AccountId: 011433970860
ContactId: e4349cb5-a7d3-408c-9886-40384c3cb6b5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 534539 ms
Total Talk Time (AGENT): 187396 ms
Total Talk Time (CUSTOMER): 285757 ms
Interruptions: 2
Overall Sentiment: AGENT=1.5, CUSTOMER=1.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/25/e4349cb5-a7d3-408c-9886-40384c3cb6b5_20250425T19:12_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], it's [PII] with Broker Resources. How are you?
[AGENT][POSITIVE] I'm good, [PII] how are you?
[CUSTOMER][NEUTRAL] I'm well. I'm wondering if you can help, um, [PII], who is on the phone. He is the broker for um group number 21302.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Governmental
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Yes, so it's probably with you guys through the hub I guess he sent um.
[CUSTOMER][NEUTRAL] A few people who are not supposed to be enrolled.
[CUSTOMER][NEUTRAL] And some people didn't get enrolled so that's obviously new business but now the problem is is I guess the like the group is super upset and he's wanting to know if he's getting premium back for those people like so basically a credit or a refund. I said that I would have to get with I was like it's it's up to billing regardless when we put those terms through so.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] OK, sure. No, you're right, you're exactly right.
[AGENT][NEUTRAL] So, um, so what he's asking for is they're gonna get refunds for the terminations, correct? I just wanna make sure that I'm understanding.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes, yeah.
[AGENT][POSITIVE] OK. Yeah, I'll help you.
[CUSTOMER][POSITIVE] Yeah, OK, thank you I appreciate you.
[AGENT][POSITIVE] OK. You're welcome, [PII]. Have a good day.
[CUSTOMER][POSITIVE] You'll have a good weekend.
[AGENT][NEUTRAL] You too.
[CUSTOMER][POSITIVE] Hey [PII], I have [PII] from billing on the phone and she's gonna help you from here, OK? Thank you so much. Hey [PII], [PII], how are you?
[AGENT][NEUTRAL] Hey, [PII]. How are you doing today?
[CUSTOMER][POSITIVE] Hey, I'm doing great, thanks. Friday, right? Ready to go home.
[AGENT][NEUTRAL] Right.
[AGENT][POSITIVE] Yeah, thank goodness.
[AGENT][NEUTRAL] Well, it's good to talk to you. I understand you've got some questions about some refunds for terminations. Is that correct?
[CUSTOMER][POSITIVE] For sure.
[CUSTOMER][POSITIVE] Yeah, what, what I'm try, what I'm trying to do and and it's, it's certainly not APL's fault at all, so like there's no blame here or anything whatsoever. I'm just trying to, you know, instill some goodwill here, um, honestly, you know.
[CUSTOMER][NEUTRAL] Uh, we have an HSA with, you know, multiple plans with Cigna there, um, with this group, and, um, I guess when they were doing the enrollment on their online portal, they allowed people to choose the APL or they're I think they're paying for uh like a base plan for everybody and um so we, we've had enrolled like about 14 or 15 people. I think we, my girl has sent you over some stuff, uh [PII] and [PII].
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, and so what I'm hoping to do is, and I know it's not, you know, the nice thing to do, uh, to ask you, but I'd like to see if I can get like premium credit for those people or, you know, terminate them retroactively back to when they were put on because they have a health savings account.
[AGENT][NEUTRAL] Yeah, let me see.
[AGENT][NEUTRAL] Do you have a policy number or a member's name that you can give me?
[CUSTOMER][NEUTRAL] But I mean it doesn't have to be done this second but.
[CUSTOMER][NEUTRAL] I'm sorry, I couldn't hear you.
[AGENT][NEUTRAL] No, I'm sorry. Do you have, um, let me, let me just go through and look at them. Do you have a policy number of one of the insurers or the member's name where I can look at the policy?
[CUSTOMER][NEUTRAL] Um, yeah, let me look here, um.
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, we can.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Hang on, let me look because we, we did just send, we did just send you guys a um or, or [PII] [PII] did. Let me just see where it's at here, uh.
[AGENT][POSITIVE] Take your time.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII], are you there?
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Yeah, I'm, I'm here I'm just I'm sorry I'm just trying to.
[AGENT][POSITIVE] Oh, it's OK. No, you're good, you're good. Sometimes I'm just making sure I, I didn't disconnect with you. What's your phone number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Yeah [PII].
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] OK. Take your time. I was just double checking. Thank you.
[CUSTOMER][NEUTRAL] Actually, if you, you know what, what's your email address? I can forward you this email. Maybe you didn't get it.
[AGENT][NEUTRAL] OK, yeah, send it to, um, send it to our care team. I, it's just gonna list the people that, that should not have the coverage and that you're requesting the refund for, is that correct?
[CUSTOMER][NEUTRAL] Yeah, so basically there's 16 employees actually here's the audit, uh, I, I can tell you a client, for example, an employee if you want.
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Yeah, so, so for example, uh, there's like I think 16 of them, like here's one, it would be.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Let me see which uh I'm just looking at the spreadsheet. I gotta see what the what the codings are here medical plan ID member status.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Right, well, one of the, one of the people that would be, would be [PII]
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] And I can give you his like social if you want.
[AGENT][NEUTRAL] Yes, please. I, I've got the same. What's your social or date of birth, Either one will be fine.
[CUSTOMER][NEUTRAL] Yeah, his um social is [PII].
[AGENT][NEUTRAL] OK, thank you so much. I did do that. OK, so, yes, he does have an active policy. He was not supposed to be enrolled, correct? If, if the renewal date of [PII].
[CUSTOMER][NEGATIVE] But he shouldn't have, he should have never been enrolled, yeah, and there's like uh.
[CUSTOMER][NEUTRAL] I guess about, let's see, one.
[CUSTOMER][POSITIVE] Yeah, let's see here I got one.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] 34.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] 678.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] 1011 1213 14.
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] 15, there's 16 people that have the HSA high deductible plan and they can't, you know, be on a, you know, your plan because it would never pay, you know.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Exactly, yes, sir. OK, let me give you, let me give you an email to send it to.
[AGENT][NEUTRAL] For list [PII]he um.
[CUSTOMER][NEUTRAL] OK, let me hear from the closes.
[CUSTOMER][POSITIVE] I'll forward it to you right now.
[AGENT][NEUTRAL] Pardon?
[AGENT][NEUTRAL] OK, it's gonna go to our, OK, it's gonna be [PII].
[CUSTOMER][NEUTRAL] OK, what is it?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yes, that's
[CUSTOMER][NEUTRAL] Yeah I got that. [PII].
[AGENT][POSITIVE] That is correct, yes, that.
[CUSTOMER][NEUTRAL] I just sent it.
[AGENT][POSITIVE] OK, all right. Well, that will go to our care team and they, and they will get it to the perfect billing processor and we'll process the terms and the refunds accordingly.
[CUSTOMER][NEUTRAL] OK, so you'll go back to the beginning then basically what you're saying, right?
[AGENT][NEUTRAL] Yeah, but he, he
[CUSTOMER][NEGATIVE] That these people should never.
[AGENT][NEUTRAL] Yeah, if they should cause, cause I noticed like this when he was.
[AGENT][NEUTRAL] I see he's had active cover since [PII], but they have a renewal for March. So was it just because March currently of this year that he wasn't supposed to enroll?
[CUSTOMER][NEUTRAL] I mean, I think so. I mean, I don't know, but.
[AGENT][NEUTRAL] Yeah, that's what, uh, that's, that's the question, because I, I noticed that they had the renewal date of [PII]. So in that, we wouldn't be able to go back all the way to [PII], you know, but, um, we, we can process it back, back to 90 days.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] So 90 days is how far you guys to go back is that the that's when we just started?
[AGENT][NEUTRAL] So in this case
[AGENT][NEUTRAL] Yes, well, that's basically, um, as far as retro and back, I, I have, we have to have it approved to go further back than that with our supervisor, but we can have that looked at.
[AGENT][NEUTRAL] If that's something that needs to be done.
[CUSTOMER][POSITIVE] Yeah, see if you can do that because yeah I'd like to see those people have been on health savings for quite a while so I mean I, I can look at this closer and get back to you, but um, yeah, that's that's kind of what I do. Alright, I'll I'll talk to the client just let him know hey we're working on this and we're gonna definitely get some refund, but we're gonna see how far back we can go, OK?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, sure.
[AGENT][POSITIVE] Exactly. Sounds great, [PII]. Is that all I can help you with?
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][POSITIVE] Thank you so much. I appreciate it. Should I ask for you again when I call back or no?
[AGENT][POSITIVE] You're welcome
[AGENT][NEUTRAL] You can, whatever you would like to do, that'd be fine.
[AGENT][POSITIVE] Not a problem.
[CUSTOMER][NEUTRAL] What is your name?
[AGENT][POSITIVE] You're welcome, [PII]. Have a great day. My name is [PII]
[CUSTOMER][NEUTRAL] What is your name, ma'am?
[CUSTOMER][POSITIVE] OK, [PII]. All right. Thank you, [PII].
[AGENT][POSITIVE] You're welcome. Have a good day, [PII].
[CUSTOMER][POSITIVE] Appreciate it.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] You too. Bye-bye now.
[AGENT][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] Right.