintance solutions. There are a few of them, they tend to be actual ample systems, who with the acutely ample IT budgets and sometimes a bent against developing themselves. But for the best part, we see hospital systems activity into the bazaar for basic care, telemedicine solutions. So, we anticipate that will be a almsman of that as the hospitals apprehend and apperceive that they can get reimbursed for these services.

This of advance is on the MA side. The trend has been good, not absolutely as strong, but acceptable on the Medicare fee for account ancillary as well. And afresh lastly, we are hopeful, it’s consistently adamantine to predict, aback this is activity to happen. But about the way the accompaniment Medicaid regs go in anniversary one of the accompaniment Medicaid acquittal affairs goes, follows CMS guidelines. So, we are hopeful that will abide to accessible up the doors into the accompaniment Medicaid opportunities, which of advance is affective added and added to Manage Medicaid solutions.

Ana Gupte — Leerink Ally — Analyst

Thanks, Jason. One aftereffect on that. As far as the business archetypal goes, would you see yourself accepting added of a aggregate accumulation archetypal rather than aloof the defined CMS PMPM and abacus on a per appointment fee of which can be absolutely lucrative, I would anticipate for the MA population, with bargain admissions, in accession to ER visits and the like?

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And afresh are you planning home bloom affiliation as about that’s breadth the basic anesthetic is able-bodied used. And I anticipate Humana others are articulating agenda bloom approaches about that?

Jason Gorevic — Chief Executive Officer, Director

Yeah. So, with account to the acquittal models, I think, it’s a little too aboriginal to say, we’re aloof starting to acquire some of those discussions because of advance the, basic regs were absolutely aloof appear on Friday. I anticipate we’ll see some a array of models and we’re consistently blessed for models in which we can get paid for the amount that we bring. So, we’re absolutely consistently accessible to those discussions and afresh we do see the befalling actuality there for us to accommodate with some home affliction plans.

We’ve done some aboriginal pilots on that, but those are still in pilot phase. I do anticipate as we go added and added against the Medicare population, that will be a bigger and bigger opportunity. And as I said afore that additionally opens the aperture to added affiliation with alien ecology accessories as those tend to be admired in that population.

Operator

Your aing catechism comes from the band of Donald Hooker from KeyBanc. Your band is open.

Donald Hooker — KeyBanc — Analyst

Great. Acceptable afternoon. Acknowledge you for catechism here. I assumption maybe affectionate of aerial level, aback you’re bringing calm — you’re bringing calm Best Doctors, Advance Medical, now that you acquire Best Doctors beneath your belt for a little over a year now and you’re ramping Advance Medical. Aback do you affectionate of feel like you hit abounding affectionate of synergies with all this from a affairs standpoint? I mean, it’s aloof activity to booty a brace of years. I’m abiding anniversary year gets a little bit added synergized. But what is your angle now array of the admission of abeyant acquirement synergies, as these three companies advancing together?

Jason Gorevic — Chief Executive Officer, Director

Yes, it’s a acceptable question. I would say the 2019 affairs division will be the aboriginal one. It will be array of the complete affairs division for bringing calm Teladoc and Best Doctors. The ’19 affairs division will be the aboriginal affairs division beyond that we’re cerebration about the array of bequest Teladoc, Best Doctors business actuality accumulated with the bequest Advance Medical. So, I would say that’s year one, year one is never maturity, year two tends to be array of aboriginal year one is never maturity. Aboriginal year two, you achievement to get to a added complete experience, compassionate about array of what the optimal mix is, what the optimal appraisement looks like, what the optimal pitches, what audience acknowledge to and how you accommodated their needs best. So, I would say U.S., anticipate about the ’19 affairs division for ’20 as actuality added mature, internationally anticipate about the ’19 affairs division is actuality year one with the ’20 affairs division actuality mature.

Donald Hooker — KeyBanc — Analyst

Okay. So, aloof to be bright not this affairs division for Best Doctors, but aing year affairs division activity into 2020?

Jason Gorevic — Chief Executive Officer, Director

Correct.

Donald Hooker — KeyBanc — Analyst

Got it. And afresh my aing catechism and afresh I’ll hop off and you apparently won’t answer, but I’m activity ask it anyhow. With account to UnitedHealth, how is the accord there developing in agreement of your exposure, and opportunities aural that bloom plan activity into aing year?

Jason Gorevic — Chief Executive Officer, Director

I’ll accommodate an acknowledgment that we feel abundant about our accord with United, beyond assorted segments of their business. We abide to see advance and amplification afresh in assorted segments of their business. And I anticipate the best array of affair I can point to, is not abandoned do we abide to see expansion, but wherever we do comparisons of the appulse that we’re accepting against added basic affliction providers are telehealth providers, we appear out on top. So, I’m optimistic — feel acceptable about the accord and the advance that we’re authoritative with United.

Donald Hooker — KeyBanc — Analyst

Thank you.

Jason Gorevic — Chief Executive Officer, Director

Thanks, Don.

Operator

Your aing catechism comes from the band of Sean Wieland from Piper Jaffray. Your band is open.

Sean Wieland — Piper Jaffray — Analyst

Hi, acknowledge you. So, aloof to on up the chat on Bigger Health. Can you aloof abode what the acceptance and licensing requirements are, that you acquire in abode for providers on that network?

Jason Gorevic — Chief Executive Officer, Director

So, we acquire a absolute vetting process, we attending at accompaniment licensure, we attending at accompaniment licensure of the providers. We are absolutely adjustable with all the accompaniment regs and we’ve taken admission that we do with all of our business, which is that analytic affection is ascendant to the charge of care. We booty actual actively the membership, who comes to us for abetment there. And at the aforementioned time, we are consistently adorning and convalescent our processes about that, which is why we acquire a Analytic Affection Committee of our Board of Directors and I mentioned bringing Mark Smith assimilate the Board. I anticipate that’s accession acceptable archetype of us absorption on analytic quality.

Sean Wieland — Piper Jaffray — Analyst

That’s great. Acknowledge you. And afresh I may acquire absent it on Advance Medical, did you amend us on the cardinal of associates today on Advance Medical? And what you anticipate the complete year acquirement accession will be?

Jason Gorevic — Chief Executive Officer, Director

No, we didn’t abode any amend on associates of Advance Medical, aback we accommodate end-of-year numbers, we’ll accommodate the calm Advance Medical contribution.

Sean Wieland — Piper Jaffray — Analyst

All right. Acknowledge you actual much.

Jason Gorevic — Chief Executive Officer, Director

Thanks, Sean.

Operator

Your aing catechism comes from the band of Jailendra Singh from Credit Suisse. Your band is open.

Jailendra Singh — Credit Suisse — Analyst

Hi, acknowledgment a lot. I’ve brace of questions, if I can ask. First, I capital to get description about your comments about gross margin. I acquire on the aftermost balance call, you talked about because of business mix, gross allowance will bead to like 65% in added half. Clearly, third division acquire appear in bigger than that. So, should we acquire like high-60% is a accustomed run-rate activity forward? And maybe advance from there? And what’s the apprehension for fourth division gross margin?

Jason Gorevic — Chief Executive Officer, Director

Hi, the advice that we provided a ages ago charcoal intact. The allowance appulse from a actual abundant flu division and acutely abundant added projected appointment aggregate in Q4 and Q1 should in actuality accompany the margins into the branch of what we had guided at previously. We did acquire a stronger allowance division in this third quarter, but that’s principally seasonality.

Jailendra Singh — Credit Suisse — Analyst

Okay. And afresh let me aftereffect on the CMS MA angle comments on telehealth. Accustomed all the ambiguity about how telehealth will be adopted or accustomed by seniors and some apropos around, whether they’d be accommodating to use it, at atomic compared to the adolescent bartering population. What gives you abundance that MA affairs will not advance for added like appointment abandoned model, accustomed they are apparently activity to get paid like dollar per dollar. And in fact, CMS estimates like $0.09 PMPM benefit, I mean, included in the bid acquiescence process. Can you accord some blush like your acknowledgment on that?

Jason Gorevic — Chief Executive Officer, Director

Yes. So, I know, you’re talking about with the $0.09. Actually, I don’t anticipate that’s absolutely what CMS said. They gave an example, but they absolutely absolutely came out and said that they don’t apperceive what the amount appulse will be because they don’t absolutely apperceive what the appulse of movement from one provider to another. They don’t absolutely apperceive what the appulse of bigger healthcare by bodies accepting affliction beforehand than they contrarily would.

They don’t absolutely apperceive the abounding appulse of busline amount abstention and so. They gave what I anticipate was an archetype of how they assignment up, but I anticipate they accustomed themselves that they don’t absolutely yet know, what that amount appulse is activity to be. Aloof to be — to be as cellophane as I can be, all of the government — the payers were talking about both Manage Medicaid as able-bodied as the MA, we’re talking about added acceptable models about to what we’ve done in the accomplished with a appointment fee and a per affiliate per month. It’s not to say that’s activity to consistently be the case, or that that’s consistently activity to be — that there won’t be added models that we attending at, as I said, aback I responded to Ana. But I anticipate we’ll — we’re not seeing that as a macro trend.

Jailendra Singh — Credit Suisse — Analyst

Okay. And afresh the aftermost question, I apperceive if you acquire this data. What allotment of your third division visits would absolutely echo users? Do you acquire the abstracts for third quarter?

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Jason Gorevic — Chief Executive Officer, Director

Repeat — echo users, I don’t acquire it all , it’s off top of my head. Yes, I know, apologetic neither Mark or I are staring at that number. Sorry.

Jailendra Singh — Credit Suisse — Analyst

Okay. No problem. Acknowledgment a lot.

Jason Gorevic — Chief Executive Officer, Director

Thank you.

Operator

Thank you.Your aftermost catechism comes from Matt Hewitt from Craig-Hallum Capital. Your band is open.

Matt Hewitt — Craig-Hallum Capital — Analyst

Hi there. Best of my questions acquire been answered, but maybe to blanket things up. Apropos the Advance Medical accretion and the software integrations, acquire those all been completed at this point? And is your plan to acquire a circumscribed belvedere that will be acclimated in all markets activity forward, or will be the markets acquire differentiated models depending aloft some of the altered offerings?

Jason Gorevic — Chief Executive Officer, Director

Our ambition is in fact, to acquire a all-over belvedere throughout the — throughout the apple accouterment those individuals, who are either in country or traveling with the aforementioned exact admission point, aforementioned architecture and aforementioned accepted the aerial affection of service, behindhand of breadth they appeal their medical consultation.

The affiliation of the app has taken abode for assertive genitalia of the Advance Medical absolute services. The absolute all-embracing and actual abysmal affiliation will booty abode throughout 2019. And that absolutely ties into what Jason was suggesting apropos affairs seasons. Aback the aggregation has that chip app, we feel that we’re activity to be in the best accessible position to action those casework on a afresh a all-over platform, but on a absolute abject throughout 2020.

Mark Hirschhorn — Chief Operating Officer & Chief Banking Officer

I anticipate I’d aloof add to that, that we see a appealing cogent befalling to roll-out our assurance capabilities amid the Advance Medical clients. And that was a bright breadth to Ryan’s catechism beforehand about best practices. That was a bright area, breadth the Advance Medical aggregation was aflame to get the admission to our assets and capabilities with account to our beleaguer complete engagement.

Matt Hewitt — Craig-Hallum Capital — Analyst

Okay, that’s great. Acknowledge you actual much.

Mark Hirschhorn — Chief Operating Officer & Chief Banking Officer

Thank you.

Jason Gorevic — Chief Executive Officer, Director

So, acknowledge you all. We acknowledge it. We had a absolutely abundant quarter. We feel actual acceptable about our drive activity into 2019. Our ample portfolio of casework and our geographic brand are actuality very, actual able-bodied received. And as you can see, we acquire the lot of tailwinds in our business. So, we acknowledge your time today and your questions. And attending advanced to seeing you at some of the accessible conferences.

Operator

This concludes today’s appointment call. You may now disconnect.

Duration: 62 minutes

Kelsey Turcotte — Vice President of Investor Relations

Jason Gorevic — Chief Executive Officer, Director

Mark Hirschhorn — Chief Operating Officer & Chief Banking Officer

Sean Dodge — Jefferies — Analyst

Stephanie Demko — Citigroup Inc — Analyst

Lisa Gill — JPMorgan — Analyst

Richard Aing — Canaccord Genuity — Analyst

Charles Rhyee — Cowen and Aggregation — Analyst

Ryan Daniels — William Blair — Analyst

Mohan Naidu — Oppenheimer & Co. — Analyst

Sandy Draper — SunTrust — Analyst

Ana Gupte — Leerink Ally — Analyst

Donald Hooker — KeyBanc — Analyst

Sean Wieland — Piper Jaffray — Analyst

Jailendra Singh — Credit Suisse — Analyst

Matt Hewitt — Craig-Hallum Capital — Analyst

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