Thumbs up: filing methods and turn-times

Making it easy to submit a claim and paying claims quickly are two of the most important components of excellent customer service. And carriers report fairly high standards for claim filing options and payment times. That means you and your clients can expect consistent thresholds and options across the industry.

All the carriers we surveyed offer multiple ways to file a voluntary claim. Paper and fax are universal methods, but most also offer online, email and phone submission. Unlike other financial services industries, mobile apps for claims submission in the voluntary space are still uncommon, but likely to grow. If your client has a large percentage of younger or remote employees, that option could be important to them.

More good news: Most carriers consistently pay claims quickly, resolving at least 80% within 10 days. Of course, this can vary by product—critical illness claims can be more complicated—and how complete the information is when first submitted. About half of carriers auto-adjudicate at least some claims, especially wellness, dental and vision claims.

Sticking points: communication and tracking

Areas with the greatest disparity between carriers—and possibly between carrier and client expectations—involve communication and claim tracking. These areas are also the most likely to trigger problems in your accounts, causing unnecessary employee questions that ultimately land on your plate and negatively affect customer satisfaction. That means it's important for you to ask questions and understand the capabilities of your carrier partners.

Notifying employees of claim receipt — Paper mail is a carrier's go-to method for letting employees know they received their claim submission. Carriers say they usually send these letters in five days or less, but it can take up to 10 days. Some carriers also use email notification for online submissions and phone calls or texts, either automatically or within 24 hours, and several carriers send multiple communications, such as an email or phone call followed by a mailed letter. However, these processes can vary by product. For example, most carriers acknowledge receipt of dental claims only through the explanation of benefits they send after the claim is resolved. Carriers are more likely to use phone notifications for life and disability claims.

Claims tracking for employees — Nearly all carriers surveyed offer multiple ways to track claims, such as toll-free numbers and online portals. But only half offer email tracking and just a handful have a mobile app, and some carriers offer claim tracking only for certain products or product platforms. Most of these methods aren't proactive and require the employee to initiate the process.

Claims tracking for you and your clients — About two-thirds of carriers allow brokers, employers or both to track the status of an employee's claim, but typically they provide only high-level information such as claim receipt, pending status and whether it was paid or denied. In addition, some carriers don't allow employers or brokers to track employee claim information, and some allow access only if employees provide permission for them to do so. A lack of status updates obviously makes it tough for you to appropriately respond to questions from your clients.

Phone call answer times — Not all carriers can provide data on their call answer times, but those who can report 82% are answered in a minute or less. However, it's less clear if those calls are effective. Fewer than half of carriers are able to report the percentage of calls resolved after the first call. Having to make multiple calls for the same issue drives down customer satisfaction.

Stay focused on the basics

Our research shows carriers are highly aware of the importance of these issues. They say the biggest concerns they face in the future stem from increased customer expectations for faster turnaround times as well as easy-to-use, technologically driven customer service capabilities. In response, they're looking for ways to streamline the claim process to make it easier for claimants, increase digital communications capabilities to accommodate customer preferences and shorten response timeframes, and develop an easy-to-navigate claim process and experience that's consistent for customers with any products.

And while carriers also say they're prioritizing claim integration, it's important for you to stay focused on the basics and the bigger picture of claims and customer service. Understanding what level of communication you, your clients and their employees will experience is a key driver of the overall longevity of your cases.

Read more: 

• Nudging employees into better enrollment choices
• Voluntary claims integration: Beyond the buzzword
• Younger workers plan to enroll in voluntary benefits, though they don't understand them