AccountId: 011433970860
ContactId: 13e37a10-9a57-4999-b7e1-07a5daa17db0
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 711200 ms
Total Talk Time (AGENT): 365907 ms
Total Talk Time (CUSTOMER): 208835 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/16/13e37a10-9a57-4999-b7e1-07a5daa17db0_20250516T19:14_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi there. I'm wanting to double check a couple of things. Um, I had the cancer coverage on my TRS active care plan or added into it with it, um, year before last, and I'm looking it up and I'm not seeing it on here now.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, what's your name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And [PII], can I get a good phone number in case we get disconnected?
[CUSTOMER][NEUTRAL] Yes ma'am. [PII].
[AGENT][NEUTRAL] OK. And what is the policy number?
[CUSTOMER][NEUTRAL] Which policy number do you need? TRS or?
[AGENT][NEUTRAL] Did you get an ID card that has a policy certification number on it at all for either of them?
[CUSTOMER][NEUTRAL] Who would it be, who would it be from is what I'm asking.
[AGENT][NEUTRAL] Uh, it should be from APL.
[CUSTOMER][NEUTRAL] Because I called TR OK, I don't have one from APR. That's what I was trying to figure out because I called TRS and they were like it said it was a different company, so I wanted to make sure.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So no, I don't remember ever getting a card.
[AGENT][NEUTRAL] OK. Um.
[AGENT][NEUTRAL] OK, let me see if I can look you up by your social security number is that OK?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, what's your social?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, one moment, let me see if I can pull you up.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I'm showing you have several policies with us, but it looks like they are all
[AGENT][NEUTRAL] Lapsed. Let me check real quick. Let me get into one and see what's going on. Um, can I get you to verify your date of birth?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK. And your mailing address, phone number, and email.
[CUSTOMER][NEUTRAL] [PII] [PII] should be the email on file, but if it's something else let me know and uh [PII].
[AGENT][NEUTRAL] It's a different email but let me, I can check on a different screen too. Everything else is fine.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yes, that's the one that we have.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Alright, let me see.
[CUSTOMER][NEUTRAL] Sometimes they make us put in our personal email instead of our school, so.
[AGENT][NEUTRAL] Yeah, I'm showing your policies with us through APL are lapsed. Um, I just looked up one of your policies and this is a uh
[AGENT][NEUTRAL] This is a uh group cancer policy it looks like and it looks like that one lapsed on
[CUSTOMER][NEUTRAL] Yeah, that's what we were looking for.
[AGENT][NEUTRAL] [PII]. So, what I would do is call your employer or whomever you all use um your HR department.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Might be your best bet um and see what all is going on because we're right now we're showing all three of your policies with us are lapsed.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, because it's still an option on here because I'm on our benefits hub for the district.
[CUSTOMER][NEUTRAL] So I know it's still an option. Um, what were the other two policies?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me go in and look.
[AGENT][NEUTRAL] It looks like you have two separate group cancer policies. Um, it could just be that one, nope, they were at the same time. Um, you have two group cancer policies with us and a hospital indemnity policy. It looks like the one that I just, I picked at random, the one that I told you about lapsed on [PII], while the other two lapsed.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] [PII]. So I would contact your employer's HR department and see what's going on.
[CUSTOMER][NEUTRAL] OK, and then my other question is if I mean if they can't do anything if we add it back on this next year because of course we've got benefits coming back up in August when the school year starts again.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Will that cover pre-existing if I'm diagnosed before?
[AGENT][NEUTRAL] It depends on the plan that they that your employer picks. It will, it, it will because since these are lapsed for so long, it might be that your employer goes with a different insurance company or your policy will be changed, um, because you even if you wanna add anything to it.
[CUSTOMER][NEUTRAL] I renew it.
[AGENT][NEUTRAL] Uh, that will, that will all go through your employer depending on what your employer buys through us. So they're given so many options that they buy from us and then they give it to you all. So it depends on what they have. So that would be another.
[CUSTOMER][NEUTRAL] How would we know which one it is because I'm looking at next year's benefit options.
[AGENT][NEUTRAL] Um, I won't have that. That would again be a question for your HR because they're the ones who buy through us, so they would know your benefits before we can. We can only see it when we have a policy with you.
[CUSTOMER][NEUTRAL] But you can't tell me if I add the policy whether or not it'll cover, I mean I'm like I said I'm looking at our HR hub that's showing benefits for next year.
[CUSTOMER][NEUTRAL] And what's gonna be available and it includes your that's where I found your phone number.
[AGENT][NEUTRAL] Right, because we have so many different ones I can't look up what your employer picks from us um that would be your employer because they've already bought them.
[CUSTOMER][NEUTRAL] Does GC 14 doesn't mean anything.
[AGENT][NEUTRAL] I have the GC 14 CL4 um and that one is the one that lapsed in August of last year.
[CUSTOMER][NEUTRAL] That's what's listed as the option for next year.
[AGENT][NEUTRAL] Um, and
[AGENT][NEUTRAL] OK, let me pull that one up and see what all it has again this will be a um based off of your old one so it could change if they bought a different one.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Because there's many types of those and it depends on if your employer.
[AGENT][NEUTRAL] Buys a different kind of policy that is also a CL. Let me look.
[CUSTOMER][NEUTRAL] Of the GC 14.
[AGENT][NEUTRAL] Right, we have many different kinds and your employer may choose to pick a very expensive kind. They may choose to pick a very basic kind. It's up to the employer which one they want because we do have several policies of those, um, let me see.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] This just says plan 1 plan 2, level 4, I don't even know.
[AGENT][NEUTRAL] You have, you had level 4 last time, um.
[AGENT][NEUTRAL] I won't be able to look at the other levels since there isn't one with that, so give me just a second and I can check that out for you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And again this is a verification of benefits and not necessarily a guarantee of payment and also this is from I am pulling from your your old policy uh so if things change um I won't have access to any of the new stuff. I can only give you what you have, you had uh last year. Let me check and you're asking about preexisting conditions correct?
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Basically, I just had a biopsy done yesterday that we're supposed to get the results back for next week, so I was hoping this coverage was still active. Obviously it's not, which I can reach out to HR about, but if I can't add it back on now or we can't figure that out, and I can add it on in August, but I've been diagnosed at that point, this is, of course, worst case scenario if the diagnosis comes back less than favorable this next week.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] My concern is, can I add this back on and it helped cover anything from that point.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Even if I've been diagnosed 2 months before those benefits renew.
[AGENT][NEUTRAL] Right, right.
[CUSTOMER][POSITIVE] I went in for scans a year and a half ago and was told there was absolutely nothing to worry about, so we haven't worried about it. Then I went in 2 weeks ago and was told I have something to worry about.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] OK. Um.
[CUSTOMER][NEUTRAL] So now we're trying to verify these coverages that apparently aren't there anymore.
[AGENT][NEUTRAL] So this old policy that you had.
[AGENT][NEUTRAL] Cut a pre-existing condition period of 12 months.
[AGENT][NEUTRAL] And let me see, and a pre-existing condition exclusion period of 12 months.
[CUSTOMER][NEUTRAL] What does that mean?
[AGENT][NEUTRAL] Uh, I'm looking it up because I, I need to check that too, um, because it's different per policy. Don't, don't worry, you are on the same page.
[CUSTOMER][NEUTRAL] OK, so
[CUSTOMER][NEUTRAL] That's fine. That's OK.
[CUSTOMER][NEUTRAL] But yeah, because I like I the stuff that I printed out from the website that showed all the plans that's all it's got like one paragraph on preexisting condition exclusion, but it doesn't tell me what that means.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So
[AGENT][NEUTRAL] No benefits are payable for any loss incurred during the pre-existing condition exclusion period.
[AGENT][NEUTRAL] Following the the covered person that would be you, effective date as a result of the pre-existing condition. So yours is a 12-month waiting period. OK.
[CUSTOMER][NEGATIVE] So if I'm diagnosed next week, I'd have to wait a year before this benefit would even be beneficial.
[AGENT][NEUTRAL] That's what this one is saying and again this is your old policy, um, if they're offering you multiple levels, I would talk to your HR and ask them if they bought one without that exclusion, uh, that preexisting condition exclusion. Um, let me see, I'm double checking on the new.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] I'm just double checking and making sure that I got everything.
[CUSTOMER][NEUTRAL] That's fine.
[CUSTOMER][NEUTRAL] Because there's nothing I can do through y'all to add that back on correct?
[AGENT][NEUTRAL] Right, that because it's through your employer, you'd have to go through your employer.
[AGENT][POSITIVE] OK. I'm still double checking making sure that I got everything that's needed.
[AGENT][NEUTRAL] Just telling me the same thing. So yeah, everything that I just told you is what's on your old policy, um, so what I would do since your since your employer is does have different options, I would talk to them because they should have um all of the different policies there with them since we have so many of them I can't just look up a generic policy because it might not apply to what your employer included specifically.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] And I would talk to them about why you got lapsed last year.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Is there anything else I can help you with?
[CUSTOMER][POSITIVE] Alright, I can do that. No, that'll be all thank you.
[AGENT][NEUTRAL] OK
[AGENT][POSITIVE] Right, thank you so much for calling APL and have a great day.
[CUSTOMER][POSITIVE] You too thanks.
[AGENT][NEUTRAL] Bye.