AccountId: 011433970860
ContactId: b0cc6542-db66-4c5d-8d14-a49511799c9a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 373170 ms
Total Talk Time (AGENT): 75163 ms
Total Talk Time (CUSTOMER): 179625 ms
Interruptions: 1
Overall Sentiment: AGENT=0.2, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/17/b0cc6542-db66-4c5d-8d14-a49511799c9a_20250117T18:49_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey [PII], hi [PII]'s name. [PII], can you, um.
[CUSTOMER][NEUTRAL] Remind me of what is this um dependent child maternity rider, what is that again? I forget.
[AGENT][NEUTRAL] It's uh for dependent children.
[AGENT][NEUTRAL] Should they get pregnant, it would cover them?
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK, let me just make a little note here so we're saying for.
[CUSTOMER][NEUTRAL] We're dependent, hang on one second.
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] OK, so for dependent children, OK, it would cover what?
[AGENT][NEUTRAL] Mhm. Mhm.
[AGENT][NEUTRAL] The hospital.
[CUSTOMER][NEUTRAL] Is it part of the uh they would have their own benefit, their own in this case $6000 benefit?
[AGENT][NEUTRAL] That would really be more of a
[CUSTOMER][NEUTRAL] Or they're using up the parents benefit?
[AGENT][NEUTRAL] Well, as long as they're covered under the major medical, it would be just like any other claim.
[CUSTOMER][NEUTRAL] OK, so in other words if let's say [PII] is uh is the dependent daughter and she's on the major medical and she goes in the hospital for any reason, is it only hospitalization?
[AGENT][NEUTRAL] It's only probably gonna be the birth of the child.
[CUSTOMER][NEUTRAL] Yeah, it's for dependent child for for dependent child it would cover.
[AGENT][NEUTRAL] And that gets more, yeah, yeah.
[CUSTOMER][NEUTRAL] Um, the hospital maternity, right?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Just like it would for a spouse who goes in.
[AGENT][NEUTRAL] To the hospital to deliver.
[AGENT][NEUTRAL] In the past, [PII], historically we did not cover dependent children who got pregnant and
[AGENT][NEUTRAL] needed hospitalization to deliver the child. It was only for the spouse. So they added that right on there.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So the way I answered the question was for for for a.
[CUSTOMER][NEUTRAL] Dependent child.
[CUSTOMER][NEUTRAL] On the major medical, right?
[AGENT][NEUTRAL] Mhm. They have to be covered under the major medical and also covered on the Medlink.
[CUSTOMER][NEUTRAL] Well, the parent has to be covered under the med link, right? Or the child has to be.
[AGENT][NEUTRAL] Well, the parent would be the
[CUSTOMER][NEUTRAL] It has to be under in other words.
[CUSTOMER][NEUTRAL] If I, if I'm on for myself as an employee and my daughter gets pregnant, she's not covered unless she's on the med link, right?
[AGENT][NEUTRAL] On the Medlink and the major medical.
[CUSTOMER][NEUTRAL] I would have to have, right, so I would have to have employee child coverage or employee um family coverage, right?
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Family. Yup.
[CUSTOMER][NEUTRAL] So I wrote it this way for a dependent child on the major medical.
[CUSTOMER][NEUTRAL] One second about my.
[CUSTOMER][NEUTRAL] Trying to do too many things at once.
[CUSTOMER][NEUTRAL] OK, for dependent child.
[CUSTOMER][NEUTRAL] On the major medical plan.
[CUSTOMER][NEUTRAL] It would cover the hospital maternity.
[CUSTOMER][NEUTRAL] Visit.
[CUSTOMER][NEUTRAL] Just like it would for the member, right?
[AGENT][NEUTRAL] Yup.
[CUSTOMER][NEUTRAL] So I have, I have, uh, family coverage. My daughter says she's [PII], she's on the major medical, she's on the on APL. She goes in the hospital. It's gonna cover, it's gonna cover her maternity.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEGATIVE] Why do we even need that as a rider if she's on the plan, she has the $6000 worth of of in hospital anyway.
[AGENT][NEUTRAL] That is
[AGENT][NEUTRAL] Because we did not cover maternity for children.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] I got you.
[CUSTOMER][NEUTRAL] When did this change happen?
[AGENT][NEUTRAL] Oh gosh. Probably about 3, maybe 4 years ago.
[CUSTOMER][POSITIVE] I got you.
[CUSTOMER][NEUTRAL] OK, I got you so I'm just gonna, just gonna finish this little note here by saying this, um.
[CUSTOMER][NEUTRAL] This um
[CUSTOMER][NEUTRAL] Was
[CUSTOMER][NEUTRAL] And update.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] APL coverage.
[CUSTOMER][NEUTRAL] From prior years.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right well thanks for clarifying.
[AGENT][NEUTRAL] OK. Is there anything else I can do for you, [PII]?
[CUSTOMER][NEUTRAL] No, so before this came in, if a [PII] daughter had a baby, um, and, and they were on family plan, it would not have covered the childbirth. It was an exclusion. Correct, I got you. OK, sounds like a plan.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] All right.
[CUSTOMER][POSITIVE] Thank you bye bye.
[AGENT][NEUTRAL] We'll take, uh-huh, bye-bye.