AccountId: 011433970860
ContactId: c9c7c93f-10d9-4dbf-a285-527eefc71131
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 663679 ms
Total Talk Time (AGENT): 330693 ms
Total Talk Time (CUSTOMER): 270223 ms
Interruptions: 3
Overall Sentiment: AGENT=0, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/26/c9c7c93f-10d9-4dbf-a285-527eefc71131_20250326T18:25_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hey [PII], uh, my name is [PII]. I'm with the Deaton Agency down in [PII], and we have a few groups with you guys and I have a quick question about, um, I guess new hires and the enrollment process with you guys.
[AGENT][NEUTRAL] OK, how can I help you?
[CUSTOMER][NEUTRAL] Um, I got an email. Um, Bluebonnet is the group that's asking. They have quite a few employees they want to go on the group short term disability.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] And one of the questions, sorry I'm trying to pull that email back up was.
[AGENT][NEUTRAL] You're you're fine.
[CUSTOMER][NEUTRAL] Where is it? Oh, here it is.
[CUSTOMER][NEUTRAL] Um, a new hires eligible for benefits, um, but she is currently being treated for cancer.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So they didn't know she was like, does she even how does that work? I mean, I, I was like I don't know I'm gonna have to call it, call and talk to APLC.
[AGENT][NEUTRAL] That's OK. So you're wanting to apply for disability?
[CUSTOMER][NEUTRAL] They're wanting to apply, so this group they have I think they have short term disability, accident, critical, and cancer so she's obviously.
[AGENT][NEUTRAL] Does she
[AGENT][NEUTRAL] Do you have the group number? Do you have the group number for that one?
[CUSTOMER][NEUTRAL] Yeah, let me pull it up um I was just in the portal hang on one sec.
[AGENT][NEUTRAL] Sorry.
[AGENT][POSITIVE] You're OK.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] And then I don't think last year we even went out and really they they hire some people take it they reach out um so after this I'd also like to just make sure.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I don't know. Do I'll change the products really once a group
[CUSTOMER][NEUTRAL] Has those products offered?
[AGENT][NEUTRAL] Not unless they usually stay the same unless they come back and you know they wanna match a different plan design or something but no that usually it all stays the same yeah for the most part.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, let's see, OK, yeah, I just, they're filling out these short term disability apps and I was just like, let me double check and make sure all the rates and everything is the same, um, so their group number is 25413.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] 13. OK, let me pull it up real quick. uh Waco Blue I was searching Bluebon that has Waco in front of it. That's why I can't find it. No, that's OK.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEGATIVE] Oh sorry, yeah.
[AGENT][NEUTRAL] OK, 213. OK, so the thing, OK, so disability is gonna have a pre-existing clause on there. So, um, let me see, somebody that has it on this policy. Give me just one second.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Is she is the person, are they still actively at work and everything?
[CUSTOMER][NEUTRAL] They are.
[AGENT][NEUTRAL] OK, I say they're currently out on disability, they wouldn't be able to apply though.
[AGENT][NEUTRAL] Let's see, and then the application is our health questions on that application?
[CUSTOMER][NEUTRAL] Yeah, so I've never known we normally have people do it. We've never known if the whole guaranteed issue.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Is for all new hires or is that just that enrollment?
[AGENT][NEUTRAL] OK, got you.
[CUSTOMER][NEUTRAL] Um, and then I just had it pulled up. Hang on, I got on my other screen.
[AGENT][NEUTRAL] Let's see, so this policy, OK, let's see, 7 day waiting period. What's that 90 days of the short term disability.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] Oh, let's see.
[AGENT][NEUTRAL] Making sure there is a preexisting.
[CUSTOMER][NEUTRAL] I think our elimination like 0 and 7 and the benefits 90.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, survivor.
[CUSTOMER][NEUTRAL] And so
[AGENT][NEUTRAL] So the way the the preexisting is on the policy, like I mean I guess if there's help if she can pass I don't know what the app looks like that you have if it has health questions on there or not, but.
[AGENT][NEUTRAL] The disability that it won't pay for anything that's pre-existing during the 1st 12 months of coverage. So, um.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] I guess the question would be like what's on the application.
[CUSTOMER][NEUTRAL] Yeah, um, so it looks the group disability.
[CUSTOMER][NEUTRAL] Yeah, OK, I see where it's saying it now. OK, I should have looked here to start on the 2nd page. Yeah, it talks about cancer other than basil or squamous cell.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK, sounds good and then.
[CUSTOMER][NEUTRAL] I guess I should probably have pulled up a cancer policy to see. I'm guessing the cancer's gonna have the same 12 months. Look back or maybe even longer.
[AGENT][NEUTRAL] Yeah, let me look at the cancer. Yeah.
[AGENT][NEUTRAL] Yeah, let me look at the cancer policy because that's the GC 14. Let's see.
[AGENT][NEGATIVE] Oh, come on.
[AGENT][NEGATIVE] Doesn't show me a policy. OK, not fair, hang on.
[AGENT][NEUTRAL] I mean, yeah, that one's gonna have pre it's gonna have the same type of pre-existing on there and then like that what the most of us have that first occurrence benefit which wouldn't be payable because they were diagnosed before the policy was in effect.
[CUSTOMER][POSITIVE] Very good.
[CUSTOMER][NEUTRAL] Uh, are you showing that that I'm trying to see if that group even, I don't see a brochure with the cans. OK, cancer there it is. I had it labeled as.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Yeah, it should be the GC 14.
[CUSTOMER][NEUTRAL] Of GC 14, OK.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah I just wanna make sure let's see.
[AGENT][NEUTRAL] For whatever reason, it's not letting me pull up a policy on that one. Let's see, hold on, I can go another way to grab one.
[CUSTOMER][NEUTRAL] Pre-X.
[CUSTOMER][NEUTRAL] The brochure and it talks about basically the same thing, no benefits are payable for any loss incurred during the pre-existing edition exclusion period.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Which is usually 12 months, yeah.
[CUSTOMER][NEUTRAL] I yeah, I'm sure it says it somewhere in here.
[AGENT][NEUTRAL] So there's, so on that one, it's like if they were diagnosed prior to the effect date, we'll look 12 months prior to the affected date. If they were diagnosed during that time period, then no benefits are payable on the cancer policy during that 12 month exclusion period, um, after the policy is in effect.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK, but after the 12 months.
[CUSTOMER][NEUTRAL] If she gets this policy in 24 months later.
[AGENT][NEUTRAL] And still receiving treatment, yeah.
[CUSTOMER][NEUTRAL] It's OK, so she's still receiving treatment for it, she still can't get.
[AGENT][NEUTRAL] No, it's the way it should read, I don't have it in front of me that what it is is it says the 12 month exclusion period, that means that um.
[CUSTOMER][NEUTRAL] Or she
[AGENT][NEUTRAL] Let me, let me hold on a second. Let me pull up the policy. I, I'm having to go a different way and I'll pull up the policy real quick. I've got a policy number.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][POSITIVE] Very good.
[AGENT][NEUTRAL] It that was confusing to explain to customers because they think they can retro file all their stuff after the 12 months and it's like, no, as long as they're receiving more treatment after that 12 months, then they can file that but I just wanna make sure what the wording is on this particular policy.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Right
[AGENT][NEUTRAL] Almost there.
[CUSTOMER][NEUTRAL] Hi
[AGENT][NEUTRAL] Well, I gonna like strike out on this. Good grief.
[CUSTOMER][NEUTRAL] It's kind of like, you know, once I feel like you have cancer, I mean,
[CUSTOMER][POSITIVE] If you're quote unquote cured, there's a good chance you're gonna have something down the road anyways.
[AGENT][NEUTRAL] Yeah, yeah, yeah, cause something else could come up, you know, that would be payable. Um, well, I guess the policy certificates for the cancer policy are not uploaded, so I can't get to any of them. Um.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK, no
[AGENT][NEUTRAL] But yes, I, I used to pay the cancer claims and especially the GC 14s. Um, so yeah, I do know that that has that 12 month exclusion period, which means if you are pre-existing, you were diagnosed before the effective date, then no benefits are payable during that 1st 12 months of coverage. And then after that, if you're receiving any type of treatment, then you can apply for benefits at that time.
[CUSTOMER][NEUTRAL] OK perfect so for both policies the look back is 12 months and then the.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Whatever you have.
[AGENT][POSITIVE] It's basically time, yeah, yeah, no pain, yeah, uh, yeah.
[CUSTOMER][POSITIVE] Is 12 months then you're good.
[CUSTOMER][POSITIVE] OK, sweet, I will let them know, um, and should everything from what you are you able to see everything, I mean just like anybody that wants short term ability.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, yeah, let me look.
[AGENT][NEUTRAL] Let's see. OK, so this group, uh, renews [PII].
[AGENT][NEUTRAL] Well that's coming up. Have you received renewal information for this group?
[CUSTOMER][NEUTRAL] I have not, um.
[AGENT][NEUTRAL] Let me, let me look and see if anything's been sent out. Hang on just a second because.
[CUSTOMER][NEUTRAL] Most everything I think goes to [PII] my dad who's I guess the the bull of the agency.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, let me just verify, make sure we haven't received or free or lacking anything.
[AGENT][NEUTRAL] There we go we we're holding.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] No, I don't see that anything's been sent out on this group. So and I know sometimes they have special arrangements on this. So [PII] is who I show that agent is, is that your dad?
[CUSTOMER][NEGATIVE] Yeah, yeah, that's my bad.
[AGENT][NEUTRAL] OK, OK, yeah, um, yeah, I don't.
[AGENT][NEUTRAL] The billing.
[AGENT][NEUTRAL] No, I'll just make sure there's nothing.
[AGENT][NEUTRAL] Did a higher
[AGENT][NEUTRAL] Yeah, I don't see anything out here. So, OK. Yeah, everything, I mean, what was your other question? I'm sorry.
[CUSTOMER][NEUTRAL] Oh no you're good um just I as long as nothing changed, I'm guessing I can just go ahead and have these folks fill out these.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Enrollment selection forms that we had from last year.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, that's what I would do. Yeah, I don't see anything that's changed.
[CUSTOMER][NEUTRAL] Yeah, I mean it's not changed just call me. I think there are 4 or 5 ladies that wanna get on the short term disability, so, uh, call them and tell them to get going when y'all, when we fill that out, I'm guessing that they're checking the salaries and the limits and everything.
[AGENT][NEUTRAL] OK. Yup. Yup.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] We should, I mean, yeah, I mean, I mean.
[CUSTOMER][NEUTRAL] For the short term disability.
[CUSTOMER][POSITIVE] OK, I, I do my best on that and I'm always like.
[AGENT][NEUTRAL] Well, what'll happen is, yeah, whatever what I mean as long as you've done, I mean that's something that you kind of vet out on your end because you're dealing with a group, you know, verifying their salary and then when it comes in and usually when if they, if they file a claim.
[CUSTOMER][NEUTRAL] Alright
[AGENT][NEUTRAL] That's generally when we check that's when we check it because we're like, OK, yeah, do you make do you make the money that's correct for this level of coverage and if not then it's adjusted at the claim time.
[CUSTOMER][NEUTRAL] Then they really
[CUSTOMER][NEUTRAL] And that
[CUSTOMER][POSITIVE] OK cool sounds good.
[CUSTOMER][POSITIVE] Alrighty, um, well that sounds good. I appreciate your help.
[AGENT][NEUTRAL] Right.
[AGENT][POSITIVE] OK, no problem. I hope you have a great day.
[CUSTOMER][NEUTRAL] Alright you too bye bye.
[AGENT][NEUTRAL] See you later bye bye.