AccountId: 011433970860
ContactId: c6e40739-f647-4e16-abfc-d47b24d63ab9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 302600 ms
Total Talk Time (AGENT): 145375 ms
Total Talk Time (CUSTOMER): 95868 ms
Interruptions: 3
Overall Sentiment: AGENT=0.4, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/09/c6e40739-f647-4e16-abfc-d47b24d63ab9_20250609T18:03_UTC.wav
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[AGENT][POSITIVE] Thank you for calling APL this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes, [PII]. um, my name is [PII]. I'm a representative. I'm at an open enrollment right now, and I have a question about, about the short-term disability, um.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That that we have the, the, the clients I've I've had these guys for about 1010, 11 years, uh, but they got a new location. I've got one of the employees that um are that is pregnant, and I wanted to see about the pre. I wanted to see about the pre-X on the uh short term disability.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, which group is it that you're calling in regards to?
[CUSTOMER][NEUTRAL] It's called Security Management of South Carolina.
[AGENT][NEUTRAL] Alright, let me look at that group number just a second.
[CUSTOMER][POSITIVE] Yes ma'am, thank you.
[CUSTOMER][NEUTRAL] So
[AGENT][NEUTRAL] You said security management of South Carolina. There it is. OK, 17717779. Give me just a second. I'll get into this.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Oh they
[AGENT][NEUTRAL] And so, so this person's already enrolled?
[CUSTOMER][NEUTRAL] No, no, this is a new, their, their new group.
[AGENT][NEUTRAL] OK, let me just
[AGENT][NEUTRAL] OK, let me just pull up. OK.
[CUSTOMER][NEUTRAL] So I mean it's under the same policy though so.
[AGENT][NEUTRAL] Yeah, you're fine. Yeah, I was just gonna pull up one of these other policies. Give me just a second here. So, uh, what's the effect is it gonna be? Do you know?
[AGENT][NEUTRAL] Or you just want to know if she's diagnosed prior to if it's gonna, OK.
[CUSTOMER][NEUTRAL] Um, no, no, no, it'll be.
[CUSTOMER][NEUTRAL] Yeah, she's, she's pregnant and I believe it's gonna be [PII] or [PII] at the latest.
[AGENT][NEUTRAL] OK, let me see, cause, OK, I got the policy up. So she was diagnosed, let's see what Pria says.
[AGENT][NEUTRAL] Pre-existing. OK. So if you're diagnosed within the 12 months prior to the effective date, um, that would be considered preexisting. And if, I mean, if, if she's diagnosed as being pregnant prior, within the, you know, prior to the policy effective date, no benefits are payable for a condition that's diagnosed um within that 12 months prior to the effective date if you become disabled during the 1st 12 months of coverage.
[CUSTOMER][NEGATIVE] So she would have no benefit for the STD.
[AGENT][NEUTRAL] Based on what, yeah, based on what you're telling me without having a claim, I can't confirm it fully, but yeah, so she's diagnosed, if she sends in a claim during the 1st 12 months of coverage, we're gonna order the medical records to determine if she was diagnosed before her effective date. And if she was, and that would be considered preexisting and the policy doesn't pay anything for pre-existing.
[CUSTOMER][NEUTRAL] Is what you is what I'm hearing.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Until you, yeah, yeah. Gotcha.
[CUSTOMER][NEUTRAL] That's what I figured, but I wanted to give a shot, see if there was any.
[CUSTOMER][NEUTRAL] Any benefit whatsoever uh that you get like even with 50% or something.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Right. I mean, that pregnancy wouldn't be covered, but obviously, you know, down the road, you have to be covered under the policy for 12 months and become disabled after 12 months for it to not be pre-existing, but a pregnancy is not gonna fall into that category, so.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] No, OK. So if we sign somebody up on like [PII], they become disabled 101.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] If the policy is not good.
[AGENT][NEUTRAL] Well, that doesn't mean the policy is not good. We have to verify if they're preexisting, so we don't know. So it's whether or not, yeah, and then.
[CUSTOMER][NEUTRAL] Yeah, oh, I got you. Uh, uh, oh, you're right, you're, you're reading off the Prix. I'm sorry, I'm sorry. OK, I'm sorry.
[AGENT][NEUTRAL] Yeah, no, no, you're fine. And yeah, and then if they do have a preexist like so say they had a chronic illness, if they had a chronic illness and they were there, we wouldn't cover that claim, but if they went back to work and became disabled after 12 months, then we would, then they would pre-existing wouldn't apply. But pregnancy is a little different because it's just a one-time thing.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Hope I didn't confuse you. Sorry.
[CUSTOMER][POSITIVE] Perfect. Well, that's, yeah. No, you did not. No, no, no, no. I, I answered my own question. So as you were saying that, and I was getting ready to ask a question, I knew exactly what I was talking about. So, all right. Well, I, I appreciate you a lot. Thank you so much.
[AGENT][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Gotcha, gotcha, gotcha.
[AGENT][POSITIVE] Yeah, you're most welcome. You have a great day. Thanks for calling APL.
[CUSTOMER][NEUTRAL] You too. Yes, ma'am. Bye-bye.
[AGENT][NEUTRAL] Mm, bye bye.