AccountId: 011433970860
ContactId: f9c82848-52e9-4566-9906-ca5db09d0a1c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 781229 ms
Total Talk Time (AGENT): 352160 ms
Total Talk Time (CUSTOMER): 339169 ms
Interruptions: 5
Overall Sentiment: AGENT=-0.1, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/30/f9c82848-52e9-4566-9906-ca5db09d0a1c_20250530T17:36_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], um, I, I just have a question. I'm trying to decide if I want the, um, what is it, the VIP classic or the pro.
[AGENT][NEUTRAL] OK, so are you looking to sign up?
[CUSTOMER][NEUTRAL] Um, for the medical insurance side.
[CUSTOMER][NEUTRAL] No, we're, we're, we're actually, we have the classic but we have until I guess end of today to decide if we wanna change it. I just wanna know what.
[CUSTOMER][NEUTRAL] I'm trying to figure out what this insurance even covers. Um, like if I go to the dermatologist, would it cover that? If, uh, like if I wanted to get
[CUSTOMER][NEUTRAL] My skin checked out or if I had skin cancer to be removed a mole or something I'm trying to figure out, does this stuff cover anything like that or is it?
[CUSTOMER][NEUTRAL] I'm just confused on what they have given us.
[CUSTOMER][NEUTRAL] But it seems to be the bare minimal as far as I.
[CUSTOMER][NEUTRAL] Can tell
[CUSTOMER][NEGATIVE] I'm just getting stressed out.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, I, I can only imagine, um, if you're looking into upgrading your policy, um, you would need to contact your employer, uh, and see what they have because they buy specific insurances from us and then name it so I don't, I can't look it up without the policy number. Um, I can look up and see what you currently have if you have insurance with us currently, I can tell you what you have now and see if you can upgrade.
[CUSTOMER][NEUTRAL] Because
[CUSTOMER][NEUTRAL] Oh, I
[CUSTOMER][NEUTRAL] Yeah, we have
[AGENT][NEUTRAL] But if you're trying to upgrade you'll need to contact your employer.
[CUSTOMER][NEUTRAL] Uh, I mean enrollment's open like I'm just wondering what this stuff covers. It's the VP Classic and the VP Pro.
[CUSTOMER][NEUTRAL] For the hospital denimity I saying that correctly.
[AGENT][NEUTRAL] Indemnity, um, and do you have a policy with us currently with that?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes, yes.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I have the plastic right now I'm just trying to figure out if I want to.
[CUSTOMER][NEUTRAL] The doctor
[CUSTOMER][NEUTRAL] Would it cover any of that?
[AGENT][NEUTRAL] Uh, let me see what you have covered currently. What's your name and a good callback number in case we get disconnected?
[CUSTOMER][NEUTRAL] Um, [PII], uh, [PII].
[AGENT][NEUTRAL] OK. And what policy do you have with us currently?
[CUSTOMER][NEUTRAL] We have the most
[AGENT][NEUTRAL] Or what, what's the policy number?
[CUSTOMER][NEUTRAL] Um, the VP.
[CUSTOMER][NEUTRAL] Let me see, I'm looking at these cards policy.
[CUSTOMER][NEUTRAL] 02622293
[AGENT][NEUTRAL] OK, let me look that up. Yeah, we don't name them, uh, so it's, it's up to the the employer once they buy options from us, sometimes they rename it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, so I won't know by the name, but I can tell you what, what you have so far. Um, [PII], can I get you to verify your date of birth real quick?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And the address that we have on file?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Alright, let's see what you got currently.
[AGENT][NEUTRAL] Give me just a moment while I pull this up. And I wanna just let you know that this is a verification of benefits that you currently have, not a guarantee of payment.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] Um, it looks like the policy that you have right now.
[AGENT][NEUTRAL] is due to an accident or injury. You do have surgery benefits for that, um, of up to $500 per day, a maximum of 1 day per year, calendar year, um.
[AGENT][NEUTRAL] You have an emergency room? I'm sorry.
[CUSTOMER][POSITIVE] Wow.
[CUSTOMER][NEUTRAL] No, go ahead.
[AGENT][NEUTRAL] OK. Um, it looks like for accident or sickness treatment, you also have treatment benefits in an emergency room of up to $50 per day with a maximum of $2 per calendar year.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Treatment
[AGENT][NEUTRAL] Um, and that's goes, that's the same for urgent care. If you get treated, it's $50 a day, uh, with a maximum of 4 days per calendar year.
[AGENT][NEUTRAL] It looks like you do have a diagnostic testing benefit um of an MRI or medical imaging test of up to $100 per day.
[AGENT][NEUTRAL] Maximum of 1 per calendar year or an advanced study or follow up test of $25 per day.
[AGENT][NEUTRAL] Um, so if you were looking to upgrade.
[CUSTOMER][NEUTRAL] So that's all they pay for any of it.
[AGENT][NEUTRAL] For the policy that you currently have.
[CUSTOMER][NEUTRAL] I'm like, how is it even?
[CUSTOMER][NEUTRAL] Is insurance because we pay more for the plan a week than for.
[AGENT][NEUTRAL] And you do have
[AGENT][NEUTRAL] For that.
[AGENT][NEUTRAL] Yeah. You also have a hospital admission benefit of up to $500 per day. Um, but let me see, if you are looking to upgrade.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Yeah, I mean that's.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Let me see here, you will need to contact the people that it was that you that it was bought from um I can give you that number whenever you're ready if you're wanting to upgrade and they'll be able to tell you more about what their other options have um because I can't see the options that that they have that you aren't that you've been given u[PII] if you're not signed up for it we only help this number will only help if you have claims or if you have questions on what you have currently.
[CUSTOMER][NEUTRAL] I'm just like
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] Uh, you'll need to speak with, um, it's called Benes in a card to see what all they've had purchased from us to see if you're able to upgrade um and make any changes.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, yeah, and I was, and they sent me to you because specifically I was just curious if.
[CUSTOMER][NEUTRAL] It would pay for a trip to the dermatologist or something like that, but I guess not I guess it's.
[CUSTOMER][NEUTRAL] Or if like I had something removed and sent off. I'm, I'm just curious if this, this, any of this pays for cancer, cancer treatment or anything like that, if this is.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Yeah, it looks like I'm
[CUSTOMER][NEUTRAL] What this pays for.
[AGENT][NEUTRAL] I see you guys have a hospital indemnity and dental plan in a group accident.
[AGENT][NEUTRAL] And it looks like short term disability. I would contact, I don't know why they sent you to us because we can't look up things that you don't have yet.
[CUSTOMER][NEUTRAL] Uh.
[AGENT][NEUTRAL] Um, I would call them and ask them if they have a.
[CUSTOMER][POSITIVE] There's uh well have the classic.
[AGENT][NEUTRAL] Yeah, I would call them and ask if they have any cancer policies allowable to you or if they, if you can upgrade, um, they shouldn't have sent you to us for something that you don't have yet, or a policy you don't have yet.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Well, they said I currently have the classic policy so I was just curious what that covered.
[CUSTOMER][NEUTRAL] So it doesn't cover any kind of visit to dermatologist or anything like that apparently.
[AGENT][NEUTRAL] I can see if dermatology would count towards that for the um
[AGENT][NEUTRAL] This advanced study in uh medical imaging testing. Let me see.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Which if all it pays is $25 I guess it doesn't matter.
[CUSTOMER][NEGATIVE] I don't even see how this even is considered health insurance.
[CUSTOMER][NEUTRAL] When it costs more week to pay for the.
[AGENT][NEUTRAL] Yeah, I'm
[CUSTOMER][POSITIVE] The coverage than what we actually would get.
[AGENT][NEUTRAL] Yeah, I would contact them and ask them what.
[AGENT][NEUTRAL] What's included, you know.
[CUSTOMER][NEGATIVE] I did it and they told me I've talked to probably 6 different people and they're sending me in circles saying to call you. I've didn't talk to somebody else earlier from this end. I've called probably literally 4 different 5 different numbers. I guess nobody really.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I was just curious, like if I, I wanted to go to the dermatologist and get my skin looked at, if I had a mole sent off, I just wonder if it would cover any of that at all.
[AGENT][NEUTRAL] Yeah, the plan that you currently have does not.
[CUSTOMER][NEUTRAL] For it to get tested.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then our other option is the VP pro and they were like, oh I need to call this number and talk to somebody to see what that would cover if that would cover it so everybody I've talked to is just sent me to a different number.
[AGENT][POSITIVE] Yeah, and I apologize for that um.
[AGENT][NEUTRAL] I'm not quite sure why they sent you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] To this line because this is to help you.
[CUSTOMER][NEUTRAL] I'm sorry, and you're like the, the 6th person I've talked to, so I don't mean to be if I'm sounding like.
[AGENT][NEGATIVE] No, I would be frustrated too, um.
[CUSTOMER][NEUTRAL] I've gone call since 8 this morning since [PII] and I'm like, I'm used to having like Blue Cross Blue Shield South Carolina, Blue Cross through Pennsylvania like full coverage. Like I'm just like, what in the world is this? No offense.
[AGENT][NEGATIVE] Yeah, I would be frustrated too. Um, no.
[CUSTOMER][NEUTRAL] But I have a family of 4. I got 2 babies like.
[CUSTOMER][NEUTRAL] We need to be able to go
[CUSTOMER][NEUTRAL] To the doctor if we need to.
[AGENT][NEUTRAL] Yeah, I'm not, I'm not sure why they sent you to us.
[CUSTOMER][NEUTRAL] Paying almost $200 a week on something.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Um, yeah, we, we can help you with the policy that you currently have. Like I said, they, they bought the insurance through us, but when they rename it like a classic and all that, I, we can't look that up because it depends on what they bought from us, um, they, they could have made it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Well, the policy that we return, the policy that you see that we have regardless of the name of it.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] What does that cover like when it says.
[CUSTOMER][NEUTRAL] Surgeries, like it's an outpatient, outpatient surgery cover so much.
[AGENT][NEUTRAL] Due to a sickness or an accident.
[CUSTOMER][NEUTRAL] Like
[CUSTOMER][NEUTRAL] Preventative outpatient.
[AGENT][NEUTRAL] Uh, this one is for sickness and accident.
[CUSTOMER][NEUTRAL] OK, because it says something.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] OK, so that don't even sound like, I don't know about just give up. I don't know.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] OK. Well, thank you.
[AGENT][POSITIVE] OK, I do apologize and um.
[AGENT][NEUTRAL] If you so did did benefits in a card send you to us or did the employer send you to us?
[CUSTOMER][NEUTRAL] It's OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEGATIVE] No benefits in the car.
[AGENT][NEUTRAL] OK, um, check with the employer and see because if they're renaming it, like the, the, like how you said the standard and the gold, I would ask them um if you could see what what those entail, like a sample policy or something.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] It says classic.
[CUSTOMER][NEUTRAL] And VP Pro VP Classic and VP Pro that's what it's saying.
[AGENT][NEUTRAL] I, I would ask them what the VP Pro entails, um, because all we see is we have it named as a hospital indemnity policy. We don't, we don't name it Pro and gold, um, they buy from us.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] There's not.
[CUSTOMER][NEUTRAL] What they sent us, uh, it doesn't, there's not much difference in it from what I can see that I mean neither one of us is really much. I want real health insurance and I try to call health, healthcare Marketplace to see if I could just get us on our own stuff and
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I don't know. I don't even know what.
[CUSTOMER][NEGATIVE] Like it's [PII]. We can't get health insurance. What's going on? I'm, I mean, I, I'm gonna pay for it. I can't even, I don't know. I'm sorry, but I'll let you, thank you for your help.
[AGENT][NEUTRAL] No, I, I totally understand being frustrated. Um, I wish I could do more for you.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] It's OK. Thank you. Have a good day.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Alright. You too. Bye.
[CUSTOMER][POSITIVE] Thanks, yeah.