AccountId: 011433970860
ContactId: 86c9a8fa-6098-4bb3-9fb3-ffa55f88578d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1134500 ms
Total Talk Time (AGENT): 362771 ms
Total Talk Time (CUSTOMER): 624373 ms
Interruptions: 2
Overall Sentiment: AGENT=0.5, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/24/86c9a8fa-6098-4bb3-9fb3-ffa55f88578d_20250124T18:12_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey, [PII], this is [PII]. How are you?
[AGENT][POSITIVE] I'm good. How about you?
[CUSTOMER][NEUTRAL] I am good. I have a group admin on the phone. Her name is [PII].
[CUSTOMER][NEUTRAL] And it's for group number 26142.
[CUSTOMER][NEUTRAL] City of [PII].
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] She's wanting to discuss she's trying to pay the January invoice online and she um just gonna give you a short because you'll need to kind of get her story that there were some employees uh that dropped some of the the meling coverages um and.
[CUSTOMER][NEUTRAL] The their premiums are paid by a third party so that so APL will automatically get that that the premiums, but when she does her calculations, of course, with the uh the employees being removed, what she should pay is less than what we're going to receive. So she's wanting to talk about the refund of premium.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right. And you said her name was [PII]?
[CUSTOMER][NEUTRAL] It's [PII] and I verified her I verified everything um the phone number um that you see is for the group, but she gave me her phone, her cell number as a callback number, so I don't know which one you want.
[AGENT][NEUTRAL] Is that the [PII] number?
[CUSTOMER][NEUTRAL] That's the group's number, but she gave me her cell number if we needed to call her back. It's [PII].
[AGENT][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] What's that? What's that number, love?
[AGENT][POSITIVE] Awesome. OK. All right, ready for whenever you are.
[CUSTOMER][NEUTRAL] OK, did you want the amounts of the premiums that was that will be OK, discuss it. OK, good, thank you, here she comes.
[AGENT][POSITIVE] No, we'll, we'll hash that out. No worries.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Hi [PII], this is [PII] in the billing department. I understand you have a question about some refunds.
[CUSTOMER][NEUTRAL] I do. I just wanna know how the process happens, so um.
[CUSTOMER][NEUTRAL] And I don't know how much [PII] provided to you. She said she was gonna fill you in and so, um, I will.
[CUSTOMER][NEUTRAL] I will try to make it as simple or as short as possible um.
[CUSTOMER][NEUTRAL] We use a third party payroll provider.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] The funds that are deducted from our employees to pay premiums are automatically sent to you guys. Um, our payroll is posting as of today, um, so you guys should be receiving funds in the amount of $5,057.58 in a day or two, probably Monday, Tuesday.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, but with that being said, so my thing is, is I always work the um APL bill based on deductions because we do 24 deductions in a year. So after the last payroll of the month post I always kind of work these deductions, um, but what I am seeing is.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So on APL side, for instance, [PII] no longer carries gap insurance.
[CUSTOMER][NEGATIVE] Unfortunately on our side we deducted for that. We did not remove that um either we just didn't do it or we did not get notified from him or from HR payroll I say we did not get notified that he had canceled that coverage. So essentially that $5,0057.58 that's coming includes $39.84 for a gap policy that he no longer has.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] And I've got, you know, I've got a handful of people that are that way where they canceled some coverages and we in payroll were not made aware of it.
[CUSTOMER][NEUTRAL] So my question is, is, will a refund check be cut to us for the overage.
[CUSTOMER][NEUTRAL] Or what happens.
[AGENT][NEUTRAL] So we could do it, we could do it a diff a couple of different ways, but since you guys um send in a check, it probably be the easiest would be to send a refund check rather than adding a credit to the invoice online because of our online service center we're able to do that, um, but I can definitely.
[AGENT][NEUTRAL] Send a refund check instead if that's what you would prefer and it would have the individual um the individual's name on there and the reason why it was refunded in his case it would be because the policy has lapsed um let's see here let me pull up the.
[CUSTOMER][NEUTRAL] OK, because like I've got a couple of them where like, so [PII] and like another gentleman, [PII], you know, there, I've got a handful of people that are that way.
[AGENT][NEUTRAL] Yes, ma'am. So, do you know what date Mr. [PII]'s policy should be termed as the lapse as?
[CUSTOMER][NEUTRAL] Well, so what I, let me cancel this, let me go in.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] I can't see what he previously had, but when I look at the like benefit summary for him, his group accident and his group uh cancer policy are effective, well, I'm sorry, his cancer was effective [PII] and his accident was effective [PII].
[AGENT][NEUTRAL] Yes ma'am, but when should his, uh, gap insurance, when should it have been canceled?
[CUSTOMER][NEUTRAL] I am.
[AGENT][NEUTRAL] You know
[CUSTOMER][NEUTRAL] Let me look and see if he was on.
[CUSTOMER][NEGATIVE] I am going to make the dangerous assumption that it was.
[CUSTOMER][NEGATIVE] Essentiall[PII] canceled as of [PII] like he ended it.
[AGENT][NEUTRAL] OK, because that's, that's what I have in my system for that policy, so that's accurate. Would you like for me to check the dates of the rest because once we receive that payment and it shows that a payment was made but the policy is lapsed, that money will automatically get um put into our suspense so that we can refund it to you. So I just wanna make sure the other policies that you know of are in fact lapsed and so that that will kick out for you.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So, [PII] is my other, I'm sorry, [PII] um is another one. I am guessing his also would lapse as of, you know, [PII] or in that day.
[AGENT][NEUTRAL] All right, so I do have his gap insurance policy lapsed as of [PII].
[CUSTOMER][NEUTRAL] OK, and when you say it laps 11 that just means they didn't re-enroll or they canceled that coverage?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, I just wanna make sure that you know when I think as on the accounting when I think of lapse I'm thinking of default.
[AGENT][NEUTRAL] Oh no ma'am, no ma'am, no ma'am, just it the policy was canceled and it was paid through [PII].
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] That way it covers the [PII] date.
[CUSTOMER][NEUTRAL] OK great um so.
[CUSTOMER][NEUTRAL] My next person on my list, let actually let me just stick with refunds and then we can go back to some other people on some other things, um.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Looks like his gap I'm assuming would have been um you know 1125 as well.
[AGENT][NEUTRAL] Yes, ma'am. I do have that.
[CUSTOMER][NEUTRAL] OK, so we deduct, so these are all people we deducted for but didn't um.
[CUSTOMER][POSITIVE] That we're gonna essentially send money for [PII] is my next one.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] I have him as uh for [PII] as well.
[CUSTOMER][NEUTRAL] OK, so that's at um.
[CUSTOMER][NEUTRAL] Let me see what I got going on.
[CUSTOMER][NEUTRAL] I'm trying to keep this in order um.
[CUSTOMER][NEUTRAL] OK, so those are, those are my refunds that where we deducted y'all are gonna receive money we deducted and didn't turn off, but all of those you've said are canceled. So now can we talk about a few other people that I have issues with?
[AGENT][POSITIVE] Correct.
[AGENT][POSITIVE] Absolutely. What's up?
[CUSTOMER][NEUTRAL] All right, [PII]
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I show her gap policy as 2988 per pay period, but she is on the bill.
[CUSTOMER][NEUTRAL] Uh, what did I say that was her gap policy. I show her on the bill for 3983 a month.
[AGENT][NEUTRAL] Yes ma'am, I see that here and it um there's a note on here it says to match benefit summary so this is something that they're gonna have to correct the coverage for if she is um.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Wanting that if it's supposed to be a different.
[CUSTOMER][NEUTRAL] Because I'm including, I'm including we deducted correctly, so I'm sending what we've correctly did.
[AGENT][NEUTRAL] OK, so what I'll have, um, I believe it's gonna be customer service. Apologize, I'm still learning the new the departments and what everybody does they'll correct her coverage to match what is being paid for, uh, let's see, and do you know how long it's been that way or is it just this, um.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Awesome.
[CUSTOMER][NEGATIVE] I think she, I think she aged up, um, that sounds terrible, um.
[CUSTOMER][NEUTRAL] I, and I don't mean it that way, but I think she got into a different group age wise.
[AGENT][NEUTRAL] No, I understand.
[CUSTOMER][NEUTRAL] Let's see here uh.
[CUSTOMER][NEUTRAL] Dates
[CUSTOMER][NEUTRAL] Yeah, so she turned, she was [PII] out of [PII], so that put her in a different bracket.
[AGENT][NEUTRAL] OK, so this to be the first time.
[CUSTOMER][NEUTRAL] So that's why.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So once this payment processes, what will happen is um that money will temporarily get kicked out and uh uh report is printed for that type of payment when it says to match the benefit um and what we'll do is go in and correct the coverage and then the money will be applied so as of right now since we haven't received that check it's just kind of.
[AGENT][NEUTRAL] Um, sitting there, but I, yeah, so once we receive that check and they process it and it posts and whatnot, it will see that.
[CUSTOMER][NEUTRAL] Hanging in limbo.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEGATIVE] What was paid didn't match what we were billing for and they'll look at why and they'll have to go in there and fix that.
[CUSTOMER][NEUTRAL] OK, all right, so that will take care of her. All right, [PII] is my next one, [PII]
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, I show him.
[CUSTOMER][NEUTRAL] And I'm sorry we're having to do this line by line. I show him only with a policy of group.
[AGENT][POSITIVE] No, it's absolutely fine.
[CUSTOMER][NEGATIVE] Cancer, so critical.
[CUSTOMER][NEUTRAL] That's the only policy I show active for him, but he was, we were billed for 7967. 0, but you know what?
[CUSTOMER][NEUTRAL] We were billed that but we did not deduct for that so that won't be included in the bill. OK, so he'll be OK.
[AGENT][NEUTRAL] Yeah, I do see that it was removed because it says term coverage for [PII], so I do see that.
[CUSTOMER][POSITIVE] Yeah, I did that right, that one's good, um.
[AGENT][NEUTRAL] Are these your notes on the online service center?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Oh, you did fantastic. I, I love that you're so on this because you would be surprised on how many people just kind of do [PII] and we're trying to figure it out. I really appreciate your notes.
[CUSTOMER][NEUTRAL] Well thank you. I, I try to make it as simple as possible but when something doesn't add up in my head, I'm just trying to make it make sense to me, um.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] All right, so.
[CUSTOMER][NEUTRAL] [PII], he's an issue. I've got to collect for him. He's not, he's not a problem. All right, my one, my favorite person is [PII], and that is [PII]
[AGENT][NEUTRAL] OK, I see him on here. Let's see.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] He was administratively termed in [PII]. He's never termed his coverage.
[CUSTOMER][NEGATIVE] He is constantly being turned off the bill.
[CUSTOMER][NEGATIVE] And almost every single month I have to add him back on the bill.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I finally got somebody to tell me that it looks like it's a file that's coming over to you guys that has that's saying to term him.
[AGENT][POSITIVE] Mhm if you guys send a file feed in yes ma'am, that's definitely what's gonna do it.
[CUSTOMER][NEGATIVE] OK, and we do send in a file feed but unfortunately.
[AGENT][NEUTRAL] So
[CUSTOMER][NEUTRAL] Nobody can tell me who's generating that file feed.
[AGENT][NEGATIVE] Oh no, oh no.
[AGENT][NEGATIVE] That's not good.
[CUSTOMER][NEUTRAL] So I'm chasing a ghost.
[CUSTOMER][NEUTRAL] Um, because I don't, you know, and we've had some turnover in our HR, so unfortunately I don't know if my HR is creating that file feed.
[CUSTOMER][NEUTRAL] I don't know if it's our plan sponsors like uh the um.
[CUSTOMER][NEGATIVE] Southeast whatever it is that it is broker or whoever they are. I don't know if it's them creating the file feed like I don't uh oh shit, I hope I didn't lose what I just had in there sorry I just got logged out.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] No worries.
[CUSTOMER][NEUTRAL] Um, you know, I don't know who's creating the file feed to put pressure on to get that corrected.
[AGENT][NEUTRAL] Yeah, I'm seeing that you've had to call about this before.
[AGENT][NEGATIVE] And unfortunately until that file feed gets corrected, this is gonna be an issue because that file feed tells our system to term him each time.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] But what I guess what I, I, what I'm hoping for is that you can tell me.
[CUSTOMER][NEUTRAL] Who I need to talk to to get that file, where is that file feed originating?
[AGENT][NEUTRAL] Um, I don't know. Let me see.
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] I could probably, I don't know if um I think it's just received in a, in a.
[AGENT][NEUTRAL] I I don't wanna call it an email because I'm not one that receives it that way, but um.
[AGENT][NEUTRAL] I, I don't know that we could tell you who we're getting it from. I just know that it comes to our system, but let me see if I can ask somebody real quick.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] Cause I know it needs to get corrected and and unfortunately.
[CUSTOMER][NEUTRAL] I just don't know who to squeeze for that.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] I'm gonna have to look into that for you. Uh, looks like, seriously, this is crazy, but nobody is available. Oh wait, hold on, let me see.
[AGENT][NEUTRAL] Let me ask this uh colleague real quick.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] Alright, let's see if she can help me out.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] So while I'm waiting for her response, um, is there anybody else that you're wanting to ask about?
[CUSTOMER][NEUTRAL] No, he's, he's, I mean, and I know that I have to add him in the bill, so it's not like it's not like I don't know that. I just, um.
[CUSTOMER][NEUTRAL] You know, I feel like we got somewhere at one point but again some turnover in HR has pushed it back to where I haven't had to worry about this in a while and now I'm like oh shit, I gotta ask about him again, um.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] But everybody else is fine. I just want, I just wanted to make sure because what I see is I see about a $119 refund due to us because there was $5,0057.58 sent to you guys. I have a worked bill of $4,938.33 so that's, you know, $119.25 so that's gonna come as a check.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] You said
[AGENT][NEUTRAL] Yes ma'am. So what I can do is, see, I, I process your group's billing, so, um, it'll be fresh on my mind when I, when we do receive that check from you and I will make sure a refund check is issued. It will come along with a paper that says who it was for and um.
[CUSTOMER][POSITIVE] Oh, OK, great.
[AGENT][NEGATIVE] Uh, why it was returned. In this case, for those, it would be because of lapsed, um, coverage. Let's see.
[CUSTOMER][NEUTRAL] The lapsing coverages, OK.
[AGENT][NEUTRAL] Let's see, that's something that.
[AGENT][NEUTRAL] So she's saying that there's no way for us to know who it's coming from because it just goes to a um.
[AGENT][NEUTRAL] I'm trying to think of a word here and I'm, I'm having a moment. Um.
[AGENT][NEUTRAL] Oh, all of our file feeds are received in the same place and it doesn't necessarily say who it comes from. She's saying to maybe check with your broker, your agent and see if maybe they know who your file feed comes from.
[CUSTOMER][NEUTRAL] OK, that's fine and I, and I can do that and you know I'm only dealing with one person at this point in time he's been, you know, it's been an issue, but I just needed to kind of track down again who I needed to start with and kind of see what I can do, but I'll I'll get in touch with our broker and uh see if they can help me out.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] OK, yeah, so they'll probably be the best source for that, um, but like I said, I'm the one that processes your your group's billing, so I'll know all of this when we do receive a check and I get that processed for you.
[CUSTOMER][POSITIVE] Sounds great.
[CUSTOMER][NEUTRAL] Alright, well then I'm just gonna submit the invoice as is with those notes on it.
[CUSTOMER][NEUTRAL] Um, and then I'll be looking for a refund check.
[AGENT][POSITIVE] Yes, ma'am. If you have any questions, my name is [PII] and you can always call and ask for me and we can discuss any uh issues that you may have.
[CUSTOMER][POSITIVE] Thank you so much.
[CUSTOMER][POSITIVE] Awesome thanks so much [PII] I appreciate your time.
[AGENT][POSITIVE] No problem. You have a great day. Thanks for calling APO.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye bye.