AccountId: 011433970860
ContactId: 3e070679-8ff8-44f5-a4bb-ec7ae514068d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 419519 ms
Total Talk Time (AGENT): 218112 ms
Total Talk Time (CUSTOMER): 175620 ms
Interruptions: 7
Overall Sentiment: AGENT=0.6, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/07/3e070679-8ff8-44f5-a4bb-ec7ae514068d_20250507T20:25_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Hi, my name is, um, I'm calling regarding, I've got questions regarding some benefits I received from my employer.
[AGENT][NEUTRAL] OK. um, may I have your name and a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Um, it is [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And do you have the policy number, Miss [PII]?
[CUSTOMER][NEUTRAL] Um, yeah, well, I don't have the policy. I want to enroll, but I have questions. Does that make sense?
[AGENT][NEUTRAL] Oh, OK. So, um, who's who's your employer?
[CUSTOMER][NEUTRAL] Who is what?
[AGENT][NEUTRAL] What's your employer?
[CUSTOMER][POSITIVE] It is superior skills, skilled trades.
[AGENT][NEUTRAL] OK, let me see if I can find that group. One moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so it's benefits in a card. OK, um.
[AGENT][NEUTRAL] How may I help you?
[CUSTOMER][NEUTRAL] My question is, um, like,
[CUSTOMER][NEUTRAL] The, let me get down to it. So my question is related to the um like the VIP classic um it says additional uh insurance products uh is, is that.
[CUSTOMER][NEUTRAL] 5, is that $500 a day? Is that the co-pay for a hospital admission? And is it one day?
[CUSTOMER][NEUTRAL] Or is this with the rider?
[CUSTOMER][NEGATIVE] I don't understand where the benefits are, what they look like.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. So you're looking at the hospital indemnity plan. Is that what you're looking at?
[CUSTOMER][NEUTRAL] Well, it says plan benefits services. I, I guess this is a multi-plan and it's backed all up, so I don't quite.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Understand what they're offering, like what, like, like what is, what would, what, what would uh like to see your primary doctor be?
[CUSTOMER][NEUTRAL] Is that, so the endility would pay you back.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] It really depends. OK, I'm, I'm looking at the group and I see several options on this group, so it's not just one option. I see option 1, level 1, level 4, level 2. So there are many, many options. Um, so basically our plan.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, are you an insurance agent?
[AGENT][NEUTRAL] This is the customer care team which we handle the costs for any um benefits like if you already have an account set up with us or um if you need your benefits, your policy, your claims, all that information, we handle that part. If you're trying to just get the information about.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] How it is covered or what plans are offered to you, usually you need to contact benefits in a card. Now if you're asking about the daily hospital confinement benefit or admission benefit, it is a flat amount. Any of our hospital indemnity plans, those are flat amounts.
[AGENT][NEUTRAL] So they can range from I think 50 to 200 a day or um 50 to 2000 for a mission one time. So you, there's some that you get to choose how many days you want to have like um you can choose from I think it's 1 to, if I'm not mistaken, 4 or something like that depending on the plan they're offering you.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Um, but yeah, it will be a flat amount. So just an example, if you see an office visit benefit of $50.04 times per year, then the amount that we're gonna pay is the $50. So if the visit is $150 you're responsible for that $100 and we pay the $50.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Good.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] OK, OK, so it's gonna be whatever the doctor, like if you had a, uh, if you go to the doctor, he says the bill is $500 you pay 100, you're still gonna pay 400.
[AGENT][NEUTRAL] Mhm. Yeah, this
[AGENT][NEUTRAL] If we pay just 100 for the visit, you're gonna pay the 400. Yes, correct. Yeah, it, it, it's gonna be just the amount that is listed because it is a limited policy. Mhm.
[CUSTOMER][NEUTRAL] I'm money that we're gonna pay.
[CUSTOMER][NEUTRAL] 400, yeah, yeah, OK, got you.
[CUSTOMER][NEUTRAL] OK, so, um.
[CUSTOMER][NEUTRAL] So, do you understand the, the, the stay healthy Mac or is that benefits on the card that I ask?
[AGENT][NEUTRAL] For stay healthy, it's going to be under IMA.
[AGENT][NEUTRAL] They're the ones that handle any preventative service.
[CUSTOMER][NEUTRAL] They're the ones that
[CUSTOMER][NEUTRAL] OK, alright.
[AGENT][NEUTRAL] That's a different company. I can give you their number if you need it, but yeah, your card is gonna be divided in several different companies including IMA Superiorvision, um.
[AGENT][NEUTRAL] Us, American Public Life, um, probably a different one for your pharmacy, Farmvale. So it's gonna be a lot of companies in one card.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, but if someone has um like pre-existing conditions, I see that you don't cover it, but if they're having a lot of doctor visits, this wouldn't be ideal, is what I think I'm seeing and understanding.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] If you have a major, um, yeah, if you have major medical issues or like if you go to the doctor a lot or if you have a sign that you're treating, you probably need a uh major medical, um, that is the one that covers like percentages, amounts and stuff like that.
[CUSTOMER][NEUTRAL] Because it's limited.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] I agree with you, girl. I agree.
[AGENT][NEUTRAL] This is more like for if you don't really go a lot to the doctor and you need something just to have it just in case if you need it, it will be great because it is a limited policy, but if, if you're gonna be going there constantly, um, then you probably are, you know, you probably need a major medical. Mhm.
[CUSTOMER][NEUTRAL] OK. All right.
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] So let me ask you this, um,
[CUSTOMER][NEUTRAL] So for surgery in the hospital, it's gonna pay, uh, it's, it, it, you, it says surgery in the hospital 500. That means no matter what that bill is, you're gonna pay 500.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] You as in the cus the company and then I will be responsible for the rest.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] Right, OK, alright, I appreciate you. You, you, you were able to answer most of my questions. I apologize and I appreciate your time and if we decide, we'll get back with you, OK? Alright.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] All right, no problem, Miss.