Employers consider claims integration to be one of the most important factors in selecting a voluntary carrier.
The concept of voluntary benefit claims integration is generating a lot of buzz in the industry. More carriers are offering it, and employers are seeking it, but what exactly does it mean? And what do brokers need to be aware of as they discuss claims integration with clients?
First, what do we mean when we say "claims integration"? Generally speaking, claims integration is the concept of using the data found in processing one claim to identify other claim-eligible voluntary coverages an employee might have. It has the potential benefit of removing the employee burden of having to remember all the insurance coverages they own and file separate claims for each. It is a meaningful enhancement of the overall claims experience and ensures that employees utilize the benefits they pay for and own.
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It may be surprising to learn that employers consider claims integration to be one of the most important factors in selecting a voluntary carrier. Eastbridge's 2020 The Employer Viewpoint MarketVision™ Report found that, after enrollment-related factors (availability of tools, calculators, benefit advice and carrier assistance), price/value of product, and ease of administration, 67% of employers are looking for carrier support of claims integration.
Carriers have recently picked up the momentum in offering claims integration. In 2020, only 38% of carriers were offering claims integrations of any kind, according to our Voluntary Product Trends Frontline™ Report. Less than a year later, 70% of carriers are offering claims integration, according to our 2021 Claims Practices of Voluntary Carriers Spotlight™ Report.
Now that we've provided a general definition and evidence to support that employers want claims integration and most carriers are offering it, what do brokers need to know when discussing this important service capability with employers? An understanding of the nuance/detail behind the broad term is critical. Consider asking the following questions:
1. What product lines can be integrated?
Carriers in our surveys noted a variety of capabilities for integrating claims. Some are able to integrate with disability claims, while others are able to integrate within their voluntary product portfolio—think looking for hospital indemnity coverage when reviewing an accident claim. Some are integrating with medical claims, either with their own medical plan or with another carrier's plan.
2. Will the employee be notified of an eligible claim or will a claim be automatically opened?
Most carriers that integrate claims with medical plans notify claimants about the possibility of filing a voluntary claim, but there are a few carriers that take it further and automatically open eligible/applicable voluntary product claims. For disability claims, carriers more often automatically open claims versus a simple notification.
3. Are all of the data collection/privacy pieces between multiple systems in place to ensure smooth delivery?
Claim integration is a practice that often requires data to be collected and held by disparate parties. There are many ways to bring all the pieces together and no universal best practice approach exists today. Many players outside of the carrier universe, like ben admin, decision-making and communication systems, are already bringing solutions to market, so you may be coordinating with a variety of vendors in addition to carriers. Discuss these data collection/privacy logistics with all parties to ensure streamlined execution.
Finally, remember that claims integration is one component in the overall claims experience, and all the other pieces are critically important. Make sure the carrier is claims-centric across the board: Do they allow for easy claims submission via a variety of methods? Do they have smooth communications and timely payments? All of these components in tandem are not just important, they are paramount to the health of the case overall.
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