LTD in General
To provide income replacement when an insured person is unable to work due to a qualifying disability.
What document typically provides a phsycician's assessment of a claimant's condition?
Attending Physician Statement.
What is an offset?
Other income the claimant may be receiving that will impact the LTD benefit.
What do we use Genesys for?
Incoming and outgoing phone calls.
This object has been in the office so long that no one knows who owns it.(hint: in the fridge)
The Tupperware in the fridge.
What is the document that outlines the benefits, limitations, exclusions, and provisions of a disability plan?
The Policy/Certificate.
What type of doctor specializes in mental health and can prescribe medication?
Psychiatrist.
Why can an SSDI award potentially result in an LTD overpayment?
SSDI benefits may be retroactive, requiring recalculation of LTD benefits for the same period.
What is the # to access another team members voicemail?
669-329-0050
What is the most common answer when asking if a form was completed?
My doctor sent it already.
What is the difference between the elimination period and a benefit period?
What does a PFR stand for?
What does an IPC stand for?
(if you get both, you double the points)
Physician File Review
Independent Physician Consultant.
How do you know if an offset applies to the LTD benefits?
Other income language in per the ER's plan.
When the person handling the call stays on the line and personally connects the claimant to another department, representative, or specialist while providing relevant background information before transferring the call.
What is the fastest way to become everyone's favorite coworker? (in an office)
Bring Donuts.
What does ERISA stand for?
Employee Retirement Income Security Act.
What evaluates the severity and progression of a condition?
Clinical Evidence.
When does a claimant typically recieve the minimum benefit?
When other income exceeds the amount of the LTD benefit.
When should we typically offer a warm transfer to our claimants for SSDI benefits? (2 answers)
At the end of the initial interview
Ongoing interviews/updated B&Os
This workplace mystery occurs every Monday morning and remains unsolved.
Where the weekend went?
What does "material and substantial duties" refer to?
The important duties of an occupation.
What links a medical condition to inability to work?
Functional Impairment.
What does FICA stand for?
and, what does it fund?
(double points if both correct)!
Social Security and Medicare.
Why should a claims Specialist should offer a warm transfer?
it creates a better claimant experience and helps ensure a smooth handoff between departments.
Reduces frustration
Improves claim outcome
Improves accuracy
What is everyone's favorite status?
PTO approved.