employee benefits presentation
606028
About Mutual of Omaha
For more than a century, we have been committed to listening to our customers and helping them through life’s transitions by providing an array of insurance and financial products. We are a total benefit solution offering a comprehensive portfolio of products including both employer-paid and employee-paid voluntary accident, critical illness, disability, dental, life and vision. Serving all markets sized from two lives and up.
Learn More
Agenda
Our Team
About Us
Account Management
Claims
Service Enhancements / Dental Overview
Implementation
Brian Hughes Manager, Group Claims
Libby Sanders Claims Consultant
Mark Kasner Sales Manager
Jennifer Orf National Account Manager
A Trusted Benefits Carrier
Chartered in 1909
Over 70 years of employee benefits experience
Covering 3 million employees nationwide and serving more than 31,000 group clients
We are a mutual company
What does it mean to be a mutual company?
We are owned by our policyholders, therefore accountable to them. Every decision we make must be in their long-term interest. We must remain financially secure through marketplace and economic changes. We must be able to deliver on our promises today and tomorrow.
One of the most reconizable names in the insurance industry
Our Mission
Our Vision
Our Values
Our commitment is simple — to always be the easiest group insurance carrier to do business with, so you can focus on the growth and success of your business.
For every customer … a financial future imagined, planned and secured.
Our values are the attributes, behaviors and beliefs that connect our associates with a common vision. We exist for our customers, we act with integrity, we are innovative, we are accountable for results, and together we achieve greatness.
Financial Strength
We are proud of our solid financial status, which is reinforced by strong marks from the leading rating agencies.
Superior
A.M. Best Company, Inc. for overall financial strength and ability to meet ongoing obligations to policyholders. This rating is second highest of 16
A+
Good
Moody's Investors Service for current financial strength and ability to withstand financial stress in the future. This rating is fifth highest of 21
A1
STrong
Standard & Poor for financial strength to meet obligations to policyholders. This rating is fifth highest of 21
Ratings as of April 2023. Rating only refers to the overall financial status of the company and is not a recommendation of the specific policy provisions, rates or practices of the insurance company.
99%
The Net Promoter Score is an index ranging from -100 to 100 that measures the willingness of customers to recommend a company’s products or services to others. A “Good” NPS Score ranges from 0-30 and a “Great” NPS Score ranges from 30-70.
of customers say it is easy to do business with us.*
“
*Source: Customer Satisfaction Survey, conducted by the Center for Strategy Research
Industry Average: 36
49
Net Promoter Score
Mutual of Omaha Customer
Mutual of Omaha’s claim department is amazing and is the reason we moved our voluntary products to MoO.
Timely response to inquiries and a true partnership are important to me. I receive both with the people we deal with at Mutual of Omaha.
You treat a small employer like a big one.
Click to watch Fitesa's customer story.
Our Inclusive Culture
At Mutual of Omaha, we strive to create diverse teams, but we know that’s not enough. We must maintain an unwavering focus on equity and conscious inclusion so that we create a culture where all can thrive. We do this because it’s simply the right thing to do, but we’ve also discovered it delivers value to our customers.
Mutual of Omaha recognized by Forbes as America’s Best Employers for Diversity 2022 and by Newsweek as America's Greatest Workplaces for Diversity 2023.
Supplier Practices
Mutual of Omaha is developing a more robust supplier diversity strategy, proactively seeking out vendors from underrepresented communities and purchasing from suppliers who are demonstrably committed to social justice and racial equity.
Recruiting Practices
Mutual of Omaha is enhancing our efforts to recruit, hire, promote, develope and retain a diverse workforce and perforance expectations are being expanded to evaluate management progress in these areas.
Management Training
Mutual of Omaha is providing our management team with additional training on diversity, equity and inclusion, including an expansion of unconscious bias training.
Additional Community Funding
Mutual of Omaha committed to $1 million in additional annual funning for community-based initiatives and non-profit organizations.
Quality of products and services.
Differentiator 4
Brokers have confidence in our abilities to exceed customer expectations
Differentiator 3
Provide high standards of customer service.
Differentiator 2
System capabilities: from quote to claim we offer a consistent customer experience on both employer-paid and voluntary lines
Differentiator 5
Online access to eligibility, booklets, bills, bill pay, and claim submission for STD/LTD
Enhanced policyholder claims reporting Strength of Sales Trainee Program
Our engaged workforce
Ability to implement new groups quickly and accurately
Over 80 years of employee benefits experience
One of the most recognizable names in the insurance industry
Providing high standards of customer service
Enhanced policyholder claims reporting and access to online eligibility and bill pay
Quality products and services
System capabilities: from quote to claim we offer a consistent customer experience
Our engaged workforce and low attrition rate as a result of our strong family culture
Our Differentiators
Our local office support will:
Serve as a Dedicated Point of Contact
Oversees Ongoing Business Partnership
Provide Local Account Management
Share Knowledge of Best Practices
Educates and Guides Administrators Through Mutual of Omaha Processes
Ensures Collaboration of Resources Required to Manage Plan Administration
Member Modifications
Reporting
Billing
service Enhancements
Employee Assistance Program
• Online, telephonic, and in-person support from professionals • Three face-to-face visits • Beneficiary support and bereavement
Travel Assistance
• Pre-trip support • Emergency medical assistance • ID theft assistance • Repatriation.
Will Preparation
• Affordable, online, and secure • Last Will and Testament • Power of Attorney • Healthcare Directive • Living Trust
Dental Wellness
Mutual's Dental Presence and Experience
Mutual's Dental Claim Highlights
Mutual's Dental Website and Member Portal
Service Enhancements
Excellent claims payment and customer service
Simplified plan administration with one-source billing
Bundled pricing when packaged with life and/or disability
Online access to reporting and invoices
Dental Differentiators
PPO
Indemnity
In-Network Only
Employer Paid
Voluntary
Flexible Plan Designs
Administrative Details
With dental insurance, your employees will have a reason to smile. Our dental coverage includes, an extensive network of dental professionals, excellent claims payment and customer service, and online resources that allow employees to view benefits, track claims and find a dentist with ease.
Enrollment
implementation
billing & Reporting
Service
Combined enrollment for all Mutual of Omaha products on one customizable form
A dedicated implementation manager to ensure a smooth transition
Administrative simplicity with combined billing and one website for claims, reporting and eligibility
Experienced, in-house dental claims processing and service team. In 2021, over $87 million in dental claims processed with a 4.6/5 customer satisfaction rating
Claims utilization management to mitigate fraud, waste and abuse
extensive network
claims payment
customer service
ease
Dental Insurance Overview
RTP Top Utilized Dental Providers
Overlap With All Networks
I pride myself on building strong and lasting connections with our brokers and clients. My goal is to work hard and exceed their expectations.
– Robin
I actively listen to my customers and implement a course of action that satisfies their needs in a timely manner.
– Emily
My strong communication background makes me highly motivated to listen to my clients and exceed their expectations.
– Ken
Electronic File Transfer Timeline
File moved to production: Mutual of Omaha will review weekly files and provide any errors via standard discrepancy report. Client will be responsible for correcting discrepancies. Any received communication will be responded to within 48 hours.
Responsibility: Mutual of Omaha/Client
Day 50
Test File Review: Mutual of Omaha will review file for accuracy and confirm if there are errors to be corrected or if the file is approved for production within 3 business days. If multiple test files are needed the same review time frame will apply File approved for production.
Responsibility: Mutual of Omaha/Benefits Administration
Responsibility: Mutual of Omaha
Day 31-49
Initial test file created.
Responsibility: Benefits Administration/Broker
Day 2-30
Once final census is processed, file specifications are sent.
Day 1
Self-Admin billing can eliminate the ongoing maintenance that comes with an EDI file. Talk with your rep if you'd like to learn more. If an EDI file is the right choice for you follow these steps: Provide necessary sold case paperwork to Mutual of Omaha. Notify Mutual of Omaha that the group will need an EDI file.
Responsibility: Client/Broker
Pre-Sales
Ongoing Administration Made Easy
Your group’s HR Administrator enters changes such as salary updates, terminations, new hires, address changes, and other life events into their own benefit administration system. A dedicated team member will assist our clients with:
“Full” vs “change only” file feeds with all carriers and most benefit administration systems for better accuracy Connections to 252 different benefit administration systems One dedication point of contact for eligibility, billing, and any technical questions about the file transfer process Faster and more accurate change processing Flexible file upload schedules No implementation fee to establish feed
When you choose an insurance carrier for your clients, you want case set up to be fast, easy, and accurate. We agree. That’s why Mutual of Omaha offers Electronic Data Interchange (EDI) services for set up and ongoing administration of your clients’ benefit plans.
Electronic Data Interchange Makes Maintenance Easy
Self Service
Through our Employer Access portal, EMPLOYERS can:
Through our Employee portal, EMPLOYEES can:
View member information and manage enrollment Access invoices and make payments View real-time Evidence of Insurability tracking Access claim reporting and IRS Form 5500 Schedule A information View plan documents and forms
View current claims Submit new short-term disability claims Report paid family and paid medical leave time Download claim forms
Visit www.mutualofomaha.com/my-benefits to access the Employee Portal
Employer Access Overview
Overview
We respect the time it takes to manage benefit plans. Our secure plan administration tool — Employer Access — makes the benefits administration process easier. Our intuitive site gives you fast access to information, including previewing next month’s bill in real time. See Employer Access tutorial below.
Secure Benefits Administration
National Accounts Team
Ensure collaboration of resources required to manage plan administration
Educate and guide administrators through Mutual of Omaha processes
Share knowledge of best practices
Recommend administrative efficiencies
Provide centralized account management
Oversee ongoing business partnership
Serve as a dedicated point of contact
National Account Executives Will:
Your Dedicated Local Office Support Team
Serves as a dedicated point of contact Oversees ongoing business partnership Provides local account management Shares knowledge and best practices Educates and guides administrators through Mutual of Omaha processes Ensures collaboration of resources required to manage plan administration
Your Dedicated Implementation Manager
Serves as a dedicated point of contact throughout implementation Ensures paperwork is accurate and complete Coordinates all aspects of installation Provides a group number within 5 business days Distributes plan booklets and first billing statement within 20 days
Our customers can count on us for friendly, reliable and responsive customer service. We built our service-oriented culture on always putting people first, a sincere commitment that extends far beyond our internal walls. Our associates are passionately driven, inspired by and committed to fulfilling one common goal — helping you and your employees protect what they care about most.
dedicated customer service
UNTIL THE REQUEST FORM CAN BE UPDATED AND SENT TO THE FIELD, YOU WILL NEED TO ASK THE SALES REP IF THEY HAVE BEEN APPROVED FOR A NATIONAL ACCOUNT MANAGER. IF THEY ARE, INCLUDE THIS SECTION. IF THEY ARE NOT, REMOVE THIS SECTION. THIS SECTION MOVED FROM THE SINCE DELETED "NATIONAL ACCOUNTS" PAGE AND CONSOLIDATED UNDER ACCOUNT MANAGEMENT PER DISCUSSION WITH THE TEAM. UPDATED ON 8/16/22
THIS SECTION WAS UPDATED FROM REPORTING TO SELF-SERVICE AND IS NOW UNDER THE ACCOUNT MANAGEMENT PAGE INSTEAD OF CLAIMS. THIS DECISION CAME FROM SPEAKING WITH BOTH TEAMS TO DETERMINE WHERE IT BELONGED. UPDATED ON 8/16/22
THIS SECTION MOVED FROM SINCE DELETED "NATIONAL ACCOUNT" PAGETO ACCOUNT MANAGEMENT ON 8/16/22
xxxxx xxxxxx
EOI applications can be submitted online through Employer Access Applications are only valid for 90 days from the signature date
Evidence of Insurability (EOI)
EOI is a medical questionnaire or statement used as a documentation of good health. This application process allows employees to provide information about the employee and/or their dependents health history in order to be considred for coverage. Our EOI application process is easy. Employees can submit an electronic application using the online eApp system and get real time updates on their status through Employer Access.
Understanding EOI
When is EOI Required?
When is EOI NOT Required?
Application Process
EOI applications are only valid for 90 days from the signature date Our goal is to have each file indexed in 2 business days or better for each piece of correspondence Visit mutualofomaha.com/eoi to start the application process
EOI is required when an employee requests a coverage amount greater than the guaranteed issue When insurance is elected more than 31 days after the date an Employee/Spouse is eligible When VTL, VSTD, VLTD, and CI are elected outside of an open enrollment When an Annual Enrollment is not an Open Enrollment
When there are no changes to in force benefits or benefit amounts To decrease or drop in force benefits or benefits amount For Accidental Death & Dismemberment (AD&D) To insure Eligible Dependent Children For timely new hires electing the guaranteed issue or under
Click here for more information
Benefits Paid
Offset information is shared so that benefits are paid accurately.
Info Sharing
Information is shared between products if new forms are received.
Integrated Filing
Claims will be open for both disability and PFML if both coverages apply rather than the employee needing to file separately. Telephonic, email, mail, fax, and online filing available
Statutory Disability and PFML Coordination
Provides a summary of medical findings, appropriate medical restrictions and limitations, and how they may affect the demands of the job/occupation Network of medical providers for IME’s, peer reviews, functional capacity evaluations and specialist to specialist calls
Vocational Rehab Specialists & Consultants
Social Security Disability Coordinator
Master-level consultants Reviews claims for return-to-work potential Conducts an interview with the claimant and begins the rehabilitation assessment and planning process as appropriate Coordinates with the employee, plan administrator, and treating provider on ramp up plans or temporary job accommodations
Dedicated Experts
We take things personally, advocating for the needs of our customers. From day one, we train our claims specialists to do everything they can to pay a claim. And our in-house specialists and expert consultants ensure our customers get the help they need — even after a claim is paid.
Our in-house experts include:
Physicians & Clinical Nurse Consultants
Determines whether or not the claimant would qualify for SSDI benefits May refer the claimant to our contracted attorney vendor at no cost to the claimant for advocacy of their SSDI claim Vendor completes SSDI paperwork, including handling of appeals Provides education about the SSDI program to the claimant
Learn More about the life of a claim
Learn More About the Life of a claim
Our Claims Service Standards
Business Days
PFML/STD decisions to either Pay, Pend, or Deny are made within four business days
4
Weeks Prior
On average, STD claims are transitioned to LTD 6 weeks prior to max benefit
6
LTD claims are acknowledged within four business days
Because when people are in need, they shouldn’t have to wait for answers.
Our Competitive Advantage
Customer Service Philosophy
Immediate Claims service
Verbal Communication
STrong Focus on Claims
Low Staff Attrition
keeping the customer in mind and personalizing every interaction
we start working towards a claims decision when we are first notified of a claim, regardless of whether all paperwork is submitted or not
for every life claim we ensure we connect with our customers over the phone rather than via email
our Life Insurance claims are processed, paid, pended, or denied in 24 to 48 hours
significantly lower than the industry average
Dedicated National Account Claims Team
The Dedicated Claims Consulant team's strong focus on family culture is displayed in their collaborative approach to utilize their depth of claims background and policy knowledge to assist in servicing our customer's requests quickly and efficiently.
Your Dedicated Claims Consultant is the subject matter expert on claims guidelines and procedures. They will walk you through every step of the claims journey, assist with hypothetical claim scenerios, and provide you with assistance before, during, and after a claim.
Your Claims Consultant will servce as a dedicated point of contact for you on all Disability, Life/AD&D, Critical Illness, Accident, Hospital Indemnity, Dental, Vision, and PFML questions and assistance needs. This allows for the building of rapport with your benefit administrator.
Making life easier during difficult times
When someone files an insurance claim they need answers, quickly — so they can get on with their lives. True to our name, we are a mutual company. This means we answer to our customers and ensure they recieve an extraordinary level of service that sets us apart in the claims industry.
Dedicated claims service
Our dedicated team handles both Short-Term Disability Income Insurance (STD) and Long-Term Disability Income Insurance (LTD) claims.
Regional Knowledge
Regional teams have a deep understanding of local medical providers and the unique needs of you and your employees in their specific regions.
In-House professionals
Physicians, nurses, vocational rehab specialists and a Social Security coordinator are all on-hand to provide dedicated service.
Solutions-oriented team
Our team takes the time to understand and adapt to your changing business and proactively address your needs.
We understand large employer groups have more complex needs from their insurance provider. That's why we've created a Dedicated National Account Claims Team that is laser-focused on providing exceptional, customized claims service for our larger groups.
Dedicated Claims Consultants
Employees can choose from a variety of convenient ways to file their claim
Flexible
Our claims process is designed to be:
Cases receive an initial decision on pend, pay or deny within 4 days of notice of claim, regardless of the amount of details provided
Fast
In certain cases, express pay and simplified filing may be available to help get the claim through faster and easier
Simple
We do a lot of legwork, such as seeking proof, obtaining paperwork, and even paying for necessary medical records
Proactive
We gather all factual information to understand your employee’s situation so we can make the right decisions for them
Thorough
Your employees will work with dedicated specialists who will guide them from start to finish
Caring
You can access real-time claims status info through our online Employer Access portal
Transparent
An Efficient Claims Process
UNTIL THE REQUEST FORM CAN BE UPDATED AND SENT TO THE FIELD, YOU WILL NEED TO ASK THE SALES REP IF THEIR GROUP HAS CORE OR NATIONAL ACCOUNT CLAIMS. IF THEY HAVE CORE, TOGGLE ON "SECTION 1 - CORE CLAIMS TEAM" AND TOGGLE OFF "SECTION 1 - NATIONAL CLAIMS TEAM" AND VISA VERSA. THIS SECTION MOVED FROM THE SINCE DELETED "NATIONAL ACCOUNTS" PAGE AND CONSOLIDATED UNDER CLAIMS PER DISCUSSION WITH THE TEAM. UPDATED ON 8/16/22
IF NO PFML, DELETE THIS SECTION
THIS SECTION MOVED FROM THE SINCE DELETED "NATIONAL ACCOUNTS" PAGE AND CONSOLIDATED UNDER CLAIMS PER DISCUSSION WITH THE TEAM. UPDATED ON 8/16/22
Life of a Claim
Submit
Initial Review
Decision
Claim is submitted to Mutual of Omaha via fax, phone, online or via email. Claim is set up and assigned to a Benefit Claim Specialist within 24 to 48 hours. Click on the timeline to learn more.
Claim Submitted
Initial review is completed. If information is missing, the Benefit Claim Specialist will reach out to the Employer and Physician via phone or email to obtain any outstanding information. We will also make at least 2 attempts to call the employee to discuss the claim.
Day 1-4
The claim will be paid, denied, or pending within 4 business days. Written and verbal communication will be made to the employee advising of the decision.
Day 4
Click on each status to learn more.
If claim is approved: • Written notice of approval will be sent to Employee and Employer. • Benefit Claim Specialist will call the employee to advise of approval. • The Benefit Claim Specialist will follow up with the employee Bi-weekly to ensure no changes to return to work plans.
If claim is pending: • Written notice sent to employee advising of information needed to continue processing claim. • Phone call will be made to employee to discuss claim and advise of additional information needed. • Weekly phone calls made to employee to ensure understanding of status, and additional information needed.
If claim is denied: • Detailed letter providing rational for the denial decision will be sent to the employee. Letter will also provide notice of appeal rights and instructions on how to submit an appeal. • Written notice of denial will be sent to Employer. • Phone call will be made to the Employee to advise of decision. • Claim closed.
Day 1-4: The claim is assigned to a benefit specialist. The benefit specialist completes their initial review and determines the claim is supported for 6 weeks following delivery.
The benefit specialist calls Paula and informs her of the approval. An approval letter is issued to Paula and her employer.
Claim Submitted: Paula submits her STD claim to Mutual of Omaha for review.
Benefits are issued to Paula in one lump sum and the claim is closed.
Payment information is accessible to Paula and her employer via online reporting.
John requires 6 weeks of disability after slipping on ice outside of his home and tearing his ACL. Click on the timeline to learn about John's story.
STD & LTD Customer Claims Story
Day 1-4: The claim is assigned to a benefit specialist. The benefit specialist completes their initial review and determines additional information is needed. The benefit specialist faxes a request for the completed Attending Physician Statement to John’s physician. A request for the completed Employer Statement is emailed to John’s employer.
The benefit specialist calls John and completes detailed call. John is advised of the additional information needed. A letter is issued to John acknowledging receipt of the claim, and outlining the additional information needed.
Claim Submitted: John submits his STD claim to Mutual of Omaha for review.
Information Recieved: The completed Employer and Attending Physician Statements are received. Upon review, the claim is approved to John’s expected return to work date in 6 weeks.
An approval letter is issued to John and his employer. John is contacted by phone and informed of the approval.
Benefits are issued to John weekly in arrears. Payment information is accessible to John and his employer via online reporting.
John is contacted by his benefit specialist two weeks prior to his expected return to work date. John informs his benefit specialist that he has experienced complications and will now require surgery. John will remain out of work for an additional 8-10 weeks, beyond the 12-week STD benefit duration.
After a call to John’s physician’s office, the benefit specialist extends John’s approval to his surgery date. Once surgery is confirmed, the claim approval is again extended through the end of the STD benefit period.
Approximately 6 weeks prior to the end of the benefit period, the benefit specialist calls John to discuss a referral to LTD. The benefit specialist initiates the referral after their discussion.
Within 1-4 business days of the referral, the LTD claim is assigned to a benefit specialist. The LTD benefit specialist completes their review and calls John to discuss the initial claim decision and next steps.
Meet John
Day 1-3: The claim is assigned to a claims technician. The claims technician calls Maria’s spouse and confirms their demographics. No death certificate is on file; therefore, the claims technician calls the funeral home and confirms Maria’s cause and manner of death.
The claim is approved under Mutual of Omaha’s Express Pay model. The claims technician contacts the beneficiary to advise of the approval.
Claim Submitted: Maria’s employer submits a Life claim to Mutual of Omaha for review.
Payment in the amount of $50k is issued directly to the beneficiary. Payment information is accessible via online reporting.
Assign
Approval
Payment
LTD Referral
Meet Greg
Greg is requesting intermittent leave to care for his sick father. Click on the timeline to learn about Greg's story.
Greg submits his PFL claim to Mutual of Omaha for review.
Day 1-4: The claim is assigned to a benefit claim technician. The claim technician completes their initial review and determines if additional information is needed. The claim technician emails an Employer Statement to Greg’s employer for completion.
The claim technician calls Greg with claim status. Greg is advised of the additional information needed and is asked to obtain the completed Medical Certification form from his father’s physician. A letter is issued to Greg acknowledging receipt of the claim, and requesting the additional required forms.
Information Received: The completed Employer Statement and Medical Certification are received. The physician supports intermittent leave once per week for up to 8 hours a day for 3 months. The PFL claim is approved for this duration and frequency.
PFML Journey Map
Click on each icon to learn more about the administration of the claim:
Leave Management
Integration with other products
MA PFML claims will be handled by a separate team of analysts Standalone correspondence, case management, and documentation Program is not a replacement for standard Short-Term Disability product
Single filing approach – no additional forms! MA PFML runs concurrently with other leaves (FMLA, STD, LTD) MA PFML is primary payment and offset from other disability benefits Automated status updates and specialized reports to share information between shared claims
Request reimbursement, top off with PTO (private plans only), terminated employees can be covered for up to 26 weeks following separation Benefit durations can vary as PFML has shared entitlement To prevent gaps in coverage, an STD policy can ensure employees have sufficient income protection
Additional Information
Under MA PFML employers can:
Received
An approval letter is issued to Greg and his employer. Greg is also contacted by phone and informed of the approval.
Greg submits his intermittent time to Mutual of Omaha and absences are reviewed, coded, and approved. Benefits are issued to Greg. Claim and payment information is accessible to Greg and his employer via online reporting.
Meet Gloria
Gloria requires maternity and bonding leave after the delivery of her daughter, Jasmine. Click on the timeline to learn about Gloria's story.
Gloria submits her PFML claim to Mutual of Omaha for review.
Day 1-4: The claim is assigned to a benefit claim technician. The claim technician completes their initial review and determines Gloria’s claim is payable. Gloria is contacted by phone and informed of the approval and an approval letter is issued to Gloria and her employer.
The claim is approved for 6 weeks of medical leave following Gloria’s delivery. Gloria has elected to take 12 weeks of bonding time immediately following her medical leave. Her bonding time is approved, for a combined total of 18 weeks of leave.
Benefits are issued weekly to Gloria, and the claim is closed. Claim and payment information is accessible to Gloria and her employer via online reporting.
PFML Customer Claims Stories
First 24 hours
Days 6-15
Days 3-5
14 Days Prior to End of Absence
Continuous Leave of Absence
Request Packet
• Provides a summary of the leave request • Includes notice of eligibility, relevant forms/instructions, any supplemental material
Reminder of Documentation due
• Reminds the employee that the due date for their documentation is coming up
Notification of Document Received
• Notifies employee that a document has been received and is being reviewed. • Pertinent information is shared with Mutual of Omaha
Decision Packet
• Provides a summary of a decision made on the leave request • Includes any additional forms, instructions or supplemental material
Additional Touchpoints
• Undeliverable Email • Unprotected Absence • Failed Fax • Shared information with Disability Team to reduce form and information redundancy
Employee receives leave approval packet and instructions for next steps
Employee tracks time for leave
Employee confirms end date
Health Care Provider certifies condition
Employee receives leave denial packet and FAQ
Employee receives leave request packet and instructions for next steps
HR Manager updates pay and benefits
Communication Touchpoints
Maternity or Parental Date Confirmation
• Seeks confirmation of actual date of delivery or placement for Maternity or Parental Bonding Leaves • Coordination of Maternity date with Mutual of Omaha. However, we are working on these in concert at a rapid pace and many times we both receive confirmation on same day (Separately)
Return to Work Date Confirmation
• Notifies employees 14, 7 and 1 day(s) prior to end of absence • Requests confirmation that the end of their leave is approaching and that they intend to return to work as scheduled • Communication with Mutual of Omaha
• Undeliverable Email • Unprotected Absence • Failed Fax • Information sharing of pertinent data with Mutual of Omaha
Leave Request Process
Leave Time Tracking and Return to Work Process
Intermittent Leave of Absence
Clear and Intuitive Claims Process
Core Components of Implementation
Eligibility File
Historical Data File
Policy/Procedure Review
Manager Training
Support the Change With Flexible Training
• Initial training for HR and managers via multiple delivery options • Ongoing communication and education around impactful changes to legislation
Thorough Review of Policies/Procedures
• Review policies from regulatory perspective and compare to best practices • Develop employee communications that reflect your policies and incorporate your culture while guiding employees through the process • Create employer contact communication and reporting package to include desired content, recipients and timing
Customized, Consultative Implementation
• Managed by an implementation expert • Programs typically implemented in 90-120 days • Project management process ensures results
Implementation and Training
Comprehensive Reporting Package
On-demand reporting (including a summary of utilization across the employee population) provides trends insight for HR personnel
Capability to work on behalf of employees to keep data in sync across HR systems
FMLA Intermittent Trends Dashboard: Dashboard of intermittent leave activity which identifies trends to watch
Online Access to Comprehensive Data & Reporting
Ongoing: Overall results and trends, compared to book of business and industry benchmarks
Weekly: Overview of individual employee leave dates, status and usage (including patterns)
Timely Pushed Reporting
Employer Reporting and Online Tools
The AbsencePro ADA Solution
SM
Identification
• ADA leave process integration with FMLA and state leaves • Review application leaves for ADA analysis • Critical leave and medical data gathered and reviewed
Guidance
• Up-to-date guidance by expert ADA coaches, all of whom are attorneys, on recent court cases, EEOC guidance, ADA analysis process points (e.g., undue hardship analysis) • Ensures a well-reasoned, individualized analysis
Administration
• Process integration with FMLA • All applicable leaves ADA-reviewed • Critical leave data gathered and transmitted to decision-maker • Standard ADA-compliant communications • Tracked, reportable leave data
AbsencePro Technology Solutions
AbsencePro Website
AbsencePro Mobile App
• On-the-go access to initiate a leave, track intermittent leave usage, check status and update a leave
• Easy-to-navigate dashboard highlighting action items and summary status • Employees have easy access to tools that enable them to: • Determine their current leave balance • View completed documentation • Update information online and request medical certificate be faxed to physician • Employer contacts can: • "Work on behalf of" employees (e.g. open a leave request, report intermittent time) • View leave documentation • View balances in real time • Manage and update return to work activity • Generate reports • FAQs help employees and managers through process
Employee Experience: Absence Journey
Contact AbsencePro to Open Leave
Educate Employees on Process and Company Policies
Send Leave-Related Notices, Communicate Status, and Address Questions
Review and Process Documentation; Communicate Decision
Send Important Date Reminders; Document Planned Return to Work
Toll-free phone
Website
Multi-Modal On-Demand Access
Rights & Responsibilities
Company Policies
Your Next Steps
(Intermittent tracking, RTW, medical certification due date, etc.)
(Policy document in letter packet)
Education and Guidance
Paid Family Leave
STD/LTD
Human Resources
Connect to Resources
Follow-Up & Support
Intermittent leave
Return to work
Notifications
Intake Experience
1
2
Employee requests leave via web, phone or mobile app
AbsencePro determines eligibility for applicable leave plans
Collects all pertinent details relative to claim
Instructs employee on process, procedures and next steps
Collects verbal authorization
Sends employee request packet
Faxes medical certification form to healthcare
3
5
7
Multiple channels available: web, phone, mobile app, fax or mail
Designed to guide employees through each step
Communicate proactively on status and next steps
“Safety net” reminders at key points along the process
Call center open Monday through Friday, 7:30am to 9:30pm CST
IVR available 24/7 to report and view status of a claim
Spanish language capabilities available
high-quality employee experience
service by the numbers
• College Graduates • Extensively trained & monitored • Specialists with clinical, legal and HR experience
Our staff members are:
Employee Satisfaction Rating
95%
Avg. Call Length
8 min.
Telephonic Intake
55%
Digital Intake
45%
Easy Access and Intuitive Tools
Easy-to-Navigate Process
Striving to Make It Easy
Determination of eligibility
Approval/denial correspondence
Secure tracking of all employee requests and absences
The ability to track leaves concurrently with disability claims
Complete documentation for case use
Access to FMLA specialists and attorneys
Digital tools and resources (web portal and mobile app)
AbsencePro (FMLA) Services
Streamlined Intake Process
Technology Highlights
• Single point of intake for FMLA and STD claims • Eliminated the employer and employee sections of the disability claim form • Combined the necessary medical certification documents
• Streamlined Eligibility file for leave and disability • Integrated reporting for leave and disability through AbsencePro online portal and mobile app for both employees and employers • FMLA communications within the required timeframes including the ability to auto approve based on an STD approval
An Integrated Experience
AbsencePro: Expertise in an Evolving Landscape
Federal Leaves
• FMLA • USERRA • ADA (leave as an accommodation)
State Leave Plans
• Civic Volunteer Leave • Crime Victim/Court Witness Leave • Bone Marrow or Organ Donation Leave • Disability Insurance With Job Protection Leave • Domestic Violence Leave • Family and Medical Leave • Family Military Leave • Pregnancy Disability Leave (PDL) • School Visitation Leave
We administer more than 200 types of leave
across the United States.
Click on the state to see which states qualify.
Maryland
8
5-6
10+
9
Expertise Helps Keep Clients Compliant
• Federal and state statutes/regulations
• Administrative opinions
• Notable court cases
Covering legal actions and regulatory changes
Proactive Quarterly Updates on Impactful Legislation
• Implementation expert • Leave specialists • Compliance experts
Providing consultative approach to policies/practices
Designated Team of Leave Experts
Providing clear direction and support through a complex process
Frictionless Employee Journey
Strict application of the law is embedded into our best practices while allowing flexibility to suit your preference of administration (e.g., regulations, DOL letters, court decisions, etc.)
Compliant Leave Administration and Guidance
Potential abuse is identified, reviewed and challenged individually Additional resources (such as the EAP, wellness, or disease management program) are engaged, where appropriate
Reducing the Cost of Unplanned Absences
Employees proactively guided through the leave process Burden of determining eligibility and administering the leave process is shouldered by AbsencePro HR leaders are empowered to oversee and manage the program Seamless coordination with STD/LTD and Workers’ Comp vendors
Providing Ease of Administration
On-staff legal experts involved in all areas of our process Updates on current legal and regulatory changes at the federal and state levels Policy review and consultation during implementation
Ensuring Compliance
AbsencePro : Expertise in an Evolving Landscape
Short and Long-Term Disability Workers Compensation Employee Assistance Programs
Integrated Absence
Jury/Witness Duty Bereavement Leaves Personal Leaves Company-provided
Non-Regulatory
State Family and Medical Leaves Pregnancy Disability School Visitation
State
Family and Medical Leave Act (FMLA) Uniformed Services Employment and Reemployment Rights Act (USERRA) ADA Tracking and Coaching Services
Federal
Combining the market leading absence management experts at FMLASource and one of the most recognizable and trusted names in the insurance industry, Mutual of Omaha to provide a fully outsourced leave management solution with end-to-end, seamless integration.
Dental
Helping employers ensure compliance, ease administrative burden, and reduce cost of unplanned absences.
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Completed and Signed Employer Application
Completed New Case Verification Guide
Updated Census (Excel)
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Your implementation will be as easy as 1, 2, 3!
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