AccountId: 011433970860
ContactId: 89c5d2c6-ae6c-419c-9e03-ad8aaf9d53e5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 362559 ms
Total Talk Time (AGENT): 138717 ms
Total Talk Time (CUSTOMER): 279084 ms
Interruptions: 7
Overall Sentiment: AGENT=-0.1, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/18/89c5d2c6-ae6c-419c-9e03-ad8aaf9d53e5_20250218T15:41_UTC.wav
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[AGENT][NEUTRAL] APL, this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hello, this is [PII] over at Southeast Insurance Group. How are you?
[AGENT][NEUTRAL] Just fine, [PII], how are you?
[CUSTOMER][NEUTRAL] I'm doing pretty good um I am calling um I've been going back and forth with, um, uh, [PII], [PII], and, um, [PII] last night and then enrollment service team today so I'm not really sure who I should um reach out to but enrollment service team reached out to me last and I need some clarification on um.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] On the process with the feed.
[AGENT][NEUTRAL] With the feed, OK, yeah, ARN is the one that handles the actual feed, but let me see what, let me see what she has out here. Give me just a second.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] What information were you wanting to clarify?
[CUSTOMER][NEUTRAL] So, um, so we have an employee with one of the clients, City of [PII], um, and, um, there was a number of open enrollment, um, changes that errors that occurred we fixed the majority of them, um, due to them moving to like an age band in the med link um so that got fixed on our end and then we just submitted to get those corrected everything was fine. Well then they there is [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEGATIVE] Gotcha.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Who um I sent screenshots to them so they could see.
[AGENT][NEUTRAL] I see it. OK. Yeah, I see your email. I found it. Yeah. OK.
[CUSTOMER][NEUTRAL] So this, yeah, so the sec if you look at the 22 um screenshots, it's in December showing that he did decline the coverage which is what he had initially done in October. It was a decline for open enrollment.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK. OK. OK.
[CUSTOMER][NEUTRAL] And um so it had gone over um.
[CUSTOMER][NEUTRAL] As uh it did go over to APL in October um just that it wasn't on the file and then in December they said yes it um had come over with a decline.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And but they, but the reason they said um so the, so he still showed up on the invoice and so we, I was like well why is he still showing up on the invoice if he declined his coverage and so the response back that we need clarification on is that it says um yes he was removed from the file starting in December, but please keep in mind APL does not terminate by omission.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Now I understand that when he dropped that med link that meant that all coverage was now gone but he is not a terminated employee so we wouldn't terminate him an employee navigator.
[CUSTOMER][NEUTRAL] But I understand that like if I manually do it in APL I would actually have to terminate him because there's you know no more coverage left so um so I understand APL does not terminate by mission and anyone waiving or changing coverage will need to be included in the file to make the changes or terminate them.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] You know,
[CUSTOMER][NEUTRAL] But if you look at the last two screenshots from December, it it says in there that he did decline it, so I'm just not sure what it, what didn't trigger.
[AGENT][NEUTRAL] Yeah, I see that.
[CUSTOMER][NEUTRAL] You know, is there something that we're missing in the way that the file is sent that it's not triggering it as like a.
[AGENT][NEUTRAL] Let me
[AGENT][NEUTRAL] I need to, let me, I need to ask too because I've, I've been told that on the file feed as long as you enter the term in the EF file and it comes over that that's what that's what we go off of to make ads changes and delete. OK, so he's not terminating.
[CUSTOMER][NEUTRAL] Right, but he didn't terminate, yeah, so he didn't terminate he did decline, no, because he's still an active employee he just.
[AGENT][NEUTRAL] OK. Oh, so he's declining the coverage. OK, got you.
[CUSTOMER][NEUTRAL] Right, and so he's gonna, yeah, so when in employee navigator he'll just show as an active employee with no coverage listed.
[AGENT][NEUTRAL] OK, so it was it like an open enrollment thing? Was it like open enrollment and he just decided he didn't want to take the coverage at this point that he had it, so he's not terminated. He's just saying I no longer want this coverage. OK.
[CUSTOMER][NEUTRAL] In the APLOSC.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] And that's exactly how it's listed in um.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, in that, um, that screenshot when it tags and that's the and that's the, um, the date that it went over so I looked up the um the transmission information and it said it went over as a decline.
[AGENT][NEUTRAL] OK.
[AGENT][NEGATIVE] Gotcha.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] But to go back to the online service center on APL again if I go in there and manually have to do something for an employee regardless of the client if they have no more coverages I have to terminate the employee in there.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Even if he's an active employee, right, because it won't let you like keep up a just a person in there.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Right, exactly, but.
[CUSTOMER][NEUTRAL] So, so that's where I'm, so that's where I'm wondering is, is that causing an issue because OSC is like, well we don't keep you but Employee Navigator saying well you're decline.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah, I know
[AGENT][NEUTRAL] Right, let me get clarification on that because I need to know myself because I do know like um I know when the file feed comes through that's supposed to trigger everything but this sounds like this is a little bit different than what I've been asked before so.
[AGENT][NEUTRAL] Um, and I see [PII]. I'm trying to see if [PII]'s available. She is on a call. Do you mind if I get with her and her team and just verify, and then I'll give you a call back because I'm interested in this myself because I've been told not to cancel coverage for people when there's a file feed because if I cancel it for you, um, and the file feed comes through that overrides what we're doing on our end. So, OK, yeah, yeah.
[CUSTOMER][POSITIVE] Right, exactly.
[CUSTOMER][NEUTRAL] OK, that's fine, sure.
[CUSTOMER][POSITIVE] Yeah, absolutely.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][NEUTRAL] Exactly, so I and and if there's something that we need to like trigger in the.
[CUSTOMER][NEUTRAL] The way the fee goes over, yeah, like in the structure and I I just need to know so that we can make sure it's good going forward and we can make sure that for our other clients they're not running into the same issue.
[AGENT][NEUTRAL] Yeah, in the file feed, yeah, to make sure that we, OK, OK, yeah.
[AGENT][NEUTRAL] Yeah, that, that's.
[AGENT][NEUTRAL] Exactly, you know, I have to ask a really good question that we need to resolve because I would like to know what happened as well. So is this a good number to reach you at the [PII]? OK, [PII]. OK, let me get with them and I'll call you back today, OK?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yep, yep.
[CUSTOMER][POSITIVE] OK perfect thank you so much I appreciate your help.
[AGENT][POSITIVE] You're most welcome. Talk to you soon. Bye bye.
[CUSTOMER][NEUTRAL] OK, OK, bye bye.