AccountId: 011433970860
ContactId: 7edd9b19-0868-4f49-92f8-e5344268ce03
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 591479 ms
Total Talk Time (AGENT): 307621 ms
Total Talk Time (CUSTOMER): 242885 ms
Interruptions: 4
Overall Sentiment: AGENT=0.4, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/28/7edd9b19-0868-4f49-92f8-e5344268ce03_20250228T20:30_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling AL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Hi [PII], um, my name is [PII]. I'm calling from Ms Charter School. How are you?
[AGENT][POSITIVE] I'm doing well how are you?
[CUSTOMER][NEUTRAL] Very well. OK, I need some assistance and I should have done this a long time ago, but.
[CUSTOMER][NEUTRAL] I have, I had open enrollment [PII] and uh we've had APL for quite a while now.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] My boss had and his wife had their own individual plans um since we started with APL.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, she decided to, she's no longer working with us, so now it's a family plan.
[CUSTOMER][NEUTRAL] It's not an individual plan. And I know, and I can't remember for the life of me, who I sent that application to. I don't remember if it was the middleman that reports to you.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Or anything I've looked through my emails and I've exhausted my emails. I just need it fixed, um, I don't know if if you need their social so you go look at their history, because she was active until October, I mean [PII].
[CUSTOMER][NEUTRAL] So his family plan would have kicked in [PII].
[AGENT][NEUTRAL] OK, so essentially they were both on individual policies and then they went together on a single policy for, OK, and so are we just needing to verify that information?
[CUSTOMER][POSITIVE] Correct, and they just merge together.
[CUSTOMER][NEUTRAL] OK, um, it's not on. They finally took her off her own.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Her, cause she had her individual plan. They finally took it off, but they never added her to his plan.
[AGENT][NEUTRAL] Oh, I see. OK, OK, so we're, I understand. OK, I understand. Just wanted to make sure we're on the same page, um, really quick, [PII], that's OK.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Yeah, I'm sorry, it's confusing and it's, and I've had issues with.
[AGENT][NEUTRAL] So the intention was her policy terminated individually with the intention of her become going on to his policy, but but she hasn't.
[CUSTOMER][NEUTRAL] all of it.
[CUSTOMER][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Joining a family, as a family because they have a daughter.
[AGENT][NEUTRAL] OK, OK, so we just need to verify and make get her added on there. OK, um, [PII] really quick if you don't mind, can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] She has not, yeah.
[CUSTOMER][POSITIVE] Please. Thank you.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] [PII] OK.
[AGENT][NEUTRAL] And then do you have a policy number or you said a social, I could do a social too, that's fine.
[CUSTOMER][NEUTRAL] I have, OK, I have, yeah, I have all their socials. OK. Um.
[AGENT][NEUTRAL] OK, um, let's do his, um, as that's where she needs to be.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you one moment and then really quick, [PII], I'm sorry, what was your relation? Are you a group the admin for the group?
[CUSTOMER][NEUTRAL] Yes, yes.
[AGENT][POSITIVE] You are OK perfect and then what was his name please?
[CUSTOMER][NEUTRAL] [PII]?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] And you have his date of birth?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] OK, thank you. One moment please.
[AGENT][NEUTRAL] And this was through Miami Arts Inc.
[CUSTOMER][POSITIVE] That's correct.
[AGENT][NEUTRAL] OK. There you are. [PII], what was your last name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Um, I think I've got a different last name for you here. [PII], yeah.
[CUSTOMER][NEUTRAL] [PII]? Yeah, they never changed it. That's fine.
[AGENT][NEUTRAL] Oh, OK, OK, OK, no worries. That's fine as long as long as that's you, that's fine. OK. Let's take a look here. So I've only got one policy for [PII], and he is the only member listed under this policy. Um, this is the secondary medical. I don't show that he has any other policies with us.
[CUSTOMER][NEUTRAL] That's me.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] No, you don't. She had her own policy with her daughter. She had an employee and child one up to [PII].
[AGENT][NEUTRAL] Oh, she was the one. OK. But that one was supposed to go onto his or he was supposed to go on to theirs?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] She, the wife and the daughter are supposed to go on to his.
[AGENT][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] And you did send it you said you sent that information to you believe you sent it to the broker?
[CUSTOMER][NEUTRAL] I, I believe, honestly right now I've looked through all my emails. I can't find the email. I know I sent it to somebody. I just, I just need it fixed at this point because, and I think the confusion was that they kept on seeing her name. And it was because she's always had a policy. So, I've had the same issue with our medical and our dental. I've had to go through this because it's kind of confusing I guess because her name does pop up, but it just pops up as individual, as employee and child and not family.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Right, OK.
[AGENT][NEUTRAL] Let's see, give me just a moment. I'm gonna go ahead and try to find hers and make sure that that is active. Um, does she have the same last name?
[CUSTOMER][NEUTRAL] right
[CUSTOMER][NEUTRAL] Yeah, I have her social.
[AGENT][NEUTRAL] That's OK since I have that she's part of the same group, right?
[CUSTOMER][NEUTRAL] Yeah, yeah, yeah.
[AGENT][NEUTRAL] OK, does she have the same last name?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Well, that might be a problem. Let's see.
[AGENT][NEUTRAL] What was her first name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yeah, I don't show her as active.
[AGENT][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] You you show her as active?
[AGENT][NEUTRAL] I do not. Um, let me try to look at the labs now.
[CUSTOMER][NEUTRAL] Oh, you do not?
[AGENT][NEUTRAL] De la Rosa. There is [PII]. OK.
[CUSTOMER][NEUTRAL] Do you see that she has a daughter under her or she had her daughter under her? They're all supposed to be together.
[AGENT][NEUTRAL] Uh, [PII] and [PII], OK, yes, yeah, OK, I see. So that was this one terminated [PII] just for good measure, OK.
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] Man, all right, so let's try to get this figured out. Give me just a moment, um.
[CUSTOMER][POSITIVE] I'm sorry. Thank you.
[AGENT][NEUTRAL] No, no, you're all right. I'm just gonna be completely honest with you I'm not quite sure um what to do with these situations. I would usually tell the insured to go to their employer so um if you don't mind [PII], I'm gonna put you on a brief hold and I'm gonna reach out to our group billing department to see if they know uh how best to handle this give me just a moment.
[CUSTOMER][POSITIVE] OK, perfect. Thank you.
[AGENT][POSITIVE] No worries.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] F.
[CUSTOMER][NEUTRAL] Customer service department. How may I help you?
[AGENT][NEUTRAL] Hi, I'm sorry, who is this?
[CUSTOMER][NEUTRAL] This is [PII].
[AGENT][NEUTRAL] [PII], hey, this is [PII] on the care team. How are you?
[CUSTOMER][POSITIVE] I'm doing good how about yourself?
[AGENT][NEUTRAL] Doing all right, thank you. Um, I've got a weird situation and frankly I'm not sure um if you can help or not. Um, I'm speaking with a group admin and apparently what had happened was there was a couple, a husband and a wife that worked together that had individual policies. The intention was that she cancels her individual and gets onto his as a family.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, and I don't know, I guess they lost track of where they sent the applications for that if they sent it to the broker they don't remember, um, but at this point she said you just need it fixed, um, because the spouse, um, her policy is terminated. His, he's still the only one active on his policy, so I guess they don't know how to add her and make it a family policy.
[CUSTOMER][NEUTRAL] We need an email, but I can talk to them. What's the policy number?
[AGENT][NEUTRAL] Um, that is uh 163-739.
[CUSTOMER][NEUTRAL] You cut out, huh. What was the last part, 39?
[AGENT][NEUTRAL] They could just send that information to uh to the.
[CUSTOMER][NEGATIVE] You're cutting out. You're cutting in and out.
[AGENT][NEUTRAL] Oh, I'm sorry. Can you hear me OK?
[CUSTOMER][NEUTRAL] Now I can hear you. You cut out when you was giving me the policy number and I got 3739 and that was it.
[AGENT][NEUTRAL] OK.
[AGENT][NEGATIVE] Oh no.
[AGENT][NEUTRAL] Sorry, OK, OK, it's 163-7396.
[CUSTOMER][NEUTRAL] OK, got you.
[AGENT][NEUTRAL] And so I just, I, I wasn't sure what, um, I think I've come across this before because typically on mode of payment one and I would just say get with your employee so they could just email um the care team that information.
[CUSTOMER][NEUTRAL] If it's a group on the phone, if it's the insured, then they'll have to have the group call us uh well they have to have the group send it in to us, put it that way, um.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] That's really good to know. OK, so simply just laying out the situation and that it could be handled that way.
[CUSTOMER][NEUTRAL] Yeah, they just need to let him know what's going on and whatnot, but we just, we can't do anything over the phone. We've gotta have documentation and once we get that we.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Sure, that's really good to know though. I, I appreciate you letting me know that. Um, did you wanna
[CUSTOMER][POSITIVE] We try to honor the retroactive.
[CUSTOMER][NEUTRAL] Dates sometimes too so that that helps us clarify too but I can speak to them and let her know um that's not a problem and you said it's the group, right?
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, yeah.
[AGENT][NEUTRAL] Right, um, [PII], she is the admin group.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And the callback number is what's on the phone log ID.
[AGENT][NEUTRAL] Um, [PII], yes.
[CUSTOMER][POSITIVE] OK. All right, we're good to go. Thank you.
[AGENT][POSITIVE] All right, I sure appreciate your help. Thank you.
[CUSTOMER][POSITIVE] No problem you're welcome.
[AGENT][NEUTRAL] All right bye bye
[CUSTOMER][NEUTRAL] Bye bye.