Compiled by Thora Madden
As part of our series of carrier surveys, Cal Broker reached out to some of the major players in voluntary benefits. Of course, they were happy to fill us in on what’s happening in their worlds. Read on for everything you need to know—and more—about these important benefits.
- List the voluntary/employee-paid benefits that you offer along with the minimum group size for each offering:
Rich Williams, EVP and chief distribution officer at Aflac:
Aflac’s supplemental insurance policies can complement any benefits package by offering an additional layer of financial protection if the unexpected happens. Aflac offers both group and individual products ranging from life and disability to hospital indemnity and critical illness. Additionally, Aflac’s supplemental coverage provides cash benefits paid directly to the insured, unless otherwise assigned, to help with the expenses health insurance may not cover. Aflac pays cash benefits quickly—often in as little as one business day*—so insureds can focus on recovery instead of their bills.
Aflac offers the following individual coverage:
- Accident (new product released in 2019)
- Cancer/Specified Disease
- Critical Care and Recovery
- Aflac Dental Insurance—Supplemental Plan
- Hospital Confinement Indemnity
- Hospital Confinement Sickness Indemnity
- Hospital Intensive Care
- Life—Whole, Term and Juvenile (updated products released in 2019)
- Lump Sum Critical Illness
- Short-Term Disability
- Aflac Vision Insurance—Supplemental Plan
Aflac Group offers the following group coverage:
- Worksite Disability
- Aflac Dental Insurance—Group Supplemental Plan
- Critical Illness
- Hospital Indemnity
- Worksite Life—Whole and Term (new products released in 2019)
In order for clients to establish an account, Aflac requests they complete and sign a Payroll Account Acknowledgement form and allow three separate W-2 employees to apply for at least one Aflac policy. To establish group billing, Aflac Group requires a minimum of 25 payers.
Michael Payton, Vice President of Sales, California Choice:
- Employer-sponsored Dental (2-199 Employees)
- Voluntary Dental (10-199 Employees)
- Employer-sponsored Vision (2-199 Employees)
- Voluntary Vision (2-199 Employees)
- Employer-sponsored Chiropractic/Acupuncture (2-199 Employees)
- Voluntary Chiropractic/Acupuncture (2-199 Employees)
- Employer-sponsored Life (2-199 Employees)
Steven Johnson, VP, Enrollment Solutions, Colonial Life:
Colonial Life provides a wide array of voluntary benefits including short term disability, life, dental, accident, critical illness and hospital confinement with offerings down to employer groups of 3 eligible lives.
Brian Sullivan, California VP for Humana’s Employer Group:
In California, Humana offers dental preferred provider organization (PPO), prepaid dental health maintenance organization (DHMO), Traditional Preferred (TRP), and Preventive Plus plans. In addition, we also offer Humana Vision plans. Both our dental and vision plans are available on a voluntary or employer-sponsored basis and require a minimum number of two lives to be enrolled.
Mike Schell, VP, MESVision:
MESVision provides vision care plans to employer groups on a voluntary basis with a minimum enrollment of five employees or 20% of the eligible employees, whichever is greater.
Tim Jander, VP, Sales, Western Region, MetLife:
- Accident Insurance
- Hospital Indemnity Insurance
- Critical Illness Insurance
- Cancer Insurance
- Auto and Home Insurance
- Legal Plan (MetLaw®)
- Worksite Short Term Disability
- Pet Insurance – MetLife recently announced the acquisition of PetFirst, a fast-growing pet health insurance administrator. MetLife is working to launch the PetFirst offerings to Group Benefits customers beginning in the summer of 2020. More information about our new pet insurance offering will be available in early 2020.
MetLife’s forthcoming Health Savings & Spending Accounts (HS&SA) offering is comprised of five different tax-advantaged benefits that help employees cover their healthcare and living costs. They are:
- Health Savings Account (HSA)
- Health Flexible Spending Account (FSA)
- Limited Purpose Flexible Spending Account (LP-FSA)
- Dependent Care Flexible Spending Account (DC-FSA)
- Commuter Benefits
More information about our HS&SA plans will be available in early 2020.
Scott Boore, SVP of Sales, MORE Health:
When facing a major medical issue MORE Health connects the patient’s attending doctors with one of our physician specialists to jointly develop a comprehensive collaborative diagnosis (or CoDiagnosis®) together with the optimum treatment plan or a second opinion.
Our HIPAA-compliant Physician Collaboration Platform™ allows doctors to work together from multiple locations in a truly effective manner. The MORE Health Co-Diagnosis® approach puts the patient at the center of the process.
Minimum account size is 10 lives for employer/broker paid coverage.
Voluntary coverage has a minimum of 100 lives.
Steve Stigliano, 2nd VP Small Group Ancillary Sales, Nippon Life Benefits:
Dental, Vision, Life, STD, LTD. Enrollment requirements: The greater of five enrolled or 25% of all eligible employees.
John Stanley, VP, Managing Director of Employee Benefits at Transamerica:
We offer a comprehensive suite of voluntary benefit solutions that allow employers to help employees care for their health while protecting and building wealth. We’ve created Express Designs, pre-set custom design plans for employers with 5 to 100 lives, available on nearly all of our voluntary benefits. For employers with more than 100 lives, we offer a wide range of coverage options and features. Our benefits include:
- Hospital Indemnity
- Critical Illness
- Supplemental Medical (GAP)
- Short Term Disability Income
- Retiree Medical
- Universal Life
- Whole Life
- Term Life
In addition, we offer employer-sponsored retirement plans (defined contribution and defined benefit), along with Individual Retirement Accounts (IRAs).
- Do you have any benefit offerings for employees that work fewer than 40 hours a week?
Williams, Aflac: Yes, we do. Aflac individual and group plans are available for full-time employees, as defined by the client, who work fewer than 40 hours a week. Please note the following:
- Individual accident and short-term disability policies: Employees must work a minimum of 19 hours a week.
- Group plans: Employees must work a minimum of 16 hours a week, with the exception of group disability. In order to be eligible for worksite disability, employees must work a minimum of 19 hours a week, and for true group disability, employees must work at least 20 hours a week.
Payton, California Choice: Yes, we offer everything listed in question one to employees working 20 hours plus per week.
Johnson, Colonial Life: Yes, we offer flexible benefits solutions to employees that work both full-time and part-time down to 20 hours per week.
Sullivan, Humana: Yes, Humana has benefit offerings for employees that work fewer than 40 hours.
Schell, MESVision: Yes. We accept the eligibility based upon the group’s participation requirements for benefits.
Jander, MetLife: Yes. For our voluntary benefit products, we look to the employer to determine the group’s definition of eligibility. While 30 hours is a common threshold for full-time consideration, some states mandate that employees working fewer hours be considered for benefits. During a group’s implementation, we will confirm the number of hours to be considered full time and whether part-time employees will also be eligible for coverage. We adhere to all applicable laws and regulations concerning eligibility, which, in some states, exclude those not working more than 24 or 30 hours a week.
Employees must be actively at work to be eligible for our voluntary benefits. Actively at work means that employees are performing all the usual and customary duties of their jobs on a full-time basis. This must be done at:
- The group policyholder’s place of business;
- An alternate place approved by the group policyholder;
- A place to which the group policyholder’s business requires them to travel.
Boore, MORE Health: Yes, MORE Health’s Second Opinion and Co-Diagnosis® is available to all employees regardless of number of hours worked.
Stigliano, Nippon Life Benefits: We can go down to 30 hrs per week.
Stanley, TransAmerica: Yes, many of our products are available to employees who work only 20 hours a week.
- Do you offer flexible enrollment data, billing capabilities and processes that work with the employer’s systems instead of the other way around?
Williams, Aflac: Yes. Aflac has the tools and flexibility to meet the unique needs of businesses of all sizes—from personalized benefit consultations with employees, to benefits marketing and education, to enrollment solutions. We will work with employers to design a seamless enrollment experience tailored to their business.
Aflac has found that the key to a great billing experience is understanding the client’s technical and payroll capabilities and assisting them with selecting the billing option that best fits their wants and needs. Aflac has the ability to work with employers’ systems and transmit billing data to an account in a variety of different ways. If an employer’s system does not seem like a good fit, Aflac and Aflac Group also work with a wide range of third-party billing companies in order to make the billing process as easy as possible for our customers.
Payton, California Choice: Our enrollment and administrative forms are compatible with most online enrollment systems in the market today. In addition, billing data is broken down to display employer and employee contributions—making deductions easy for payroll.
Johnson, Colonial Life:
Yes, as your dedicated enrollment partner, Colonial Life gets to know your organization and adjusts to what your current needs and challenges are. We have the unique ability to create a technology solution that meets you where you are now, and accounts for where you want to go in the future.
The enrollment strategy is tailored to a companies’ specific needs, from the methods and communications we use to educate employees, to the technology we use to enroll them. We want to help employees get the most out of their benefits when they need their benefits the most.
One of the most commonly utilized capabilities is Colonial Life’s Harmony enrollment system. It is built to accommodate any size case and the many specialized needs businesses have for enrollments and data reporting. It is our proprietary enrollment system that we provide at no cost to the employer.
We also support multiple benefits administration and HRIS systems to provide companies with a simpler, streamlined benefits enrollment and administration. This allows users to enroll in their core benefits on a vendor’s platform and seamlessly bridge to our Harmony enrollment system and elect their voluntary benefits. We also offer the option to build out our group products on another benefits administration or HRIS system for qualified customers. Our technology solutions ensure that data transfers are seamless and accurate. In addition, all of our data is securely encrypted to keep employee information safe.
We also can provide employers with daily enrollment reporting that shows which employees have been seen and which coverages they’re selecting. This reporting capability allows employers to assess the enrollment’s progress daily and make any necessary adjustments. Colonial Life also has several convenient electronic services for businesses that allow them to receive their bills, make payments and adjust their bills, as necessary, online.
Sullivan, Humana: Yes, Humana is able to accept an electronic enrollment via the SFTP or HTTPS protocol in a HIPAA 834 or Humana proprietary layout. There is not a cost assessed by Humana for implementation and maintenance of an electronic enrollment file feed. Humana offers both electronic and paper billing options as well as several bill sorting options to accommodate a group’s billing needs.
We accept automated clearinghouse (ACH) payments via our online billing tool through Humana.com known as eBilling. eBilling is offered to groups invoiced through our billing system to enhance the administration of our clients’ accounts. After we provide the group with a secured logon to our website, Humana.com, they are able to view the eBilling option in the billing panel of the employer self-service page, which offers the following features and conveniences:
- Receive email notification when the group’s billing is available
- Access the last 18 months of the group’s invoices (available the day after the group is billed)
- View summary and detail of an invoice (preferences are shared with the assigned billing representative)
- View detailed rosters of employees by type of coverage via PDF or Excel
- Download invoices into the group’s benefit system to simplify reconciliation
- Terminate members online and see the adjusted premium instantly
- Make payments via electronic funds transfer, through either one-time or recurring payments
If electronic bill payment is the group’s preference, the group can register to pay invoices electronically at Humana.com through eBilling, which offers the ability to sign up for email notifications, download invoices, review past invoices, view detailed employee listings, process terminations, and instantly receive credit. Wire transfers are also available.
Schell, MESVision: Yes, MESVision offers flexible enrollment data, billing capabilities and processes that work with the employer’s system.
Person, Title, MetLife: Yes. As the billing service provider for our products, we can work with virtually any TPA, benefit administration system or technology platform. We offer a platform-neutral payroll, time and attendance HRIS file feed at no additional charge. This feed can be linked with the customer’s payroll and/or time and attendance systems to provide updates. We will assist with appropriately mapping the fields on the file to a customer’s internal or third-party systems.
We are experienced and flexible in our ability to integrate with enterprise systems and enrollment firms to present a seamless enrollment process and ongoing administration. Our five most-used benefit administration vendors across all markets are bswift, businessolver, Empyrean, PlanSource and Benefitfocus.
Boore, MORE Health: Yes, MORE Health offers flexible billing capabilities and accepts many forms of enrollment data.
Stigliano, Nippon Life Benefits: Yes, Nippon offers flexible enrollment data, billing capabilities and processes that work with the employer’s systems.
We have developed a simplified process that allows us to work with almost any benefit administration and enrollment platform. Our billing capabilities are extremely flexible and can meet nearly any need an employer has.
- Do you offer the flexibility to conduct enrollments through one-on-one benefit sessions, group meetings, call centers and online self-enrollments?
Williams, Aflac: Yes. Aflac has the flexibility to conduct enrollments through each of these methods—one-on-one benefit sessions, group meetings, call centers and online self-enrollments. However, the availability of each method is determined by the number of eligible employees and state regulations.
Payton, California Choice: We commonly provide Benefit Enrollment Sessions in person (at group meetings) and via telephone conference. Online enrollment is also available.
Johnson, Colonial Life: Yes, we are a high tech and high touch enrollment firm. We know that employees still prefer personal interaction, based on Colonial Life’s 2019 research. Employees identified email, group meetings, and 1-to-1 meetings are their preferred methods for learning about their benefits.
This is why it is Colonial Life’s desire is to educate and enroll employees in all their benefits, all year round, wherever they are: in person, on the phone or online. We have a full spectrum of benefits communication and enrollment options, including group meetings, one-to-one meetings, call centers, co-browsing and online self-enrollments. Our national team of local, professional benefit counselors pride ourselves on educating and communicating benefits to employees so they can make better benefits decisions.
One unique way we do this is through Dispatch. Dispatch, powered by Wonolo, is an application that sends notifications of enrollment events to qualified benefits counselors. This mobile application is highly customized to Colonial Life’s unique enrollment staffing strategy. The app allows Colonial Life to easily alert qualified benefits counselors, in a timely and efficient manner, through an application on their phone. By utilizing Dispatch, Colonial Life pairs the human touch with technology to deliver the expertise our clients expect.
We also make it easy for employees to schedule benefits counseling sessions with our scheduler, powered by Interview Stream. In just minutes, employees can register for face-to-face, virtual or telephone enrollment appointments.
Scheduler is a tool integrated with our communications and makes it easy for employees to schedule time to talk with a Colonial Life benefits counselor about their enrollment options. One can schedule a date and time that fits their schedule. Once meetings are scheduled, employees receive a calendar invite and reminder emails or text messages leading up to the session. There is an 88% attendance rate for cases scheduled through this system.
Lastly, we know employees want choices. By 2020, an Intuit report predicts that nearly 40% of all U.S. workers will be engaged in some sort of alternative work arrangement. With our value proposition, we can honor our enrollment promise to its fullest potential. That is why we provide dedicated, telephonic support to every account, via all benefit platforms for mobile, remote, virtual or secure location employees. This is also a great enhancement to have in place for bi-lingual needs, multi-site locations, variable work schedule employees, high travel industries and new hire support. The experience is the same, and our team is trained on both voluntary and core offerings.
Overall, Colonial Life and its benefit counselors serve as an extension of one’s staff, providing personalized service that positively impacts the overall employee benefits experience.
Sullivan, Humana: Yes, to maximize employee participation in the group’s dental and vision plan, Humana schedules enrollment meetings to meet the unique needs of a client’s workplace. We assign the group a trained enrollment coordinator to conduct these meetings. Additionally, we supply an account representative to visit the group throughout the plan year for question-and-answer sessions with employees.
We also offer an enrollment package designed to educate and encourage members to utilize all their dental and vision benefits. Although our call centers are not available to enroll members, they offer the members information, answer any questions, and are able to assist in the enrollment process as needed.
Humana also offers all commercial employer groups the option for online web enrollment through the employer self-service portal. The Human Resources Benefit Administration (HRBA) web tool is the application used by employer group benefits administrators (BAs) to perform common enrollment and maintenance tasks on behalf of their employees, such as new hire additions, demographic updates, dependent additions, benefit elections and/or terminations. Additionally, HRBA is used by internal Humana associates as well as agents/brokers who have been granted access and have the authority to make enrollment maintenance updates to the employer group’s membership. It is the same tool for all users, ensuring continuity between user types.
Schell, MESVision: MESVision will meet with the group’s employees to explain the benefits and provide all materials to educate them on our vision care plans. Eligible participants must come directly from the group.
Person, Title, MetLife: MetLife does not offer an in-house enrollment solution, we partner with many companies (i.e., enrollment firms, technology vendors, third-party administrators and human resource outsourcing firms) who specialize in online enrollment and who deliver a high quality, flexible and relevant environment for employers and employees.
During the annual benefit enrollment period, we will ask that our voluntary products are programmed as an on-ballot benefit option with a yes/no benefit election decision alongside the customer’s medical, disability and life insurance. We can supply suggested text to the customer or their enrollment firm that will provide an overview of the products as well as the rates.
Enrollment and Communications
Our team of MetLife Voluntary Communications Specialists (VCS) will act as a dedicated resource throughout an employer’s enrollment process. He or she will meet with the employer to gain an understanding of the company’s demographics, voluntary benefits product history, organizational structure and any case-specific requirements. With this information, the VCS will recommend the best enrollment methodology and create communication materials to maximize employee education and participation. We can provide a variety of printed communication materials including posters, table tents, payroll stuffers and email blasts. The VCS can also provide digital copies of employee-facing materials such as product overviews, FAQs and slip sheets that can be added to a customer’s communications.
We can also create microsites that feature product overviews. Our standard templates allow for customization such as customer logo, document downloads and other assets. A microsite cannot be used for enrollment but it can be linked to an employer’s intranet.
Upon request, we can provide onsite support before or during the customer’s open enrollment period for group meetings and benefit fairs with more than 100 employees at one location. Onsite support for wellness and non-enrollment related events is typically provided for group meetings with 100 employees on location, and benefit fairs with more than 250 employees at one location.
An Onsite Services Enrollment Representative will work with the employer, their TPA or broker, to determine what types of meetings can be supported. Enrollment methods include:
- Group informational meetings followed by individual enrollment assistance
- Employee group meetings
- Train-the-trainer sessions for HR staff
- Benefit or health fairs
Our Onsite Services team works with over 400 benefit counselors across the country. These benefit counselors average 10 years of industry experience. Typically, there is no cost associated with these services.
Boore, MORE Health:
MORE Health is flexible in supporting the broker or account’s enrollment methods.
Stigliano, Nippon Life Benefits: Yes, we offer these.
Stanley, TransAmerica: Yes, we offer all of the above. Our goal is to provide enrollment options that best suit the needs of the brokers, employers and employees.
- Do you honor broker-of-record letters?
Williams, Aflac: Yes.
Payton, California Choice: Yes, so long as the business has been in force for six months or more.
Johnson, Colonial Life: Yes. Upon receipt, the new broker is placed on the account moving forward and receives renewals on in-force group product policies.
Sullivan, Humana: Yes, we can honor broker-of-record letters on a case-by-case basis based on the information received. However, we prefer the group provide us with a specific broker designation.
Schell, MESVision: Yes.
Person, Title, MetLife: Yes. MetLife will honor any written request from an authorized officer of a policyholder to recognize a broker or other intermediary as broker-of-record for purposes of providing such broker or other intermediary with information and/or paying commissions. This commitment is provided as long as the request is not inconsistent with any statutory laws or in-force compensation agreement.
Boore, MORE Health: Yes, MORE Health honors broker of record letters.
Stigliano, Nippon Life Benefits: Yes.
Stanley, TransAmerica: Yes, we do honor broker-of record letters.
- Do you offer simple and hassle-free account billing and payment processes?
Williams, Aflac: Yes. Aflac’s goal is to make billing and payment of premiums simple and hassle-free for your client. Aflac’s systems are flexible to accommodate a variety of billing methods and handle almost any type of billing layout.
Payton, California Choice: Yes, our bill is itemized, which makes it easy to understand. We also offer auto-pay.
Johnson, Colonial Life: Yes. Colonial Life offers many electronic services for businesses that allow them to conduct transactions online such as receiving their bills, making payments and making any necessary billing adjustments.
Sullivan, Humana: Yes, our billing and payment process offers a simple and hassle-free process.
Schell, MESVision: Yes.
Person, Title, MetLife: Yes. A single bill file platform is available for all voluntary benefit group products, which allows a single customer payment on a per-pay period or monthly basis.
One exception is that unlike our other group products, MetLife Auto & Home enrolls employees individually.
Boore, MORE Health: Yes. The billing processes are extremely simple.
Stigliano, Nippon Life Benefits: Yes.
Stanley, TransAmerica: Yes. In fact, because we know that billing can often be the most difficult part of the process, we offer self-administration which means that the employer simply needs to tell us how many people are covered and the total premium remitted by product and we will apply those funds to the group. This process eliminates billing frustrations and ensures that employees with coverage do not experience issues at claim time. As with our other processes, our goal is to meet the needs of the brokers, employers, and employees in the most straight-forward manner possible.
- Does your billing system allow plan administrators to make online deletions and changes to their plan account?
Williams, Aflac: One of Aflac’s billing options is an online invoicing portal for the account to review current participants, plan levels and billing information. This portal is where the account would reconcile their invoice monthly. Your clients are able to safely update, reconcile and pay their Aflac invoice electronically. This automated service enhances accuracy, speeds transactions and minimizes paperwork. Your client can save time and money, as their electronically remitted payments and changes are processed faster.
Payton, California Choice: No, not at this time.
Johnson, Colonial Life: Yes, Colonial Life offers online billing capabilities. A plan administrator also has the ability to make changes online, as well as update employees’ coverage and general information through our secure website.
Sullivan, Humana: Yes. A client’s administrator can use Humana’s website for changes, additions, and deletions to their employee and/or dependent information. However, if a client chooses EDI enrollment, all eligibility changes need to be made using the ongoing EDI files and the website then provides view capabilities only.
Schell, MESVision: Yes.
Person, Title, MetLife: Yes. Through our online billing system, per-pay-period deduction amounts can be changed in accordance with each payroll run.
Boore, MORE Health: Yes, a portal is available to allow plan administrators to easily update their changes.
Stigliano, Nippon Life Benefits: Yes.
Stanley, TransAmerica: Yes, our online reconciliation process allows employers to terminate coverage.
- Does your billing/payroll deduction process make it easy for the employer to offer multiple products?
Williams, Aflac: Aflac offers many billing options designed to meet a variety of needs. Aflac can handle almost any type of billing layout and accommodate several billing methods (e.g., list bill, self-bill, summary bill, self-accounting).
Payton, California Choice: Absolutely! This is exactly why an ancillary exchange makes sense for small business owners. We offer multiple products in a single program. Billing is broken down to display employer and employee contributions–-for all selected coverage. This makes it easy for an employer to pay for coverage, yet still have an itemized list of what their employees have selected.
Johnson, Colonial Life: Yes. Colonial Life can enroll an employer’s core and voluntary benefits and provide the account with enrollment data on all employee elections in an easy-to-use spreadsheet. Employers can electronically submit this information through our secure website, and Colonial Life reconciles the bill to eliminate any additional work for the employer.
Sullivan, Humana: Yes, our billing options make it easy for a group to offer multiple products.
Schell, MESVision: Yes.
Person, Title, MetLife: Yes. We will accommodate a customer’s preference. We can offer a single voluntary benefit deduction for numerous benefits or separate deductions for each benefit on one bill.
Boore, MORE Health: Not applicable.
Stigliano, Nippon Life Benefits: Yes.
Stanley, TransAmerica: Yes, on our enrollment platforms as well as on our bills the policies are in one place. All policies will be shown on one bill or statement.
- Does your system offer online searches for employee policy status, coverage effective dates and policy/coverage type?
Williams, Aflac: Aflac offers online services for policyholders who have an individual insurance policy. Policyholders can log on to myaflac.com 24/7 to do the following:
- Download claim forms and check claim status
- Access policy information
- Update personal profiles
- Request forms or copies of their policies
- Obtain contact information of their Aflac agent
- File claims quickly using Aflac SmartClaim®
Payton, California Choice: Yes. Employers can view all of this information, by line of coverage at choicebuilder.com.
Johnson, Colonial Life: Yes. The plan administration section of our website offers online searches for employee policy status, coverage effective dates and policy/coverage type.
Sullivan, Humana: Yes, once a member signs into Humana.com, they can review this information.
Schell, MESVision: Yes.
Person, Title, MetLife: Our online billing system allows the employer to sort the bill by different criteria for group products. MetLife Auto & Home enrolls employees individually.
Boore, MORE Health: The portal allows an easy search for information or download of CVS file.
Stigliano, Nippon Life Benefits: Yes.
Stanley, TransAmerica: Yes, we offer the ability to search employee policy status to determine coverage type and effective dates.
- Do you offer downloadable claim forms?
Williams, Aflac: Yes. Aflac policyholders who have an individual insurance policy may download claim forms from myaflac.com or file online via Aflac SmartClaim® (Aflac.com/claims). For Aflac Group claims, forms may be downloaded as well as submitted online at aflacgroupinsurance.com/customer-service/file-a-claim.
Payton, California Choice: Yes, many of our carrier partners’ forms are available online.
Johnson, Colonial Life: Yes. Policyholders and plan administrators can download and print Colonial Life claim forms on the company’s website at www.ColonialLife.com. One can also file a claim online for many types of claims such as: wellness, doctor’s office visits, accident, pregnancy, sickness and vision claims. They may also find answers to many claims related questions as well.
Sullivan, Humana: Humana Dental: Humana doesn’t have a single sample dental claim form to provide as typically the dentist submits the dental claim directly to Humana. However, if a Humana member enrolled in dental benefits needs to submit a dental claim for reimbursement, they can send a copy of the itemized statement from the dentist to the address on the back of their dental ID card. The itemized statement should include the patient’s name and the Humana ID number.
Humana members may also be able to get a claim form from their dentist. If using a dentist’s claim form, members should mail the completed form to the following address:
P.O. Box 14611
Lexington, KY 40512-4611
Humana Vision: Yes, claim forms can be printed from Humana.com. Members are only responsible for submitting claims when receiving out-of-network services. It is the responsibility of the provider to verify eligibility and submit claims forms for in-network services. Members are only responsible for the designated plan co-pays and any other incurred charges for in-network services.
Schell, MESVision: Yes, MESVision is the largest vision care network in California and claim forms are only needed if the plan member accesses care from a non-network provider. 98% of our plan members stay in our network and claim forms are not needed.
Person, Title, MetLife: Yes.
Accident, Cancer, Critical Illness, Hospital Indemnity and Worksite STD
For groups with less than 5,000 lives, enrolled employees can download claim forms on our employee website, MyBenefits. Online, participants can also:
- Initiate a claim
- Upload claim documents
- Check status of a claim
- Submit information electronically
- View claim correspondence
- Opt-in for eAlerts from product groups
- Access their core MetLife benefits such as Life, Disability and Dental
- Change beneficiaries
MetLaw/Hyatt Legal Services
Claim forms are not required for our legal services product because payment for covered services is handled between MetLaw and the network of provider attorneys. Participants simply call our toll-free number for a referral code for a participating attorney. Once the services have been provided, payment is facilitated from MetLife to the attorney at no cost to the participant.
MetLife Auto & Home
Claim forms are not usually required for Property and Casualty claims, as most claims are submitted telephonically and an adjuster can often settle the claim within the same phone call.
That said, MetLife Auto & Home participants can download claim forms at MyBenefits, our employee website. Customers can submit completed claims information and photographs by uploading, emailing or mailing the claim form. In addition, we can process towing claims online in many states.
MetLife Auto & Home also offers a downloadable app for iOS and Android platforms which can be downloaded via the Apple App Store and Google Play Store.
Boore, MORE Health: The second opinion/co-diagnosis process may begin with an email. Then a HIPPA form is sent electronically for the member to sign through docusign.
Stigliano, Nippon Life Benefits:
Yes. Stanley, TransAmerica:
Yes, employees can download claims forms or simply submit claims online with our web-based forms.
- Do you require carrier reps. to have a comprehensive knowledge of all of the products they deal with?
Williams, Aflac: Yes. Aflac’s broker sales professionals and agents go through training to learn about products and processes particular to the company.
Payton, California Choice: Yes, both our inside and outside sales representatives are trained to answer any product-related questions. We also have a customer service team on standby to help employers and employees with answers to questions.
Johnson, Colonial Life: Yes, from products to end-to-end enrollment with second to none service, we are committed to developing strong, long-term relationships with our teams. Colonial Life has a 10,000-member national organization of benefits professionals. These individuals receive comprehensive product training through Colonial Life College on both voluntary products and the employer’s core benefits, at the employer’s discretion. One of our areas of expertise is helping employees better understand their benefits programs, uncover their unique insurance needs and select the coverage they need to protect themselves and their families from financial risk.
Sullivan, Humana: Yes, the assigned account representatives have comprehensive knowledge of all the products they deal with.
Absolutely and all of our MESVision representatives are licensed Life/Health insurance agents in California.
Person, Title, MetLife: Yes. Our licensed representatives have extensive experience designing benefit programs for all MetLife group products.
Boore, MORE Health: Yes. All the MORE Health reps have an in-depth knowledge of the product and processes.
Stigliano, Nippon Life Benefits: Yes.
Stanley, TransAmerica: Yes, we do require carrier reps to have comprehensive knowledge of our products and we provide in-depth product training programs for our new reps as well as for anyone who needs a refresher course.
- How does your company support good working relationships between brokers and carrier reps?
Williams, Aflac: Aflac has a strong history of working with brokers. In 2015, Aflac established a national, W-2 team of experienced insurance professionals focused on broker partnerships and large employers. Since then, we have continued to expand and evolve our model so we are able to serve large national brokerage houses as well as smaller, regional broker firms. Our professionals are assigned by broker, giving them the best opportunity to build relationships and ensure Aflac is meeting the needs of our partners.
Payton, California Choice: Our representatives are committed to fostering positive relations with our carrier partners and our customer brokers (as well as their customers). We regularly organize events to network with brokers regionally and statewide.
Johnson, Colonial Life: Education, enrollment, administration, integration-–we do it all. And when we do, both the brokers and clients save money and enjoy simpler, more streamlined enrollment process. This is why Colonial Life places a high priority on working with brokers to help solve their clients’ benefit challenges. Colonial Life has regional broker marketing managers who are dedicated to strengthening broker relationships nationally and regionally, supporting national alliance partners and interacting with worksite specialist brokers.
Sullivan, Humana: Humana has long been one of the most ardent supporters of the independent agent distribution model. We have supported NAU on a national, state and local basis. Many of our sales and service associates have served in volunteer and leadership roles within the state and local organizations. This is especially true in California. We partner with several of the leading General Agencies in the state to support their distribution efforts in terms of their support of agents and brokers. Humana provides state of the art technology solutions for quoting, enrolling, installing and servicing of a producer’s client base.
Our model of agent support is via a pod structure. We have sales and service associates in key markets in California buttressed by a phone based crew who support the agents telephonically and electronically. Our reps do not compete with, but rather collaborate with our General Agent partner. Our approach is many doors, one destination.
Schell, MESVision: MESVision has been providing vision care benefits to thousands of employer groups and millions of plan members for over 43 years. We value our broker relationships and our carrier partnerships.
Person, Title, MetLife: We have a broker-centric model with a dedicated team, access to experts and simplified processes and technology. Our model is designed to work the way you do and ensure that our team is responsive, accountable and has access to resources that will help support and grow your business.
Boore, MORE Health: MORE Health works directly with the brokers and carrier reps.
Stigliano, Nippon Life Benefits: Yes, we have a dedicated account manager for all size groups.
Stanley, TransAmerica: Our carrier reps visit with brokers to learn their business and share how Transamerica products can provide solutions for specific clients. Our reps are available for face-to-face meetings and brokers also have continual access to our virtual reps who are easily accessible to support brokers throughout the sales process.
- Do you offer marketing materials that are easy to present and simple for clients to understand?
Williams, Aflac: With more than 60 years of experience in supplemental coverage and a brand that nearly 9 out of 10 people recognize today, Aflac’s worksite marketing materials are designed to create awareness, improve understanding, and increase participation in benefit programs. Whether supporting a small business or large corporation with complex logistics, Aflac can help your clients reach employees through various channels, such as:
- Brochures and flyers
- Posters and tent cards
- Payroll stuffers and direct mail
- Product videos
- Microsites, web banners and emails
- Sponsored ads on social media
- Augmented reality
- Beacon technology
Payton, California Choice: Yes, our marketing materials are written and designed to be easy to understand.
Johnson, Colonial Life: Yes. Benefits are only as valuable as the employees’ understanding of them. That’s why Colonial Life focuses on creating a customized, high impact communication strategy that enables employees to get the most out of the benefits an employer offers.
The marketing materials are available for our sales agents and brokers to use in educating customers and employees. One can quickly create digital postcards, customized fliers, posters, email campaigns, specialized benefits education websites, and booklets. We also have product and enrollment platform brochures available. Materials are available in English and Spanish.
Educating employees about the value of their benefits is at the core of what we do. We begin every enrollment with a series of communications, crafted to spark employees’ interest and inform their decision making. Then we meet with them one to one to answer questions and help them navigate their benefit options.
We have found that the key to enrollment is reaching employees where they are, how they want to communicate and with information that interests them.
Sullivan, Humana: Yes, we offer an enrollment package designed to educate and encourage members to utilize all their benefits and services. Our communication strategy consists of various components, which may include the following, based on a group’s needs:
- Certificate of Benefits/Subscriber Agreement (for fully insured clients) or Summary Plan Description (for self-funded clients); both are available electronically
- Network informational flyers
- Explanation of Benefits (EOB)
- ID card, available electronically
- Printed benefit descriptions
In addition to the materials listed above, we provide information on how to access our website, Humana.com. The site offers a broad range of tools and resources, including a tool for locating in-network dentists and specialists and preventive health content through various respected health content vendors. The group can also work with their single point of contact at Humana to distribute any printed or digital educational materials to employees, as needed.
Schell, MESVision: Yes.
Person, Title, MetLife: Yes. We offer a broad range of materials that clearly demonstrate the value of voluntary benefits to employees. MetLife will work closely with brokers and their clients to understand an employer’s workplace culture, communication style and preferences.
One of the keys to successfully enrolling current employees and new hires in voluntary benefits is using communication strategies that reflect the demographics of a group’s employees, the available budget and the customer’s participation expectations. We will work collaboratively with our customers to design tailored communication campaigns that promote awareness, education and enrollment in our products.
Our communication campaign highlights a triple phase approach (announcements, enrollment period and reminders) with several delivery options. We will partner with the customer to develop a communication strategy that could include leveraging the following materials:
- Emails, intranet posts, product overviews, FAQs, posters, onsite presentations and benefit fair slip sheets
- Supplemental materials such as videos, microsites, infographics, and our new interactive BenefitTalk tool
- Direct mail options are available but utilization is determined on case-by-case basis and these strategies could incur an additional cost
Boore, MORE Health: Yes. Materials for the employee and account are available.
Stigliano, Nippon Life Benefits: Yes.
Stanley, TransAmerica: Yes, we provide materials that take the guesswork out of voluntary benefit solutions. Our collateral explains the important features of our products as well as how employers and employees will benefit from the coverage. We continually evaluate our materials to determine if they are meeting the needs of brokers, employers and employees.
- How do you track the quality of the customer service you provide to employers? For example, do you set annual service goals and measure and report results?
Williams, Aflac: Aflac constantly measures our customer satisfaction level with policyholders and business accounts in a variety of ways, such as surveys and audits, to ensure we are meeting our established customer service goals and standards. We monitor satisfaction with the total Aflac experience as well as satisfaction with enrollment, claims and billing. Aflac’s customer service quality program is administered by our Quality Assurance department. Each major business function is sampled monthly. Additionally, for quality scoring, a minimum of five audits per month for each customer service center representative are guaranteed. All scoring and error trending are reported weekly, monthly and quarterly to management. Aflac’s Internal Audit department also conducts audits by line of business in addition to their annual assessment of internal claims controls.
Payton, California Choice: Yes, we measure and track both production and call metrics on a daily, monthly, and quarterly basis, to ensure we are delivering quality, timely service to our broker, employer, and member customers.
Johnson, Colonial Life: Colonial Life provides superior customer service to all of its customer groups: brokers, employers and policyholders. The company sets internal annual customer service goals and results are measured quarterly. Colonial Life also works with independent research firms to conduct ongoing surveys of plan administrators and policyholders and reports those results externally through news releases. In addition, all employees who have an interaction with a Colonial Life benefits counselor are asked to rate their one-to-one benefit counseling experience following their enrollment. Every account participating in the post-enrollment survey receives a report card with the survey results. Our benefits counselors are highly rated by employees. 97% who have had a counseling session with a Colonial Life counselor say their understanding about their benefits with their employer have increased.
Sullivan, Humana: Yes, to ensure consistent, quality customer service for our clients, Humana sets annual service goals for our Customer Care department. Performance goals are achieved by leveraging Customer Care teams and their skill-based training across all accounts. Humana utilizes Customer Care specialists dedicated to providing quality, timely service to all callers.
Our Customer Care team’s structure is designed to optimize supervisor/specialist interaction and includes a Resource team, which handles call escalation, monitors quality control and escalation analysis, and serves as an information source for Customer Care associates. In addition, the dedicated Training and Communications team oversees all training and promotes proactive communication efforts to Customer Care associates.
Humana’s mission is to foster a culture of customer service that is empathetic, proactive, conclusive, and encourages every one of our associates to seek ways to improve our service. With this mission in mind, we monitor customer satisfaction in a number of ways.
Humana implemented the Voice of the Customer (VOC) program, which is a client-focused tool that provides a random, outbound, automated phone survey to our members. VOC surveys are conducted daily and give us an opportunity to listen to members and gauge their experience with Humana. Through VOC, randomly selected members are asked questions about their experience after their call with one of our Customer Care specialists. A group’s members can voluntarily elect to take the survey. VOC provides detailed survey results, which are calculated with representative-level, team-level, service center-level, and corporate-level reporting. We use these results to coach our associates, provide feedback to our Customer Care teams, and to conduct direct member outreach to ensure satisfaction as necessary.
Humana also administers a customer satisfaction survey by email to a group’s members. Those surveyed include all group members, excluding those with contract-mandated “do not contact” blocks or those who have not provided email addresses. Each member is invited once annually to participate. The survey addresses member satisfaction and overall Humana performance on a five-point scale.
In addition, we are willing to perform a group-specific member satisfaction survey funded by the group. Pricing is discussed at the time of the request based on the scope of the survey. We utilize a third party vendor to conduct the survey, collect the data, and run the analysis. Our research consultant monitors and guides the process along.
Schell, MESVision: MESVision performs member and provider surveys on a quarterly basis and reports to our brokers and employer groups our survey results.
Person, Title, MetLife: We have always viewed the delivery of high quality customer service as a key element in our partnership with our customers. Our Voice of the Customer Satisfaction Survey program ensures that we solicit input from our customers and their employees and implement changes to improve the process when and where necessary.
Research firm, Radius Global, conducts annual Client Service and Implementation surveys on our behalf for our group customers. The surveys are conducted to measure satisfaction with various aspects of our service and to evaluate the overall relationship between customers and their Client Service Team and to help assess our performance during the implementation process within 60 days of the effective date.
Upon request, we can provide utilization reporting to group customers. Each voluntary product has a set of service goals and performance standards. Whether we provide performance guarantees with a percentage of premium at risk depends on the customer-specifics and which products are sold.
Boore, MORE Health: We send surveys to all members that have activated service. Feedback is analyzed for improvement areas. Goals are monitored and tracked.
Stigliano, Nippon Life Benefits: Yes, we monitor.
Stanley, TransAmerica: We perform customer service surveys to evaluate the level of service we offer and we continually work to optimize those results. We also have mechanisms and procedures in place, including reviews of customer phone calls, to ensure that established levels of quality are being met.
- Do you have an established local sales and service team that can provide critical service in the same cities that the broker’s clients are in?
Williams, Aflac: Yes. We have a local account management structure to provide localized support for brokers and their clients. In addition, Aflac has a team of independent sales agents licensed to sell Aflac products throughout the United States. Aflac’s certified enrollers are available to service multi-location accounts, and we have a national sales coordinator team to manage these relationships. The company also offers a team of dedicated broker sales professionals in every major metropolitan area to support and service Aflac’s brokers and their clients. Aflac’s agent distribution model and broker channel can help you manage your clients’ open enrollment needs no matter the size or location.
Payton, California Choice: Yes, we have representatives statewide who are able to assist brokers with clients, regardless of location.
Johnson, Colonial Life: Colonial Life has more than 45 territory offices across the country and a national team of 10,000 sales professionals who provide local enrollment support and service for its broker partners’ clients. Many of the company’s accounts have thousands of employees in dozens or even hundreds of different locations across the country. Colonial Life’s sales representatives provide employers with valuable services at no direct cost, such as free dependent verification, discount program for health items, wellness benefits communication and more. Colonial Life benefits counselors can meet with employees at each location and conduct individual counseling sessions with them. Because the benefits counselors are local, they can be on hand to help out with next year’s enrollment and any ongoing service needs. The goal is for the company’s benefits counselors to build strong relationships with employees in the account.
Sullivan, Humana: As outlined in Question 12, we have sales and service associates located in key markets throughout California, as well as a telesales team. Our people are equipped to serve agents in all markets in California.
Schell, MESVision: Yes.
Person, Title, MetLife: Yes. We have representatives who specialize in voluntary benefits located throughout the U.S.
Boore, MORE Health: Yes, MORE Health has a sales team in various states and metropolitan areas that can provide support.
Stigliano, Nippon Life Benefits: Yes.
Stanley, TransAmerica: We have successfully built an internal virtual team consisting of sales professionals who can partner with brokers to answer any questions that arise during the sales process. We also have a stellar account team readily available by phone to take care of any business needs the employer has. Our virtual teams are incredibly responsive and have the knowledge and decision-making authority to ensure that clients’ needs are met.
- Do you have a sales rep. and a service rep? (The sales rep helps the broker market and position products, manage blocks of business, and develop target markets. The service rep helps implement and fulfill account enrollments.)
Williams, Aflac: Yes. We have a local account management structure to provide localized support for brokers and their clients. In addition, Aflac has W-2 broker sales professionals and designated service teams that support our broker channel. The service teams will lead the broker and client throughout the implementation and ongoing administrative process.
Payton, California Choice: Yes, we have a team dedicated to assisting brokers and their clients, including an outside field representative and inside sales representative, as well as enrollment and renewal support.
Johnson, Colonial Life: Yes. Colonial Life’s national team of sales professionals has specialized roles they perform during the enrollment process. Sales professionals work with brokers and their clients to help develop voluntary benefit strategies that will help clients solve their benefit challenges. Account coordinators help manage the enrollment logistics and report. And benefits counselors meet individually with all employees to educate them on their benefits, help uncover any unmet needs and select insurance plans to meet those needs.
Sullivan, Humana: Yes, Humana’s sales representatives are available to perform the tasks noted above and our client service representatives are available to handle groups after the final sale.
In addition, to ensure account service satisfaction throughout implementation, we assign an installation administration professional, trained in the specific sold product, to serve as a single point of contact, providing service on a group’s plan to the benefits administrators, designated HR representatives, and agents, brokers, or consultants. The assigned installation administration professional serves as the day-to-day contact for any service-related issues or concerns, assisting on items such as enrollment/eligibility submission or premium payment discussions, and they can engage other areas within Humana on a client’s behalf, as necessary.
Schell, MESVision: Yes.
Person, Title, MetLife: Yes. Our sales and service teams work together to meet the needs of brokers and their customers. The core members of the service team are the Account Executive (sales rep) and the Client Service Consultant (service rep.)
Account Executive (AE): The sales rep/AE develops benefit solutions specifically for a customer by using his or her detailed knowledge of our product offering and a comprehensive understanding of the customer’s benefit goals. The AE answers the employer’s or broker’s questions related to the MetLife quote and our product solutions.
Client Service Consultant (CSC): The service rep/CSC is the customer’s MetLife contact for day-to-day administrative needs and claims escalation. The CSC facilitates resolutions for billing inquiries, provides reporting, escalates claim inquiries, and coordinates plan changes.
After notice of a sale, each customer is assigned an Implementation Leader (IL) who will coordinate and manage the implementation. The IL designs a project plan and timeline for onboarding or transitioning the benefits to MetLife. The IL and the Implementation Team establish connections for billing, enrollment and any other systems to ensure the account is claim-read on Day One.
Boore, MORE Health: Yes, we have sales reps and account management that provides service support.
Stigliano, Nippon Life Benefits: Yes.
Stanley, TransAmerica: Yes. We have regional vice presidents who consult with brokers on the solutions available for clients and to help grow their business and we have dedicated account managers to assist brokers and employers with onboarding and implementation, general account management and to ensure that enrollment is successful.
- Do you specialize in voluntary benefits?
Williams, Aflac: Yes. Aflac is a leader in individual supplemental insurance products at the worksite in the U.S. Aflac offers individual and group products as well as a portfolio of value-added services. Aflac is a leader in providing policies that pay cash benefits directly to insureds, unless assigned. With our broad portfolio of offerings, Aflac’s solutions suit virtually every business size and type. From three employees to more than 300,000, Aflac can fit easily within almost any benefits package. Many times in the supplemental insurance business, companies tend to use the same approach to market similar benefits. Aflac is different. We back our plans up with the following:
- Innovative marketing campaigns
- Strong financial stability
- Brand recognition
- A solid company reputation
- Responsive claims and customer service
*One Day PaySM is available for certain individual claims submitted online through the Aflac SmartClaim® process. Claims may be eligible for One Day Pay processing if submitted online through Aflac SmartClaim®, including all required documentation, by 3 p.m. ET. Documentation requirements vary by type of claim; please review requirements for your claim(s) carefully. Aflac SmartClaim® is available for claims on most individual Accident, Cancer, Hospital, Specified Health, and Intensive Care policies. Processing time is based on business days after all required documentation needed to render a decision is received and no further validation and/or research is required. Individual Company Statistic, 2019.
Payton, California Choice: Yes, our ancillary benefits exchange was developed specifically to help employers expand their benefit offerings to employees, while still controlling their costs. We offer both employer-sponsored and voluntary benefits options.
Johnson, Colonial Life: Yes. When Colonial Life was founded in 1939, it sold accidental death coverage to individuals. In fact, the company pioneered the concept of offering voluntary benefits at the worksite in the 1950s. Colonial Life has always marketed only voluntary benefits, and during the 80 years it has been in business, the company has developed strong expertise and experience in the voluntary benefits industry.
We serve more than 95,000 companies and organizations to protect more than 4 million U.S. workers and their families.
Sullivan, Humana: Yes, Humana has provided voluntary dental benefits since 1978 and our voluntary vision benefits have been offered since the early 2000’s. We do not currently offer traditional workplace voluntary benefits such as Hospital Indemnity, Cancer, Heart and Stroke, etc.
Schell, MESVision: MESVision has numerous plan designs for both voluntary and employer paid plans. We specialize in vision care plans only and we do work with carrier partners that can provide bundled plans as well for other health benefits.
Person, Title, MetLife: Yes. Our leading market positions, innovative product offerings and 100+ years of group benefits’ experience contribute to long-standing and productive relationships with our customers. We help our customers deliver information effectively and improve employee engagement and satisfaction. For more information, please visit www.metlife.com.
Per LIMRA’s first-quarter 2019 U.S. Workplace Voluntary Sales Report, our market rankings based on new sales are as follows:
- First in total voluntary health sales
- First in the critical illness insurance market
- Second in the accident insurance market
- Second in the hospital indemnity insurance market
- Second in the cancer insurance market
MetLife is the largest Group Auto and Home benefits provider in the country, with approximately 44.9% market share. MetLaw is the nation’s leading provider of employer-sponsored legal plans.
Boore, MORE Health: The vast majority of MORE Health’s business is employer or broker paid. Voluntary benefits is a minority of the overall business.
The voluntary is a smaller portion due to the value offered compared to the premium base.
Stigliano, Nippon Life Benefits: No.
Stanley, TransAmerica: Absolutely. Transamerica has been providing voluntary benefits for nearly 90 years and we are committed to protecting the wealth + health of employees. We work with brokers and employers to ensure that our solutions are easy to understand, flexible regardless of internal processes or platforms, simple to implement, and ultimately allow for a seamless enrollment and claims experience for employees. Transamerica’s voluntary benefit solutions help employees live their best lives.
Thank you to our contributors!
Rich Williams, AFLAC
Michael Payton, California Choice
Steven Johnson, Colonial Life
Brian Sullivan, Humana
Scott Boore, MORE Health
Steven Stigliano, Nippon Life Benefits
John Stanley, TransAmerica