Guest Post Contributor: Voya Financial, national insurance carrier and PlanSource Boost partner
How an integrated and intuitive claims strategy can help boost benefits utilization.
In a recent survey, nearly 70 percent of workers considered supplemental benefits and perks at least as important as employer-based health insurance and retirement benefits.¹ However, even as employees value these benefits, the underuse of supplemental benefits remains an issue across the industry.
For example, when Voya Consumers Insights & Research interviewed employees with current supplemental benefits coverage, only 11% responded they had ever filed a claim for those benefits. “During enrollment, employees appreciate the opportunity to sign up for these benefits. After enrollment, not all employees remember to use them,” says Shannon Shafer, Director, Employee Benefits Customer Experience at Voya Employee Benefits.
“Some fault lies with the industry – we haven’t taken post-enrollment education seriously enough,” Shafer continues. “We need to remind employees they have this coverage and re-educate them about everything it can do for them throughout the year.”
Employers support this idea. According to a voluntary benefits study conducted by LIMRA, 98 percent of employers are willing to let voluntary carriers fill this gap and communicate directly with enrolled employees on an ongoing basis.² One area, in particular, that employers would like increased communication with employees is with claims.
As that LIMRA study shows, employers feel the claims process requires too much documentation and isn’t transparent enough. “There’s a perception that submitting a claim is an arduous process. And, in the past this might have been true,” says Sean Fahey, Director, Claims at Voya Employee Benefits.
“That’s why at Voya, we’re going beyond communication and into the experience itself,” Fahey continues. “We’re working to make it simpler and streamlined. After all, employees are often paying for this coverage, so it’s only right to make sure employees are maximizing all their protection.”
Using data from medical claims
One solution to helping employees make the most of their supplemental benefits may come in analyzing claims for other related benefits, like medical insurance. In the past this was only possible when a medical carrier also offered supplemental benefits. But today, technology can help look across carriers for claim opportunities.
“Once employees opt-in to medical claim integration during enrollment for their supplemental benefits, we really can be the one that connects the dots between coverages for them,” says Shafer. “Our technology allows us to be medical carrier agnostic. And by being medical carrier agnostic, more claims can be connected.”
More claims with less documentation
Another point of frustration noted in the LIMRA study was that employers are discouraged with the amount of documentation needed for claims, as well as the speed of the claims approval process. By using an intuitive claims model, supplemental benefit carriers can anticipate the needs of employees who have filed initial claims, making supporting paperwork unnecessary.
“With an intuitive claims model, if an employee files a claim for a covered event like a fracture, it’s very likely that the initial urgent care or hospital visit isn’t going to be the last time they need medical attention,” says Fahey. “That’s why we go ahead and send a check toward other covered benefits, like the x-ray, the follow-up visit, and the medical equipment they might need. We do all this without requiring any supporting documents.”
While auto-notification by carriers ranks high with employees—more than 4 out of 5 say they would appreciate this option, according to the LIMRA study—auto-adjudication of claims ranks even higher.
This capability is growing among carriers. “For instance, if we see a Short Term Disability claim involving a fracture, we’ll check to see if that employee also carries Accident coverage,” says Fahey. “If they do, and they haven’t yet filed a claim for the fracture, we’ll send them a check automatically without the need to file a claim themselves.”
The response from employees who receive a call informing them they’ll receive a check they weren’t expecting because of their supplemental benefit coverage is often one of disbelief. “When we tell people they’re about to receive a check, they’re often apprehensive at first,” Fahey says. “Insurance companies don’t usually proactively pay claims.”
“When they realize it’s real, they’re beyond appreciative,” Fahey continues. “If they’re on STD, they’ve been out of work because they’ve been injured—and they usually really need the money.”
An eye to the future
As medical claim integration, intuitive claim payments and auto-payment claims are used more widely, Voya believes that employees will see an increased value in their optional coverage. “We’ve had a lot of success stories, and we’re hoping that will encourage more people to get the benefits they’re owed when they experience a covered event,” Fahey says.
And while, according to the LIMRA study, most employers are already very pleased with the interactions they have with their voluntary carriers, employee satisfaction is also important to them. Integrated, intuitive claims can help.
“When claim integration works for an employee, that’s a story they tell their co-workers,” Shafer says. “They tell their family and friends.”
“When employees learn they’re getting a benefit payment that they didn’t expect, you can see the hope start to build,” Shafer continues. “That money could help them keep their house. They can use it to help pay their bills. They can see a way out.”
More than just a workplace perk to attract and retain talent, supplemental benefits tie into an employee’s financial wellness. “We know the financial hit that unexpected—and even planned—medical events can cause, and we know that the stress can follow them into the workplace,” Shafer says. “Supplemental benefits can help alleviate that stress. Employers benefit, employees benefit and even carriers benefit when technology like claim integration helps employees use their supplemental coverage.”
Insurance products are issued by ReliaStar Life Insurance Company (Minneapolis, MN) and ReliaStar Life Insurance Company of New York (Woodbury, NY). Within the State of New York, only ReliaStar Life Insurance Company of New York is admitted, and its products issued. Both are members of the Voya® family of companies. Voya Employee Benefits is a division of both companies. Product availability and specific provisions may vary by state and employer’s plan.
¹SHRM, “Using Voluntary Benefits to Support Workforce Strategy,” https://www.shrm.org/resourcesandtools/hr-topics/benefits/pages/voluntary-benefits-support-workforce-strategy.aspx.
²LIMRA, Employers’ Service Expectations for Voluntary Benefits, 2020.
This post originally appeared on Voya Financial and is republished with permission.
Voya’s Employee Benefits business offers stop loss, group life, disability and supplemental health insurance products through the workplace, as well as health savings and spending accounts, to employers and their employees. Voya has extensive experience in the design, implementation and administration of employee benefits plans, and it offers a full range of supplemental insurance products that include critical illness/specified disease, accident, hospital indemnity and disability income insurance covering over 6.6 million individuals through the workplace.
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