Justworks
If a Justworks client calling through the Justworks skillset cannot be found in our system, this is the entity where you should create their member record.
What is, "Justworks Employment Group LLC - Core and EAP - JNY"?
These are the start and end dates for Bloomberg's 2027 Open Enrollment period, and whether enrollment is passive or active.
What are, "October 19, 2026, through November 6, 2026, and enrollment is active"?
At the Tier 1 level, this is what you must do if you do not have access to the necessary systems to answer a member's question.
What is, "Submit a CSR (Customer Service Request)"?
This is the amount of time employees are expected to take to read and respond to emails.
What is, "within 24 hours"?
This is the expected response time for following up with a member after their inquiry or case update.
What is, "Within 24 hours"?
These are the dates when Justworks employees can make their benefit elections for 2026, with enrollment being active.
What are, "September 17, 2026, through September 28, 2026, for employee Open Enrollment"?
If an advocate receives a member question on a topic where no information is currently available, this is the next step they should take.
What is, "Submit a Client Service Request (CSR)"?
This is the biggest recent change to the UPHS process regarding how member emails are handled.
What is, "All emails will now be automatically routed to Health Advocate"?
This is when timecards should be sent to Kim, what they should include, and how to handle adjustments.
What is, "Timecards should be sent to Kim on the last day you work for the week, should include all time off, and any adjustments should also be emailed to Kim"?
This is the minimum member outreach required—by call or SMS and by email—before a case can be closed.
What is, "One call or SMS plus one email follow-up per case before closing"?
These resources should be used to answer employers' questions about plan differences and to compare plans, including clicking on the plan name for more details.
What are, "the Comparison Spreadsheet and the applicable Summary of Benefits and Coverage (SBC)"?
These are the two medical plan options available to Bloomberg U.S. employees for 2027, and the key difference in how family deductibles work between them.
What are, "the PPO Plan (with embedded deductible) and the HDHP with HSA (with aggregate deductible)"?
This is where you will go to find the UPS Tier 2 Escalation Navigation tool to show you the next steps.
https://intranet.healthadvocate.com/spaces/6/operations/uphs_escalation_navigator
What is, "The Health Advocate intranet page for the UPHS Escalation Navigator"?
This is the AI tool you should use to help make calls and emails easier by asking questions from calls, requesting resources, and creating member emails.
What is, "Clara"?
This is the action you should take after completing a "review new email" or "case review" task for a member.
This is the action you should take after completing a "review new email" or "case review" task for a member.
Regardless of which option is selected, this aspect of prescription drug coverage remains unchanged within each carrier’s offerings (UHC, Aetna, or Kaiser).
What is, "the formulary list applies uniformly to all plans from the same carrier"?
This interactive tool should be used to provide Bloomberg employees with personalized plan comparisons and explanations, but advocates should not recommend a specific plan or contradict its guidance.
What is, "ALEX"?
This escalation process should be used when a member's issue cannot be resolved at Tier 1 and requires UPHS involvement, following specific steps like using the UPHS Tier 2 email template, emailing the correct UPHS mailbox, and setting follow-up tasks.
What is, "When should the UPHS Tier 2 escalation process be used"?
This is why it’s important to keep calls concise—by clearly explaining what you found, where the information is documented, and any next steps—since members often call during breaks or while balancing other responsibilities.
What is, "Keeping calls focused and efficient to respect members' limited time and busy schedules"?
This is the consent you should ask for during every call, so that members can be contacted with updates.
What is, "SMS consent"?
For NY Tristate, Colorado, and California, most employers can only offer one medical carrier (with an exception for Colorado employers). For all other areas, employers must offer these plans, and which state mandates apply?
What are, "Aetna plans under the JFL organization, and Florida state mandates apply"?
This is what Bloomberg employees will need the most help understanding during 2027 Open Enrollment, since they have not previously needed to contribute toward healthcare costs
What are, "premiums, deductibles, coinsurance, and copays"?
This describes the escalation steps to follow when there is no response: follow up after 24 hours if there is no initial response, allow additional time if UPHS requests it, follow up again after the ETA for a second time, and escalate if there is still no response after 4 business days.
What is, "the follow-up process when there is no response to a Tier 2 escalation”?
To maintain schedule adherence and ensure excellent service, you should log into CXone and be ready to take calls at the start of your shift. If you encounter issues with your headset, CXone, or other systems, notify a supervisor immediately, contact the call-out line if appropriate, and reach out to IT for assistance.
Certainly! Here’s a Jeopardy-style Q&A summarizing your adherence reminder:
Answer:
To maintain schedule adherence and ensure excellent service, you should log into CXone and be ready to take calls at the start of your shift. If you encounter issues with your headset, CXone, or other systems, notify a supervisor immediately, contact the call-out line if appropriate, and reach out to IT for assistance.
Question:
What should you do to stay in adherence and promptly address technical or login issues at the start of your shift?
Before adding these to cases, you should always check that the links will properly open the intended information for the member.
What is, "resources"?