5 Ways to Shake Up Your Open Enrollment Strategy This Year

5 Ways to Shake Up Your Open Enrollment Strategy This Year

11/14/2018

by Lindsay Jacobs

 

As temperatures drop and the fall season comes to an end, stress spikes in HR departments all over the country—that’s because it’s open enrollment season. Open enrollment is a window during which individuals and employees may add or drop their health insurance, or make changes to their coverage. The 2019 open enrollment period runs through Saturday, December 15, 2018, and if your employees don’t act by then, they can’t get 2019 coverage unless they qualify for a special enrollment period. Keep in mind that for employer-sponsored coverage, the open enrollment period is set by the employer, so be sure to clearly communicate these dates to your employees.  To make a better impact on your employees this year and drive engagement to new levels, here are a few suggestions on how to innovate your strategy.

 

1. Make Your Benefit Meetings Fun

Who says that employee benefits can’t be enticing? Consider creating a workplace party or fun event at your employee benefits meeting this year. With bean bag toss games, door prizes or even a raffle drawing, you’re more likely to draw a crowd and to get your message heard. You’ll also be there in-person to answer any questions someone may have about their benefits, and nothing beats personal interaction.

 

 

2. Meet Your Millennial Employees Where They Are

Millennials are now the largest generation in the labor force, and their preferences should be taken into consideration when picking your employee benefits communication strategy. Long, lengthy paragraphs of dry content won’t be cutting it for this group; instead, consider using interactive quizzes or digital communications to reach them with pertinent information. As younger professionals, they might not have the expertise in life insurance or retirement planning, so introducing some educational tools would also be beneficial to help ensure they make the best decision for themselves.

 

3. Don’t Try to Guess; Find Out What Your Employees Want

Are your employees interested in consumer-directed healthcare plans? Would they appreciate participating in a workplace wellness program if it was made available? If you don’t know the answers to these questions, ask for them. That’s the best way to find out what employees are looking for in the ideal benefits package. Conducting a survey prior to enrollment is a great way to show employees that you’re engaged in what they’re looking for, and asking for feedback afterwards will show you how much progress you’ve made.

 

4. Simple Is Better

Let’s be honest: Fine print is exhausting. Do your employees a favor and outline the benefits and disadvantages of each plan option so that there’s a clear understanding of expectations, costs and advantages. Simple charts, engaging videos and quizzes help to make difficult benefit decisions easier for the average participant and will eliminate the hassle of questions entering your inbox.

 

5. Keep the Conversation Going

After employees have made their decisions and enrollment is complete, the conversation regarding benefits and best practices does not have to end. Consider touching base with your employees every few months with tips and tricks regarding their benefit plans and how to save costs and utilize the tools available. This will not only make the next year’s enrollment easier due to better understanding, but will make employees feel that they are an equal participant in their benefit plan and taking control of their overall health.

 

We hope these tips will help you to evolve your open enrollment strategy this year. Looking for more insights? Read about what consumers care about during open enrollment and what employees need to know about their HSA and FSA dollars at year end.

 


Lindsay Jacobs WEX Health

Lindsay Jacobs

Marketing Content Strategist at WEX Health

Lindsay Jacobs is a Content Strategist at WEX Health where she focuses on developing strategic and engaging consumer-driven healthcare content to elevate the WEX Health brand and help WEX Health Partners grow and succeed. She graduated with her Bachelor’s Degree from Concordia College in Moorhead, MN and completed her Master’s in Business Administration at Hamline University in August 2018.

6 Best Practices for Engaging Employers and Members with CDHP Plans

10/26/2018

by guest blogger Kathy Anderson, senior manager CDHP operations, HealthPartners

 

I recently worked with Jeff Bakke, WEX Health’s chief strategy officer, to cohost an America’s Health Insurance Plans (AHIP) webinar on consumer-directed healthcare plans (CDHPs) and how they can be used to improve employer partnership and member engagement. In addition to sharing the full webinar with WEX Health Partners (access it here), I’m highlighting some of the best practices that Jeff and I have come across in our work at our respective companies.

 

As uncertain out-of-pocket expenses and rising deductibles combine to put financial strain on more Americans, Jeff and I have both become passionate about the role that CDHPs can play in reducing financial stress and empowering employees to successfully manage their healthcare expenses. But first the challenge is to educate both employers and employees about the plans and to engage them with the accounts before and after open enrollment. Here are six of the chief learnings that Jeff and I shared in our webinar about maximizing engagement with CDHPs:

 

  1. Get involved as early as possible with a new employer. Getting on the same page with an employer is a must. If possible, review their existing plan documentation early on, and gain an understanding of their employee populations and how to best reach them. Not only will this inform your recommendations going forward, but it will allow you to inject account-based plans into the conversation from the beginning.

 

  1. Don’t overwhelm employees with information during open enrollment. Instead, give them the personalized experiences and communications they need when they need it. People can consume only what’s relatable to them in the present. Consider how you can deliver individual employee guided tours, and when certain tips and resources will be best received. Learn more about what consumers care about during open enrollment.

 

  1. Maintain personal touches with employees post-enrollment. Look for ways to continue to create in-person touchpoints with employees, whether with an outreach call after they experience their first medical claim with an HRA account or by hosting a brown-bag session where employees can have their individual questions about their CDHP answered. Here are some more examples of effective uses of personalization in healthcare benefits.

 

  1. When person-to-person isn’t feasible, email is the next best way to communicate. Some employees prefer paper, depending on industry and demographics, but overall, email is the preferred method for employees to receive information about their CDHP accounts. We’ve also learned that, for quick updates, people prefer text messages or automated notifications—e.g., “Your HSA available cash balance is below $250.00.”

 

  1. Help employees track and measure their healthcare goals online. Beyond just working with employees to establish an HSA or HRA savings goal at open enrollment, it’s important to provide tools for employees to be able to measure and track their progress toward that goal and to make changes as needed. Learn more about consumer-driven health and mobile technology.

 

  1. Give employees ongoing access to online tools and resources. Employees need to be able to have their account information at their fingertips when they want it. Dashboard views can give employees a consolidated snapshot of their experience and how their plan is working. People generally don’t spend a lot of time making decisions about their healthcare benefits, but if we can give them the data in an easy-to-use, accessible way, they’re more inclined to make better decisions as they move forward with their plans.

 

We invite you to watch our webinar in full here. And learn more about how personalizing is a key strategy for simplifying the business of healthcare.

 


Kathy Anderson

Senior Manager, CDHP Operations at HealthPartners

At HealthPartners, Kathy Anderson oversees the successful implementation of all Health Reimbursement Account and Flexible Spending Account plans. She partners with Sales to build and maintain strong client relationships and manages the daily administration of these products. She was also the Business Project Manager for the implementation of the WEX Health platform in 2016.

Prior to joining HealthPartners in 2001, Kathy worked as Manager of Health Plan Accounting at United Health Group and was an auditor at KPMG. Mrs. Anderson earned a Bachelor of Science degree in Management and Accounting from Drake University.


Data Talks. Are You Listening

Data Talks. Are You Listening?

09/18/2018

by Becky Kinder

 

At the World Congress Health Plan Consumer Experience and Retention Summit last week, I spoke alongside two other panelists about the importance of listening to the many ways that data talks. My fellow panelists shared that by listening to data extracted from their call center, they had been able to improve the experience of their members—many of whom had questions about how much of their health plan deductible they had met. A simple analysis of call data allowed them to significantly improve an online experience for their members. When paired with the stat from our 2018 WEX Health Clear Insights report that nearly two-thirds of employees are somewhat or very worried about unexpected healthcare needs and associated costs, you get a sense that people can have high levels of anxiety about pre-deductible and unexpected out-of-pocket spending.

Data-listening made simple and actionable

At WEX Health, we work hard every day to help consumers be better prepared—and less worried—about healthcare expenses. One of the ways we do this is by listening to the vast amount of data that’s collected as consumers interact with their benefit accounts.

Data is only useful if you have the right tools to make it actionable.

 

To help our partners leverage data to guide consumers to take the next step, we built powerful analytics tools that reveal useful insights for us and our partners: administrators, employers and consumers.

The data-driven insights found within WEX Health Cloud can be used by our partners to drive a consumer experience that is highly personable and relevant to the next step that a consumer may need to consider. That next step can be small, like contributing through payroll to a health savings account (HSA) or enrolling in a tax-saving dependent care account. Or it can be very daunting—like deciding how and whom to pay when you or a family member succumb to illness. Regardless of where consumers are in their healthcare journey, we want to be there with technology that helps make a difference in their lives.

Using data to personalize outreach to different consumer groups

Listening to data is also important when it comes to understanding how to personalize and reach different consumer segments. For instance, by analyzing aggregate consumers’ interaction with our portals and mobile apps, we found the 35 – 44 age group was more engaged than the 18 – 25 age group. This was a bit of a surprise to some who assumed that the younger population of users would be more likely to use these online tools. Armed with this information, you would want to vary the experience. Online campaigns and engagement may be preferred for the older segment, while outbound phone calls, employer-sponsored events or more interactive experiences may work better for younger audiences. This example is also a good reminder that we must listen to data with “open ears” to avoid missing insights that don’t map to our preconceived notions.

Data inevitably reveals a wealth of ideas that you can translate into action. I’m excited for what WEX Health will uncover as we continue to listen to data, and I’m even more excited about what we will be able to deliver into the hands of consumers through our continuous study. My hope is that we will reduce stress and anxiety and help consumers feel better about their financial wellness.

 

If you have not yet seen the 2018 WEX Health Clear Insights report, you can download it using this link. Also, see this recent blog post exploring the ways that WEX Health Cloud capabilities can be used to analyze, segment and effectively engage with consumers.


What Is a QSEHRA? by Becky Kinder

Becky Kinder

Director, Product Management at WEX Health

As a seasoned member of our Product Management team, Becky drives the definition and development of features for several different functional areas of the software, serving as the voice of our partners, employers, and consumers to our development teams. Specific areas of focus include notional accounts, debit card, admin operations, and the consumer and employer portals. Becky has over 15 years’ experience collaborating on the delivery of technology solutions for the IT and healthcare industries. Since joining the team in 2007, she has defined and launched hundreds of features on WEX Health Cloud platforms.

 

How Healthcare Expenses Are Putting American Workers’ Retirement in Peril

How Healthcare Expenses Are Putting American Workers’ Retirement in Peril

09/11/2018

 

The old and faded American Dream version of retirement calls up sun-drenched images of fun and leisure, and perhaps even ideals about reinvention and new beginnings. But the reality today is much more ominous: Looming retirement is more likely to evoke Americans’ anxiety and/or to serve as an indicator of our naivety (numerous studies show that most of us are terribly unequipped for retirement, but not necessarily aware of it).

In the last couple of weeks, WEX Health has been tracking two new reports, each of which unpack the ways in which healthcare’s rising costs in particular are imperiling retirement for so many Americans. “Health Care USA: A Cancer on the American Dream,” co-released by Willis Towers Watson and the Council for Affordable Health Coverage, and “Preparing for Tomorrow by Fixing Today—Helping Low- and Moderate-Income Americans Thrive in Retirement,” released by the Center for Financial Services Innovation (CFSI), both contained some key takeaways for WEX Health Partners:

 

 

Excessive healthcare costs are reducing employers’ contributions to retirement benefits.

According to the Health Care USA report, compensation for most workers grew between 2000 and 2010, but during that same time period health premiums and the cost of retirement benefits grew 2.25 and 3.25 times the 1990s rates, respectively.

In this report, Willis Towers Watson estimates that employer allocations to health and retirement benefits in 2001 were 41.9 percent for health and 58.1 percent for retirement. By 2015, the split was in the other direction: 63.5 percent for health benefits and 36.5 percent for retirement benefits. As a result, between 2010 and 2015, employers’ average hourly contributions to retirement plans declined by $0.22 compared to the prior decade.

 

 

The situation is worse for people with low and moderate incomes.

The United States is home to 6.4 million seniors who live below the poverty line. The new report from CFSI takes a look at the challenges faced by Americans living at, or even right above, the poverty line. According to Census Bureau data, the typical household that earns less than $67,200 a year has no retirement savings. And only 19 percent of Americans with low and moderate incomes (LMI) say they could make ends meet for at least six months, much less long enough to sustain them during retirement.

 

It’s not necessarily that Americans are less prepared than we once were for retirement; rather, it’s that we once didn’t have to be so prepared for it.

 

We used to be able to count on employer-sponsored defined benefit plans to supply most of our income during retirement, along with income streams from Social Security and our accumulated individual savings. That’s certainly not the case anymore. CFSI data shows that 27 percent of Americans report having less than $1,000 saved for retirement.

 

 

Financial services innovators are needed to educate and empower Americans to prepare for retirement.

CFSI calls on financial services providers to help LMI retirees enjoy a financially healthier retirement by developing ideas and solutions that rethink the user experience, customer service, marketing and distribution from the consumer’s point of view.

 WEX Health’s guiding purpose to “simplify the business of healthcare” is far more than a tagline. As a proud member of the CFSI Financial Health Network, we are partnering with CFSI to find more ways to make it easier for individuals to better prepare for healthcare expenses and retirement. Learn more about CFSI and the CFSI Financial Health Network here.

WEX Health 5 Back-to-School Expenses You Can Cover with Your HSA, HRA or FSA

5 Back-to-School Expenses You Can Cover with Your HSA, HRA or FSA

08/29/2018

 

What do reading, writing and arithmetic have to do with your consumer-directed health (CDH) account? You may not know that you can use the funds you’ve been squirreling away in your health savings account (HSA), health reimbursement arrangement (HRA) or flexible spending account (FSA) to cover some of the back-to-school expenses that hit all at once this time of year. To mitigate those costs, here are five things you can use your CDH account to pay for now:

 

  1. Vaccinations: Need to get up to date on immunizations before school starts? They’re eligible for reimbursement with an FSA, HSA or HRA. And when flu season follows, don’t forget you can also use your CDH account for your annual flu shot. The Centers for Disease Control and Prevention recommends that anyone over the age of 6 months should get a flu vaccination each year to build up an immunity to the virus prior to flu season.

 

  1. School and sports physical exams: You can take care of this standard checkup with the funds you’ve saved into your FSA, HSA or HRA. For children heading back to school or onto a sports field, these annual exams are necessary to assess their physical well-being, build their medical history and gather the necessary paperwork to ensure that they’re up to date on state-required vaccines.

 

  1. Eye exams and corrective eyewear: Speaking of physicals, your child’s physician will likely check their eyesight during their physical. But should he or she need the services of an optometrist or ophthalmologist, you can also turn to your CDH account to cover the cost of both the eye exam and any corrective eyewear, including prescription glasses and contacts.

 

  1. Certain medical and orthopedic supplies: With back-to-school germs and boo-boos (acquired both on playgrounds and sports fields) on the horizon, you’ll be happy to know that you can use your FSA, HSA or HRA to stock up ahead of time on things like bandages, children’s pain relievers, first-aid kits, lice treatments and thermometers. Likewise, certain orthopedic supplies for student athletes are also eligible for reimbursement, including ankle, knee and back braces/wraps, athletic tape and arch supports.

 

  1. Acne treatments: The most common skin condition in the U.S., acne is extremely prevalent in pre-teens and teenagers especially. Eighty-five percent of people ages 12 to 24 experience at least mild acne. Acne is considered a disease, so the cost of treating it, whether with OTC meds, topical prescriptions, antibiotics or other medicines, qualifies as an eligible expense for CDH account holders.

 

With the number of active high-deductible healthcare plans (HDHPs) on the rise, CDH accounts are also becoming far more common, as consumers look for ways to take more financial responsibility for their healthcare expenses. This makes it more important than ever to educate consumers about their HSA, HRA or FSA and what expenses can be covered by these accounts.

 

Have questions about health savings accounts? We have answers to the most common questions about these tax-advantaged savings vehicles.

5 Reasons WEX Health Is a Great Place to Work

08/27/2018

by Sherry Olson

 

How does WEX Health simplify the business of healthcare? With the help of great people. By the end of this year, we anticipate hiring at least 50 more creators, innovators and leaders to join our staff. To accommodate our continued growth, we’ll have positions to fill across our offices. And on the heels of our very successful WEX Health Career Fair, I want to tell you what sets WEX Health apart as an employer and why you may want to consider joining our team:

Continue reading

Brokers, Look for an HSA Provider Who Does These 4 Things

Brokers, Look for an HSA Provider Who Does These 4 Things

08/14/2018

by Angela Greenhalgh

Originally posted on BenefitsPro.com

 

When securing new employer group clients, a strong HSA vendor can be one of a broker’s greatest allies. Not only can the right vendor make the job easier for both you and the employer, but it can further your reputation, leading to retention and more revenue. The ideal HSA vendor should provide expertise that complements your own in the following ways:

 

They know how to empower employers to help employees make better healthcare decisions.

The 2018 WEX Health Clear Insights Report, which surveyed more than 1,000 U.S. workers with employer-provided health insurance, found that most consumers with consumer-directed healthcare (CDH) plans need help figuring out how much money to set aside to cover deductibles and help with managing their doctor bills. Keeping consumers’ limited health literacy in mind, your HSA vendor should have a tight grasp on these and other employee pain points and have a plan to educate employer groups in ways that allow them to influence the desired action during open enrollment and beyond. This includes providing employers with consumer-facing education pieces, tools and continued support to ensure that employees understand how to manage their accounts outside of the open enrollment season. There are now platforms and apps, for example, that allow employees to scan a product bar code to instantly determine whether an expense will be covered by their HSA and online dashboards that show employees their spending trends year-over-year, by expense type and even by family member.

 

They understand the power of personalized employee engagement.

When asked to select all the tools and resources they would find most helpful to become educated about their healthcare plan options, consumers ranked highest those that compare plans, estimate costs and calculate savings—all tools that yield personalized results. Deloitte’s 2017 survey of U.S. healthcare consumers corroborates this, finding that personalization—including clear communication and sensitivity—was rated as respondents’ top healthcare priority. To grab and hold employees’ attention and drive desired behaviors, your HSA vendor should offer numerous ways for you to customize messaging, allowing employer groups to send data-driven communications directly to employee populations.

 

They bring one integrated platform to the table. 

Your CDH vendor should provide an intuitive technology platform that removes the complexity of managing multiple accounts, allowing employer groups to manage numerous plans and products seamlessly as well as to customize plans and portal designs. This will lessen the administrative burden on both you and the employer group, which helps to save on time and costs, not to mention resulting in less confusion for employees. Look for a platform’s integrated capabilities to include claims and EDI feeds, payroll, claim reimbursement invoices and automatic investment allocation.

 

Their reputation precedes them.

You should ask a lot of your HSA vendor: They should make the entire enrollment process seamless for your employer groups and their employees, increasing engagement and ultimately enrollment. But that’s not all. Vendors must also be known for their ability to pair up complex CDH account strategies that will satisfy the needs of employees while helping to control costs for the employer (such as pairing an HSA with a limited-purpose FSA). The best vendor will also continuously monitor—and demonstrate thought leadership on—industry trends and technology advancements. This will ensure that your clients receive top-tier services and are properly informed about any trends that could affect their benefits plan designs.

As a broker, you’re well-aware how relationship-based this market is. To reinforce your important relationships with employer groups, partner only with the best-of-the-best CDH vendors.

 

Want more? Download the Clear Insights Report here.

 


Angela Greenhalgh

Angela Greenhalgh

Vice President of Vertical Sales at WEX Health

Angela Greenhalgh has over 25 years working in health care and supporting the needs of employers, health plans, consumers, and members. She has been with WEX Health for almost 2 years where she focuses on educating and nurturing relationships with brokers and consultants. Previously, Angela spent nearly 9 years at Truven Health Analytics (now part of IBM Watson Health) where she worked to solve the data analytic, consumer engagement, and data warehousing needs of those same constituents. Her varied positions and collaborations with many brokers and consultants has fostered an understanding of the powerful role trusted confidants and relationship building plays when assisting employers with their benefits designs.


West Fargo, Join Us for the WEX Health Career Fair

West Fargo, Join Us August 16 for the WEX Health Career Fair

08/09/2018

 

WEX Health is hiring for our North Dakota location! And you’re invited to attend the WEX Health Career Fair to learn about our fast-growing payments company, career opportunities and how you can make a difference.

 

When:

Thursday, August 16, 2018, 1 p.m. – 6 p.m.

 

Where:

WEX Health

700 26th Ave. East

West Fargo (south of Costco)

 

What:

We’re seeking qualified candidates for multiple opportunities, including customer service specialists, technical roles and more. We’re looking for people who are passionate about providing great service, who like to solve problems and who deliver results in a fun work environment. WEX Health is a place where you can grow your existing skills, cultivate new ones and take your career to the next level. Please bring your resume.

 

Unable to attend our career fair? Visit our careers page or email your resume to careers@wexhealthinc.com.

Must-Listen Podcast: Opportunities for Banks in the HSA Market

Must-Listen Podcast: How Consumers View and Engage With Their Healthcare Benefits

08/08/2018

 

Jeff Bakke, Chief Strategy Officer at WEX Health, is a featured guest on Besler’s Hospital Finance Podcast. He discusses the findings of the WEX Health Clear Insights Report which looks at how consumers view and engage with their healthcare benefits.

We invite you to take a listen:

 

Visit the full blog post here

More Than Half of Employers Now Offer HSAs to Help Them Recruit and Retain Talent

More Than Half of Employers Now Offer HSAs to Help Them Recruit and Retain Talent

07/31/2018

by Sherry Olson

 

In 2018, employee benefits make up approximately one-third of a company’s total compensation costs. To maximize an employer’s return on this investment, it’s critical for HR departments and organizations as a whole to take a strategic approach to designing their benefits packages. This will also make it easier to recruit and retain talent in a candidate-driven market at time when the unemployment rate has declined by approximately 20 percent between 2015 and 2017, and in the last year, 14 states set record lows for unemployment.

 

A good place to start when looking to inform your approach to benefits planning? In addition to WEX Health’s Clear Insights report, the Society for Human Resource Management (SHRM)’s annual Employee Benefits report should be required reading. Springing from its survey of U.S. employers, it tracks the evolution of benefits offerings including healthcare, wellness, paid leave, retirement savings and planning, work/life and convenience, financial and career, professional and career development, travel and relocation benefits. Below are four key findings we pulled out that are relevant for our WEX Health Partners.

 

  1. More Than a Half of Employers Now Offer Employees Health Savings Accounts

Given the increase in the prevalence of organizations offering Consumer-Directed Healthcare Plans (CDHPs) since 2014 (30 percent in 2014 versus 40 percent in 2018), it is not surprising that Health Savings Accounts (HSAs) have also increased in popularity, with more than one-half of employers offering this benefit in 2018 (56 percent), as compared to 45 percent of employers in 2014.

 

  1. Popularity of Health Reimbursement Arrangements Remains Steady, While Interest in FSAs Has Declined Slightly

In contrast, the percentage of organizations offering health reimbursement arrangements (HRAs) has remained steady at 17 percent to 20 percent over the past five years; flexible spending accounts (FSAs) have declined from 68 percent in 2014 to 63 percent in 2018.

 

  1. PPO Plans Are Still the No. 1 Choice, with Consumer-Directed Healthcare Plans in Second Place

Preferred Provider Organization (PPO) plans continue to be the most popular (84 percent), followed by CDHPs (40 percent), Health Maintenance Organization (HMO) plans (35 percent), high-deductible health care plans not linked to an HSA or an HRA (29 percent), and point of service (POS) plans (17 percent); less than 10 percent of organizations offered other types of healthcare plans.

 

  1. The Prevalence of CDHPs Has Been Volatile the Past Five Years But Things Are Looking Up Again

In a 2016 SHRM survey, 28 percent of HR professionals indicated that offering CDHPs was the most successful activity in terms of helping their organization control the costs of healthcare. However, the prevalence of CDHPs has been volatile over the past five years, falling by 11 percentage points between 2015 and 2017 and then increasing 17 percentage points (to 40 percent) between 2017 and 2018.

 

More than two-thirds of organizations increased their benefit offerings to retain employees in the last year. According to SHRM, “Second to compensation planning, designing a strategic benefits plan is the most important step organizations can take to stay competitive. Once a strategic benefits program is in place, the next step is to ensure effective communication of benefits to both current and potential future employees.”

 

The WEX Health Cloud platform can help employers personalize communications with their employees and customize data to help employees make the most of their CDHP. Learn more here.

 


Sherry Olson WEX Health VP of Human Resources

Sherry Olson

Vice President of Human Resources at WEX Health

Sherry specializes in implementation for human resources policies and practices, benefits, rewards, performance management and HR efficiencies. During her 20-plus years in the corporate world, Sherry has served in HR positions in healthcare, high-technology software development and banking. She holds designations as a SHRM Senior Certified Professional, a Global Professional in Human Resources (GPHR), Senior Professional in Human Resources (SPHR), a certified Discovery Insights Practitioner and career advisor, President-Elect for the Agassiz Valley Human Resources Association (AVHRA) organization.