AccountId: 011433970860
ContactId: c5ab2573-e69c-4016-9b44-336aeac9bb0c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 652250 ms
Total Talk Time (AGENT): 297039 ms
Total Talk Time (CUSTOMER): 215705 ms
Interruptions: 4
Overall Sentiment: AGENT=0.4, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/07/c5ab2573-e69c-4016-9b44-336aeac9bb0c_20250307T15:50_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hey [PII], good morning. This is [PII].
[AGENT][NEUTRAL] Hey [PII], how are you?
[CUSTOMER][POSITIVE] Had to get I'm good hope you're having a good Friday. I had to give you your our usual call so that we make sure otherwise we wouldn't, we wouldn't be happy. I got you.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yeah, of course.
[AGENT][NEUTRAL] Oh right.
[AGENT][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] So, uh one of our groups, um this is called Genius SIS [PII] [PII], right? [PII] I got an email this morning.
[AGENT][NEUTRAL] Genius.
[AGENT][POSITIVE] Genius [PII] OK.
[CUSTOMER][NEUTRAL] And um it says.
[CUSTOMER][NEUTRAL] Let me just read this to you, um, it says the we noticed that [PII].
[CUSTOMER][NEUTRAL] [PII] We noticed that Heathereers, parenthesis spouse of [PII], former employee, and her dependents were removed from our last APL invoice without request.
[AGENT][NEUTRAL] Hm
[CUSTOMER][NEUTRAL] They are under COBRA, and I'm assuming that they were removed because as of March, it marks 18 months of of coverage. However, they are under [PII]'s coverage and since he moved to Medicare, it's our understanding that he's still eligible for COBRA to continuance of up to 36 months, which is correct. You know, if you, if somebody goes on Medicare, then they can stay on COBR for 36.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Right, let me, let me go here and see.
[CUSTOMER][NEUTRAL] So that they wanted to stay on the Cobra.
[AGENT][NEUTRAL] OK, let me see one second, let me get this pulled up real quick. This is group 20339.
[AGENT][POSITIVE] Like real quick.
[AGENT][NEUTRAL] Who's the policyholder? What's the policyholder's name? Was it [PII]?
[CUSTOMER][NEUTRAL] I think it's [PII].
[AGENT][NEUTRAL] OK, hang on.
[CUSTOMER][NEUTRAL] I'm just gonna pull him up.
[AGENT][NEUTRAL] And what and what was, what was the wife's name?
[AGENT][NEUTRAL] Didn't she have a different name? [PII], OK, so, OK, I thought I heard a different name. OK.
[CUSTOMER][NEUTRAL] [PII]. [PII], yeah.
[AGENT][NEUTRAL] Yeah, I don't see, let's see, I don't see either one of them, so let me look under la.
[AGENT][NEUTRAL] I see [PII] or [PII]. Oh wait, [PII], [PII] Ver, so she's the policyholder, I think. OK, [PII] Vers, let's see, yeah.
[CUSTOMER][NEUTRAL] Oh, maybe he's the policyholder now because he's on he's on Medicare.
[AGENT][NEUTRAL] Yeah, let me go look at this policy real quick though and see who was attached on it. Give me just a second here.
[CUSTOMER][NEUTRAL] I'm gonna look her up in the uh system here as well, [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] VER
[CUSTOMER][NEUTRAL] WYS OK let me look it up in the uh.
[AGENT][NEUTRAL] Yeah, so [PII] looks like he was the primary, and then [PII] and then there are two dependents on here, a dependent, yeah, so all of them dropped, so the whole policies is dropped as it looks like as of [PII]. Let me see what notes we have on here.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] If any, so no lapse policy covers expired. Yeah, you're right. So you're saying that.
[AGENT][NEUTRAL] He's still on Cobra.
[CUSTOMER][NEUTRAL] He's still on medical. I'm just looking at [PII]. [PII] is on medical. I'm just, I have [PII] pulled up now yeah [PII] is active subscriber.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, medical is active.
[CUSTOMER][NEUTRAL] Um, let me look at the kids. There's a kid named [PII].
[AGENT][NEUTRAL] OK. OK, so, so back in May, back in May, we got something that says per email from group, insured [PII] asked to be removed from policy. He has Medicare and kept wife and children covered. Cover up is for the wife.
[CUSTOMER][NEUTRAL] Let me look at
[AGENT][NEUTRAL] Change coverage to pay a new premium effective 51. So she's, OK, so we're saying her 18 months, I guess is expired for her being on the policy, but you said what was the reason that she's extending? I'm sorry, I'm just trying to get it straight.
[CUSTOMER][NEUTRAL] Husband went on Medicare.
[AGENT][NEUTRAL] Yeah, the husband went on Medicare, but he termed his coverage, which is weird. He took himself off.
[CUSTOMER][NEUTRAL] Well, he has to turn his he has to turn his coverage otherwise.
[AGENT][NEUTRAL] Because of the Medicare, OK.
[CUSTOMER][NEUTRAL] Yeah, it's not gonna cover on Medicare Medicare, but the, the primary now becomes [PII] and she can stay on for 36 months.
[AGENT][NEUTRAL] What
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] That's what we need to check on them because I think maybe that's not what we did. So let me
[AGENT][NEUTRAL] Let me see, hang on one second.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, I'm gonna need to get billing. Can you hold on for just a second? Let me have them look at this real quick. OK, just a second.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Uh huh.
[CUSTOMER][NEUTRAL] Sorry.
[CUSTOMER][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[AGENT][NEUTRAL] I'm sorry, who is this?
[CUSTOMER][POSITIVE] This is free.
[AGENT][NEUTRAL] [PII], hey, [PII], this is [PII] over on Broker Resources. I have got a broker on my other line. I'm not sending him over, but can, can you look at this account with me? It's a core question.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, it's 237-81999.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] For [PII].
[AGENT][NEUTRAL] Yeah, OK, so he, it looks like there's a note in there stating on the the dad was a policyholder, so.
[AGENT][NEUTRAL] He took his self off because he had Medicare, and the wife was on COBRA.
[AGENT][NEUTRAL] So when he took himself off of the policy, [PII] would become the primary account holder, is that correct?
[CUSTOMER][NEUTRAL] Um, as far as like policy removals like dependent changes and stuff like that, that would be customer service, um, but if you have anything like billing specific, I can answer that if you'd like.
[AGENT][NEUTRAL] Mhm, mhm.
[AGENT][NEUTRAL] OK, yeah, that's kind of what I'm calling about. It has to do with COR. So it looks like um coverage was terminated for the entire policy [PII], and the broker is saying that the wife, because [PII] removed himself from the policy, it looks like back in May, and [PII] was on Cobra, so that should, I believe, make her the primary policy holder if he's been removed. I think I'll check with customer service if I need to on that.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] But for Cobra, if she was the primary policy holder, he's saying that she should be staying on there for 36 months and not 18.
[AGENT][NEUTRAL] Do you know anything about that?
[CUSTOMER][NEUTRAL] OK. So,
[CUSTOMER][NEUTRAL] Yeah, so you're saying uh [PII] was the original insured and then um he was removed from the policy.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] He, he because he had me cause he was Medicare eligible, so he had to drop the coverage, yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And he, it was just his wife and kids that were left on the policy.
[AGENT][NEUTRAL] Right, right, under Cobra.
[CUSTOMER][NEUTRAL] Let me see.
[AGENT][NEUTRAL] So he's saying that she should still be on CoR for 36 months because she's the primary and not the dependent.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] OK, looks like [PII] also one who works on this, so she'll definitely know asking [PII] about the coverage question, um, while I look into the billing part, uh, because I was working on, uh, with her on something else, so I was just asking.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, let's see.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Do you want to research it? Uh-huh.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Yeah, I didn't know if you do you want me to call you back or?
[AGENT][NEUTRAL] Yeah, can you? I've got a meeting to go to anyway, so can you just IM me whenever you've researched it and then I'll tell him that I'll get back in touch with him.
[CUSTOMER][NEUTRAL] Yeah, you said this is [PII]. What's your last name? I'm sorry.
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] OK, OK, OK, I, I, I see. All right, yeah, I will, um, look into this and message you back.
[AGENT][POSITIVE] OK, perfect. Thank you so much.
[CUSTOMER][NEUTRAL] And then [PII] just replied and said that it was this the tricky one so.
[AGENT][NEUTRAL] Oh.
[AGENT][POSITIVE] OK, OK, OK, yeah, that's fine if y'all can research it, just holler at me whenever you get it done. Thank you so much. I appreciate it.
[CUSTOMER][POSITIVE] No problem bye.
[AGENT][NEUTRAL] Alright bye.
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Hi
[AGENT][NEUTRAL] OK, we're, they're gonna do some research on it. I explained the situation, so they're gonna get look at this, and they're supposed to get back with me here in just a little bit, and when they do, then I will call you and let you know what we find out or explain that he was taken off because he was eligible for Medicare and that the wife was still supposed to remain on the policy for 36 months because now she's the primary holder. So yeah, they're looking into that and then they're supposed to get back with me and tell me what we're gonna do to fix that or what's needed and all that good stuff.
[CUSTOMER][POSITIVE] OK sounds like a plan thank you.
[AGENT][NEUTRAL] OK. All right. I'll talk to you in a little while, OK?
[CUSTOMER][POSITIVE] OK thanks bye bye.
[AGENT][POSITIVE] Mm thank you. Bye-bye.