While we’re all sick of hearing the word “unprecedented,” that’s exactly what 2020 was. 

That’s why we interviewed 200+ Jellyvision customers to learn about their 2021 priorities and how they’ve shifted their focus a year into a worldwide pandemic. 

Last year was full of “firsts” for HR teams. Between adopting virtual strategies, shifting to remote work, and continuously assessing the funnel of new information coming your way, no doubt you agree it was a clusterf*ck (pardon our language). 

Fortunately, there’s a silver lining to the chaos. Through immense change, we’ve all learned and evolved. Circumstance pushed leaders to adapt, pivot, create fast solutions to broken processes, and innovatively support their teams. In fact, 98% of HR leaders we spoke with are expanding their benefits offerings in some way, in response to the pandemic.

Even though “holistic wellness program” has been a buzzword for a while, the pandemic accelerated this notion due to sheer need. Companies had always wanted to keep workforces healthy, reduce healthcare costs, and offer well-rounded benefits packages (that people actually understand and use)—but always seemed to fall short. 2020 forced employers to make this happen ASAP, through quick action plus trial and error. In many ways, it was the shove that HR teams and managers needed. 

At Jellyvision, we saw the writing on the wall: 2020 was one of the most experimental years for managers, HR leaders, and businesses in general.

The global pandemic shined a spotlight on the areas where HR priorities were lacking, where benefits and resources fell short, and most importantly—the necessity to support “whole person” health. That’s why we interviewed 200+ of our customers in late 2020 and early 2021 to glean invaluable insights on their lessons learned and biggest areas of focus for the year ahead. Our conversations revealed what the future of HR will look like.  

Spoiler alert!
Most organization’s main concerns revolve around supporting “whole person” health for their teams.

We always say that in order to perform at your best, you need to be running at your best. In order to be well and run at your best, you have to be healthy physically, mentally, emotionally and financially.

Kelly Quinn, HR Total Rewards Consultant, SAP

With everything that’s going on … mental wellness, physical wellness and wellness in general is something that will be a hot button issue moving into 2021. We have to come up with ways to help staff get through what’s going on, both personally and professionally.

VP of HR, Financial Company

Part of our mental health push is also financial. Any way we can help people make sure they’re on a budget and watch what they’re spending is all part of a wellness push.

Benefits Manager, Construction and Engineering Company


Don’t feel like reading the full report? We get it; you’re a busy person. Here are the highlights to give you an idea of the seven key HR priorities we uncovered: 

  1. Mental health cannot be ignored: Our report shows 7x more employers plan to prioritize mental health in 2021, and countless other studies confirm this as well. Companies are putting their money where their mouth is by offering resources like meditation apps and virtual therapy, robust manager training, and expanding employee assistance programs (EAP).
  2. Companies are experimenting with physical care: Employers are trying unique and innovative care options to promote better physical health for their staff. These initiatives include telehealth, Centers of Excellence (COE) partnerships, on-site clinics, and a variety of fitness/nutrition programs focused on real wellness. 
  3. Financial wellness assistance isn’t just a “nice to offer” benefit: The financial strain of the pandemic helped companies understand they need to increase financial education and help employees leverage available resources. Our customers introduced education on retirement, partnered with financial wellness platforms/apps, and explored student loan benefits. 
  4. Chronic conditions shouldn’t plague employees: Managing chronic conditions leads to lower health care costs down the road. Teams realized this even more in 2020, with 5x more employers prioritizing disease management. They rolled out digital platforms to support management of common conditions like diabetes, hypertension, and GI disease.   
  5. Communication is key: As we’re distanced, communication is the most important channel to reach employees. Our customers focused on efficient and consistent communication, specifically in the areas of HSA education and resources, to help employees be smarter healthcare consumers. 
  6. DEI translates to benefits, too: Diversity, equity, and inclusion aren’t just imperative to management and hiring but also benefits as well. Employers expanded focus to items like family benefits (maternity/paternity leave, family planning, fertility, and adoption assistance). 
  7. Childcare is difficult: Employers realized parents are people too, and it’s challenging to balance a family and career (esp. in 2020). As such, there was a 15% increase in prioritization of family and childcare this past year. Leaders helped more with childcare resources, as well as supported more fertility and family planning programs.  

It’s time for employers to think about their team as whole people. We talked to 200+ real HR leaders, gathered the most recent data and research, and compiled it into one handy report, so you can have a top-down view of HR in 2021. (You’re welcome! 🙂) Curious about where and how to focus your efforts for the year ahead? Use these priorities to guide your process. 

Also, know that you NEED to focus on every aspect of employee health. Financial health is mental health is physical health—they’re all intertwined and equally important. 

2021 HR Priority 01

Supporting Employee Mental Health

Yes, it’s true, mental health is health.

Mental health has always been a priority, and now it’s been amplified because the need has become so prevalent.

Stephanie Riedel, Benefits Manager, ServiceNow, Inc.

more employers are prioritizing
mental health in 2021

It only took a global pandemic and a complete workforce shift, but employee mental health is now front and center. 

Unfortunately, recent research corroborates that the past year took a toll on mental wellbeing, which impacted physical health and productivity:

  • SHRM found that between 22% and 35% of U.S. employees experienced symptoms of depression during the pandemic. 
  • A Qualtrics survey of 2,000 global workers found that more than half (57.2%) had increased anxiety from the pandemic, which led to other symptoms such as exhaustion, sadness, irritability, confusion, and insomnia.
  • A Kaiser Family Health poll echoes this, explaining half of adults reported adverse effects from pandemic ranging from difficulty sleeping to problems eating to an increase in alcohol or substance use.  
  • Another Ginger survey of 1,200 workers discovered that 91% reported moderate to extreme stress, and 62% said they lost at least one hour daily in productivity due to COVID-19. 

The good news is that employers have noted these mounting challenges and taken action to support their team’s mental wellness.

Action Items

Our customers reported that they took a long, hard look at their mental wellness offerings. Their goal was to fill gaps and offer innovative new solutions (especially ones that made sense in remote or hybrid workspaces). A few of the most commonly named resources included:

  • Meditation apps, which offer employees the opportunity to explore meditation on their own schedule. What’s more, guided and beginner resources make meditation less intimidating to get started. Microsoft research confirmed that when their employees used a mediation app after just 30 days, stress decreased by 32%.  
  • Sleep-improvement programs, which provide digital therapy personalized to each individual to offer practical techniques. Studies show stressful work situations can cause sleep disturbances, so it’s huge for employers to embrace better sleep patterns.    

Virtual therapy service platforms are also popular. With many non-essential healthcare services suspended, virtual therapy gives people access to mental health support from the comfort of their homes when they need it most.

Many employers already offered awesome mental health resources via their Employee Assistance Programs (EAPs). However, they never communicated or promoted it properly to their teams. A common theme with our customers was brainstorming ways to highlight and encourage their employees to use their existing and FREE programs.


ALEX answers common benefits questions in real time, so you can guide employees to available resources and help them make smart choices 24/7.

Another insight uncovered by the previously mentioned Qualtrics survey was that 57% of workers are comfortable with their manager asking them about their mental health, and 41% want their manager to proactively ask them.

This goes to show that mental health awareness starts from the top down. Our customers started grasping this more and more in 2020 with an increase in manager training regarding mental health support. 

There’s been a big push with manager training and what we do to give managers the tools they need to point people in the right direction or to develop emotional intelligence.

Benefits strategy manager, industrial supplier

A Mercer survey confirms this, finding that 27% of employers have already provided formal training for managers to support employees’ emotional and behavioral health needs, with another 24% planning to start.

2021 HR Priority 02

Innovate Physical Care

To make a difference, physical care needs to be robust and personalized.

I want to push the envelope in terms of using virtual care. The one good thing that has come out of COVID is people are using virtual healthcare more than ever. The lack of primary care physicians has always been an issue, so I want to see where I can take virtual primary care medicine in the future.

Director of benefits and compensation, maintenance products company (NCH Corporation)

more employers are prioritizing
innovation in physical care in 2021

Due to the pandemic, preventative care usage was much lower than normal. CDC reports confirmed that 41% of U.S. adults delayed or avoided medical care because of COVID-19 concerns.

While this makes sense (people sheltered in place for months at a time), preventive care is key in lowering long-range health costs and ensuring a healthy workforce. As such, companies looked for new ways to deliver care via virtual means, on-site clinics, and other methods. Even after in-person care options resumed, our customers found these innovative solutions still made sense and served their team well.

Action Items

The forced adoption of telehealth (there was a 154% increase in March 2020, according to the CDC) is one of the positive outcomes of the pandemic. Even when the virus is no longer a threat, telehealth is a convenient, efficient option for many types of routine or preventative visits.

Organizations are exploring Centers of Excellence (COE) as a way to provide access to costly, specialized care to their employees. The COE model partners businesses with expert healthcare institutions to offer their staff easier and more affordable access when they require specialized care. COEs often cater to specialties such as cardiology, orthopedics, cancer care (oncology), neurology, or niche areas. 

If this seems too good to be true, here’s a little more background on COEs: The beauty of this arrangement is that employees get better care, and their company isn’t paying an egregious amount for the coverage. The specialty healthcare institutions offer this option (at a lesser cost) because it gives them a healthy flow of patients and allows their expert team of doctors and specialists to optimize their care. Insurers are on board because it lowers overall costs by stopping inefficiencies (e.g., patients aren’t going to a ton of random appointments to figure out care before finally seeing a specialist). 

COEs increased in popularity and gained traction as they offer employees a network of high-quality providers with better long-term outcomes and lower overall healthcare costs.

On-site clinics are a bit of a no-brainer. If employees are already at work, bringing clinics to them is a convenient and efficient way to provide high-quality, low-cost preventative care.  

A recent survey found that 72% of large employers either have on-site clinics in place or will by 2023. In addition, 34% of employers offer primary care services at their worksite, and 25% plan to have similar services available by 2023. 

Many of our customers also agreed that they’re on board with this increasing trend.

We all know staying active, eating healthily, and working a full-time job isn’t easy, especially if you’re remote. Employers helped meet this challenge by introducing nutrition and fitness resources. Our customers wanted to support their employees to be even healthier in 2021. (Especially after putting off preventative and basic doctor visits and increased stress due to the pandemic.) 

A healthy team is paramount. Not only does it equate to lower long-range healthcare costs for a company, but let’s face it, healthier employees are more effective. 

Science backs this up. One study found that workers who exercise perform better at work than those who don’t. (They reported better mood, concentration, workplace relationships, and resilience to stress.)

While many companies had pre-pandemic wellness programs, they’re stepping up their game even more in 2021. Some of our customers introduced targeted resources such as employee well-being solutions and remote fitness offerings.

We had a wellness program in the past, but it was not holistic. We want to have a whole program that can incentivize folks and measure return—a more well-rounded program.

Healthcare company benefits manager

2021 HR Priority 03

Drive Financial Wellness

Cash does rule everything around us.

Once our employees retire, I want them to be happy and enjoy their retirement. But when it comes to retirement, we see that our employees aren’t saving enough.

HR specialist, state government

increase in employers
prioritizing financial wellness

It’s no longer enough for a management team to offer what they think are fair salaries and good benefits, then leave the rest of it up to their employees. Financial wellness support is essential.

Financially comfortable employees are more productive. Just check out some stats from a recent Salary Finance Report:

  • 42% of working Americans surveyed are stressed about finances.
  • That stress results in the loss of 3 working hours per week due to money worries.
  • Those with financial stress are 9x more likely for it to affect the quality of their work.
  • Financially stressed employees are 10x more likely not to finish daily tasks.
  • The estimated impact of a financially stressed employee is 13-18% of their salary cost.

But folks want to achieve better financial wellness (and stop their money worries), especially after the increased strains of the pandemic. And their employers want to help, too. A Bank of America report found that 62% of employers feel extremely responsible for employee’s financial wellness. 

Our conversations supported the need and want to support financial wellness. In 2020, companies realized they couldn’t sit back and let their team figure it out on their own, especially when they offer resources that could help, but folks just don’t understand them. 

Action Items

Several of our customers turned their attention to education around retirement savings—and rightfully so, as the pandemic has caused individuals to shortchange their retirement plans. Our own research found that 4 in 10 employees who are able to save for retirement saved less due to the pandemic.  

All signs point to the need for increased education, awareness, and support for employees in this space.

A few of our customers spoke to us about rolling out financial wellness programs. Such resources give employees a more holistic understanding of financial fitness and literacy.  

In 2020, 45.3 million student borrowers were in debt, with an average of $37,691 in loans, according to recent reports. Moreover, 65% of all student debt belongs to people under 40, a group that will make up three-fourths of the U.S. workforce by 2025. As many student loan programs halted due to the pandemic, employers become increasingly aware of the educational-related debt their teams face.

Some of our customers considered rolling out student loan benefit programs to help with the burden of debt and support better financial wellness. While this type of benefit isn’t commonplace, it’s increasing in popularity. New reports show that companies that help pay off student loans doubled in 2019, from 4% the previous year to 8%. It’s not a huge population, but that’s something! 

What’s more, legislation passed in 2020 allows employers to reimburse employees up to $5,250 for most student loan payments, which can be excluded from taxable income. These provisions are in place for the next five years, and we expect more companies will opt to offer this benefit.

2021 HR Priority 04

Better Manage Chronic Conditions

Chronic conditions shouldn’t cause chronic issues for employees.

We’re focusing on chronic conditions and managing costs, as well as high-cost claimants and how we can better navigate those situations. We’re exploring programs to invest in that are valued by our employees, will help to improve their well-being, and have an impact on our medical spend.

Garrick Wisner, Manager, Compensation and Benefits, Plexus Corp.

more employers are prioritizing
disease management in 2021

Recent Mercer research discovered that in their database of 1.6 million plan members, the sickest 6% represent 47% of total medical and pharmacy spending, on average. This isn’t altogether shocking news, as most people are aware of the high cost of healthcare in this country. However, employers can work with their staff to keep costs down and help them better manage chronic conditions—a common theme that popped up in our conversations with customers.

Action Item

Several of our customers implemented and promoted chronic condition management platforms. Such resources can control claimant costs and increase productivity for those with chronic conditions. For example, for back pain alone, an integrative approach might save $11,000 in costs per employee per year.

Employers are taking a deeper look at how chronic conditions affect quality of life for individuals and how their behavioral wellness impacts workplace productivity (not to mention healthcare costs). 


Money-saving programs are only as good as their utilization. ALEX promotes your cost-saving tools, such as chronic care management programs, at enrollment and beyond.

Examples of the platforms employers pursued include: 

  • Diabetes and Hypertension Management Platforms
    Livongo, for example, offers health monitoring devices paired with employees’ personal devices and health coaching. ALEX users who leverage Livongo save an average of $1,908 per year on gross medical costs.  
  • Musculoskeletal Management Platforms 
    Digital musculoskeletal solutions provide access to virtual, specialized care.
  • GI Disease Management Platforms 
    These programs provide personalized, comprehensive digestive health care.

2021 HR Priority 05

Keep on Communicating

Do more than talk to your team; ensure you’re actually saying something.

I think one of the main things we need to do is communicate our offerings—because we do have tools and resources available for employees, but employees don’t know about them.

Benefits specialist, construction company
1 in 4

are prioritizing year-round
education and communication

Employers and HR teams increasingly understand communication can’t just be a one-and-done effort during open enrollment or other important periods. To see meaningful benefits engagement, education and communication must be at the forefront.

While a quarter of our customers confirmed they’re prioritizing regular education and communication—that’s not enough. 1 in 5 employees said they want more benefits education, so it’s time to increase focus in this area. 

And now that many organizations have shifted to remote work, benefits communication is even more essential. However, there’s a fine line between effective communication and over-communication.  


ALEX cuts through the jargon to explain all your medical, dental, vision, and voluntary benefits offerings—including complex plan designs such as EPOs, HMOs, tiered networks, narrow networks, and ACOs.

You can talk, message, and email your staff until you’re blue in the face (or hands), but unless what you’re saying offers real value, and is delivered at a time most relevant to the employee, it may come across as white noise. Targeted, ongoing communication is the way to do it; here’s how our customers accomplished that in 2020 and will continue to work on it and 2021.

Action Items

Many of our customers confirmed that their primary focus for 2021 was to streamline and optimize their year-round communication strategy. One plus of the pandemic is that it taught companies a lot about how their team prefers to communicate. For example, some employees may need more touchpoints, while others might want fewer but more targeted messages. Everyone’s different! 

Unfortunately, while trying to hit the mark, employers felt they might have communicated too much. 

Combined with the stress of 2020 and adapting to remote work, employees often felt overwhelmed. 

Instead of inundating their teams with too much information, employers now strive to offer strategic communication at the moments that matter most to employees.

Many employers will continue to prioritize education on HDHPs and HSAs. Interestingly, leaders tend to focus on different stages of education depending on how long their HDHP has been in place. For example, some employers try to spread a broad understanding of how HSAs work, while others push their staff to understand HSAs as a long-term savings vehicle for retirement.


ALEX HSA guides employees’ behaviors to drive big financial outcomes. In partnership with HSA Bank®, ALEX uses behavioral science to promote cost reduction and guides employees to smart day-to-day savings choices.

Many of our customers chose to focus on helping employees become smarter healthcare consumers via additional resources. Examples include: 

  • Second-opinion services 
  • Cost and quality transparency tools

When individuals truly understand and correctly utilize their benefit programs, it’s a win for them and their employers. Personalized communication strategies and resources will only further ensure that employees get the most bang for the buck from benefits and use them in relation to their financial and medical situations.

2021 HR Priority 06

Promoting Diversity, Equity, and Inclusion

DEI extends to all facets of the workforce.

There’s work coming out of our ERGs on benefits to consider: what are we not offering, what are our plans currently covering and what can we cover in the future?

Benefits specialist, investment management firm
For the first year, DEI is a priority across HR teams in 2021.

Racial injustices and healthcare disparities were even more painfully magnified in 2020. Consequently, employers chose to prioritize action as far as their diversity, equity, and inclusion (DEI) initiatives. While aspects like hiring and management practices are often at the forefront in DEI discussions, benefits are also another piece of the puzzle. As one customer explained,  “Benefits is one face of the DEI cube.”

In response to the heightened awareness around inequity this past year, employers examined their benefits strategy to confirm they support inclusivity as well as underrepresented groups.

Action Item

By expanding family benefits to cater to a more inclusive set of needs, employers can not only attract a more diverse workforce, but ensure they’re in touch in 2021. Recent Willis Tower Watson research found that 65% of companies offer inclusive family benefits because they align with their corporate strategy and mission. 

The data also showed that 73% of employers offer paid parental leave to birth mothers, which is expected to rise to 84% by 2022. However, fewer organizations (64%) currently offer parental leave to biological fathers. This inconsistency has been pointed out, and 80% of the organizations that don’t offer paternity leave expect to within the next two years.

Additionally, 58% of organizations offer parental leave for non-biological parents (opposite-sex and same-sex) and 64% offer leave to adoptive parents. 

The customers we spoke to for this report agreed that they planned to make updates to their parental leave in the lens of DEI:

  • For example, employers who previously relied on short-term disability for maternity leave plan to expand benefits to include parental leave, inclusive of any way a person becomes a parent. 
  • Other employers evaluated their strategies, and expect to increase benefit offerings in areas such as fertility treatments and adoption assistance.

As CEOs confirmed to BenefitsPro in a recent article, many employers plan to expand benefits to cater to a more diverse workforce via various initiatives, such as mental health support, transgender-inclusive health benefits, fertility, adoption support, childcare, and more.

2021 HR Priority 07

Childcare and Family Planning

Managers should understand that managing a family is hard.

We might bring in a care program to help people with childcare. A lot is going to be dependent on whether the vaccine works and how it’s going to be distributed.

Benefits manager, construction company

increase in employers who are
prioritizing family and childcare

Getting a peek inside our coworkers’ homes via Zoom this year means we’re now all familiar with the juggling act of being a working parent. The shift to remote work and virtual learning left employees stretched thin and at their wit’s end. According to Pew Research, more than half of working parents with children under the age of 12 found it difficult to handle child care during the pandemic. Another survey found that 66% of working parents confirmed their productivity suffered due to balancing childcare and work during the pandemic.

Action Items

While all working parents struggled the past year (and continue to do so), a lion’s share fell on women in particular. A McKinsey and Lean In report uncovered the grave impact of COVID on working mothers. One in three mothers considered downshifting or leaving their career due to childcare responsibilities. Additionally, women are 3x as likely to be responsible for housework and caregiving than their male partners. This means moms are 1.5x more likely to spend an extra 3+ hours per day on housework and childcare. That adds up to 20 hours per week. That’s a part-time job on top of their existing career!  

Employers can help ease this stress with childcare benefits and resources (even after children are back at school full time). That same Willis Tower Watson research found that 34% of employers provide access to childcare referral services and 19% offer emergency or backup childcare services. The average annual amount paid for childcare benefits was $1,600.

Companies not only want to support existing families but also hopeful parents. Fertility treatments such as IVF or even surrogacy can be prohibitively expensive. Employers want to help their team along their family planning journey by providing new fertility-related benefits and resources. 

According to the Insurance Program Managers Group, the most common family planning benefits include: 

  • In-vitro fertilization (IVF) treatments
  • Fertility medications
  • Genetic testing to determine infertility issues
  • Non-IVF fertility treatments
  • Visits with fertility counselors
  • Egg harvesting or freezing services

Other benefits our customers offered included: 

  • Maternity and family planning platforms 
  • Fertility-specific programs

I think there’s certainly a case for fertility and family planning. Based on feedback that we’ve received from team members, it hits a smaller population, but for the population that it does hit, it’s very impactful.

Global benefits director, staffing firm

Action plan

If 2020 taught us anything, it’s that we need to be ready to pivot—because our world is constantly changing.

Just as no one person is the same, no benefits package or experience can be one-size-fits-all. 

Our customers echoed that when they described the various changes they made and expect to make as we trudge on in 2021.

One of the pros of our jobs, homes, workspaces, professional lives, and everything else blending together for an entire year in lockdown is that managers got a front-row seat to what HR pros have always known: Outside factors have an outsized impact on professional performance. It’s immensely obvious that employers must focus on whole-body health. If you want happy, engaged, invested, and productive team members, you need to care about what’s happening when they’re not at work. 

So here’s what your main priorities should be this year, according to our customers and the latest industry research:  

  • Mental health isn’t “in our heads.” Mental wellness equates to physical health, period. You can’t have one without the other. 
  • Bringing physical care options to your employees is an easy way to ensure better practices. 
  • Your staff wants to both understand and work towards financial security; as their employer you have a unique opportunity to assist with both.  
  • Helping people manage chronic conditions helps in the present as well as down the road.  
  • You need to communicate the right amount in the right way. (Hint: This might mean different strategies for different people, and you’ll likely need to update this as your team and their needs evolve.) 
  • Inclusion should carry on into HR and benefits via family planning, adoption assistance, fertility resources, family leave, and more. 
  • Childcare + full-time job = challenging. Support the parents on your team with childcare-related resources and benefits. (Bonus, this will attract a wider range of talent in the future as well.)

2021 priorities in action

Your priorities are clear. Can you say the same for your benefits offerings? 

You know how to support employees. But your offerings are only meaningful if employees know about and use the benefits available. And getting employees engaged with your benefits, while ensuring they make smart choices (especially while working remotely) is no small feat. Fortunately, ALEX ensures employees maximize benefits offerings and avoid costly mistakes by: 

  • Guiding employees to the benefits that are right for their needs. Whether it’s enrollment season, a pressing mid-year question about coverage or someone logging into ALEX HSA to check their HSA balance, ALEX generates awareness for your entire slate of benefits offerings, including mental health services and EAPs. ALEX helps each of your employees understand their options and make recommendations based on their unique health and wealth situations—maximizing your benefits investments.
  • Promoting and driving enrollment into cost-saving programs. For employees with chronic conditions, ALEX guides them to your chronic care management programs, like Livongo, and helps them enroll on-the-spot. In fact, our partners who use Livongo save $1,908 per employee per year in gross medical costs.
  • Engaging with employees in the moments that matter. As employees use their benefits throughout the year, ALEX intercepts them and encourages better care choices when healthcare is top of mind. For example, when employees have questions, Chat, our smart chatbot, gives instant answers and plugs your cost-saving tools, such as prescription cost-comparison tools, helping employers save even more money when they implement Chat.
  • Helping employees discover new ways to save and turn it into action. Let’s face it, benefits are hard. ALEX breaks down complex topics with choice bits of humor in a way that makes information stick. For tips and tricks on how to get the best bang for their buck, employees can rely on Smart Tips videos that are available 24/7 and cover everything from saving for retirement to when to use urgent care vs. the ER—saving you and your employees time and money.


Jellyvision performed a qualitative survey of 200+ companies from December 2020–February 2021 via phone interviews. Job titles of individuals surveyed include VP of human resources, global director of benefits and compensation, HR specialist, benefits strategy manager, total rewards consultant, and others. Company size ranged from small- and medium-sized businesses to large enterprises. All interview participants are based in the U.S.