AccountId: 011433970860
ContactId: 232f3f7d-aef9-4f48-8f92-829efbd76444
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 196380 ms
Total Talk Time (AGENT): 80501 ms
Total Talk Time (CUSTOMER): 113352 ms
Interruptions: 1
Overall Sentiment: AGENT=0.7, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/23/232f3f7d-aef9-4f48-8f92-829efbd76444_20250423T12:46_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling ATL.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] Hey [PII], good morning [PII].
[AGENT][NEUTRAL] I see.
[CUSTOMER][NEUTRAL] How are you?
[AGENT][POSITIVE] I'm pretty good.
[CUSTOMER][NEUTRAL] Well good. I, uh, just worked the renewal for a group called M and R Distributors and, um, you know, the owner said, hey [PII], you know a few of my employees are complaining about APL. I said, well, they probably don't know how to use it. He said, yeah, you're right, get me a new uh plan summary description so I just requested that with one of your associates.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Um, but he also asked me could he get a utilization report, and I said I don't know if a group your size would have availability of utilization. Uh, the group number is 22592525925. I think they're utilizing it pretty heavily, uh, because they got a rate increase.
[AGENT][NEUTRAL] So
[AGENT][NEUTRAL] Right, that's probably a good indication, but [PII], they're a small group. If we released, you know, any kind of utilization that can potentially, you know, release some PHI that, you know, we can't, we're, you know, we can't rightfully do.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Why is it different in large group?
[AGENT][NEUTRAL] Because there's more of a, you know, there's a larger group to spread out the claims, whereas if you have a small group, an employer could potentially like if there are a lot of claims they could potentially point them to one or two employees.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So we just anything under 50 we we don't.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So it's, it's it's it's basically the risk, the risk of claim matching.
[AGENT][NEUTRAL] Yeah, so I mean if they got a rate increase I would assume that that's due to their using the plan.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] So isn't there a formula? I mean I think Russell told me uh at some point or sent me something that uh if utilization is above a certain level it triggers a certain rate increase.
[AGENT][NEUTRAL] Sorry
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Um, no, I'm not sure what I, I know there are some formulas that probably our underwriters use. I, I am not familiar with those, and you know those are.
[CUSTOMER][NEUTRAL] You could, you could ask [PII] because Russell had sent me something on it a while back and I think you know if you, if the utilization is at, uh, you know, uh, let's just say equal to the the premium then this happens if it's 120% more this happens if it's 150% more, and then they do something where if it's over a certain level for 3 of uh uh for two of the past 3 years then the group can be declined, you know, things like that.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Right, that's now that is true. I do know that, so, uh, but I don't have access to those or, you know, I mean.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEGATIVE] Unfortunately
[CUSTOMER][POSITIVE] OK, all right, well thank you very much.
[AGENT][POSITIVE] Not a problem, [PII]. I'll get that brochure over to you just as soon as I can.
[CUSTOMER][NEUTRAL] OK, well, I, yeah, I think your team is working on. I spoke with [PII], I think this, you know, 10 minutes ago.
[AGENT][NEUTRAL] Right, yeah, she sits, she, she sits next to me, so I'm gonna work on it for her.
[CUSTOMER][POSITIVE] OK, thank you very much appreciate it.
[AGENT][POSITIVE] Thanks team have a good one.
[CUSTOMER][NEUTRAL] You too bye bye.