ACRONYMS
PERFORMANCE
PROCEDURES
COMMON TERMS
TIMELINES
100
S.O.H
What is Statement of Health
100
Where would one look to determine their caller satisfaction score?
What is NICE system
100
Caller notifies benefit center of a member's passing. Your procedure consist of.....
What is processing of a death notification ticket.
100
Coverage amount deducted out of your paycheck
What is a premium
100
Power of Attorneys (POA) are reviewed by the client and a decision is provided by...
What is 30 business days
200
P.E.W
What is Personal Enrollment Worksheet
200
How to determine your Average Talk Time (ATT), Average Wrap Time (AWT), and Average Handle Time (AHT) for the day?
What is WebStation and StatsViewer
200
Member calls into initiate his retirement. What process do you take first....
What is congratulate member on his retirement.
200
Fixed dollar amount you pay before the carrier begins to pay for medical services
What is a deductible
200
Family calls in to report the passing of a member. They would like to know when they will be notified of any survivor benefits. Condolence letters are mailed out....
What is 7 -10 business days from the date of notification.
300
B.C.D
What is Benefit Commencement Date
300
When should representatives pay attention to details, anticipate caller's needs, provide exceptional service?
What is ALL THE TIME....
300
Member calls in because his spouse have surgery two days from now, but he was just notified by the insurance carrier that his spouse was not showing active coverage. What should be done first....
What is escalation email
300
The formula used to calculate the amount of an eligible member's benefit under the rules of the pension plan. Usually based on years of service and annual compensation.
What is Benefit Formula
300
Member calls into request his actual calculation to begin his pension benefit. It has been determined he has a QDRO. What is the turnaround time for member's kit to be mailed...
What is QDRO calculations take up to 30 business days for mailing of the kit
400
Q.D.R.O
What is Qualified Domestic Relations Order
400
A member calls in to determine what health benefits he may be entitled to once he separates 15 years from now. What resources should be reviewed to determine member's eligibility?
What is Knowledge Base (KB) & Benefits Workstation (BW)
400
Former employee calls in to start his benefits as a retire. However, you cannot locate an account for caller in any of our systems. What should be done....
What is Pension Benefit Inquiry (PBI) process
400
A employees usually has to wait a 12 month period before he or she can actively participant in a retirement pension plan.
What is computation period
400
Member calls in to inform us their dependent will be turning 26 years old on 10/12/2017. He wanted to confirm when his dependent coverage will end.
What is coverage ends for 26 year old dependents the last day of the month in which they turned 26 years old.
500
Q.M.C.S.O
What is Qualified Medical Child Support Order
500
What Level of Performance Metrics qualifies a CCR for the $500 incentive bonus every quarter.
What is Level 4, Exceeds Expectations
500
Member's daughter calls in to assist disabled father with his benefits. Member is unable to come to the call to grant us authorization to speak to daughter. What information are we providing to caller...
What is Power of Attorney (POA) information
500
The Internal Revenue Code requires employers to report the entire cost of any Medical, Dental and Vision Plan coverage for a domestic partner who doesn’t satisfy the definition of a dependent.
What is Imputed Income
500
Member's spouse give birth to their child 2 months ago. However, member has only called in today to notify us of the birth. How long does member have to report the major life event?
What is within 90 days member has to report life event and coverage will retro back to event date.
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