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Customer Experiences
Using Tools
Plan Rules
Benefits
Miscellaneous
100
During a call, a CSA informs a customer that they cannot make changes to their plan outside of their annual enrollment period unless they have a qualified status change during the year because it violates the plan provisions. Has the CSA participated in unathorized practice of law? Yes or No
What is NO
100
Jadda recently updated her beneficiaries on the YBR website, and returned a signed beneficiary authorization form. Which tool can help you verify if the service center has received this from her? A. CS Pro Documents/ Imaging B. Case Management C. CS Pro Guides/ Callflows D. Call Wrap-Up
What is A. CS Pro Documents/ Imaging
100
I support my step mother, and for tax purposes, the IRS considers her to be my dependent. Is my step mother eligible for HW benefits coverage as a dependent? Where would you find this information? A. TBA Inquiries B.Workflow/Siebel C.Summary Plan description or Callflows D.Client News/Team alerts
What is C.Summary Plan description or Callflows
100
I am already enrolled in my benefits on the website, but I need to ind a new Primary Care Physician who accepts my medical insurance. What should I select? A. Click find a doctor B. Choose Medical from the current coverage section C. Click Plan Information D. Click health and Insurance summary
What is A. Click find a doctor
100
I live with my husband Sam, our natual children Sally and Sid, our adopted son Clem, and my parents- who are healthy and fully employed. Who can I cover as dependents for medical coverage? Which tools would you use to determine who could be an eligible dependent for this customer? A. Workflow/ Siebel B. Callflows or summary plan description C. CNNC D. TBA Inquiries
What is B. Callflows or summary plan description
200
Hello, I am calling because I am considering quitting my job and going on COBRA. What is the maximum length of coverage I can get? A. an employee qualifying event makes you eligible for 18 months of COBRA coverage. B. an employee qualifying event makes you eligible for 24 months of COBRA coverage C. An employee qualifying event makes you eligible for 29 months of COBRA coverage D. An employee qualifying event makes you eligible for 36 months of COBRA coverage
What is A. an employee qualifying event makes you eligible for 18 months of COBRA coverage.
200
I'm on the YBR site, and I'm confused by all the options. Can I just tell you what I want and you make the elections for me? A. Advise the customer to log off YBR B. Click the annual enrollment tab C. Click enroll now D. Tell the customer you'll show him how to make his own elections
What is A. Advise the customer to log off YBR
200
I have money left over in my current HCFSA and I'd like to re-enroll this year. How can I roll those funds into a new account? A. I understand that you want to re-enroll in your HCFSA, and I can definitely help you with that. However, any money left in the account at the end of the year is forfeited. B.Yes, you do need to re-enroll in your HCFSA. Fortunately, if you have money left in the account, it will automatically roll over into your new account when you re-enroll. Can I help you with your enrollment today? C. Actually, you do not have to re-enroll in a HCFSA as long as your account still has funds in it. May I help you enroll in any of your other benefits? D. I would be happy to help you with that, though I will need to transfer you to a specialist who handles HCFSA. Can you please hold for a moment?
What is A. I understand that you want to re-enroll in your HCFSA, and I can definitely help you with that. However, any money left in the account at the end of the year is forfeited.
200
Adam Goldstein called the SC and said "I currently have medical, dental, and life insurance. Which of these plans can be continued under COBRA? A. You can continue all 3 plans under COBRA B.You can continue only medical and dental under COBRA C. You can continue only medical under COBRA D. You can continue only medical and life insurance under COBRA
What is B.You can continue only medical and dental under COBRA
200
Natalie Deveraux called the Service Center and you helped her enroll in her benefits. She then asks: "How long does it take for my helath plan to find out I've enrolled?" Based on information available in Premeir's callflows, how do you respond? A. Eligibility files are processed every day and sent to health plans of Friday B. Eligibility files are processed every Tuesday and sent to the health plans on Friday. The health plan then has five days to update their records. C. Eligibility files are processed every Friday and sent to health plans on Tuesday. D. Eligibility files are processed every day and sent to health plans at the end of every day
What is B. Eligibility files are processed every Tuesday and sent to the health plans on Friday. The health plan then has five days to update their records.
300
I'm retiring now, but I won't be eligible for retiree medical benefits for another year and a half. I want to continue my current level of medical coverage. What should I do? A. You may want to convert your medical to a third party carrier until you're eligible for retiree medical B. You may want to wait a couple of years before you retire because medical insurance is very hard for retirees to obtain. C.You have the option of enrolling in COBRA coverage for your medical until you are eligible for retiree medical, but it costs up to 90% of your employer's premium cost. D. You have the option of enrolling in COBRA coverage for your medical for up to 18 months, though it costs 102% of your employer's premium cost
What is D. You have the option of enrolling in COBRA coverage for your medical for up to 18 months, though it costs 102% of your employer's premium cost
300
I heard there is a way to compare the medical plans and plus how much I would pay at the doctor's office or for a hospital visit. Can you tell me where to find that? A. Unfortunately we're only able to estimate costs based on average medical service needs. Would you like me to help you to do this? B. Yes, there is a Medical Expense Estimator link on the YBR site that allows you to compare the costs of different plans and even customize your own estimated expenses. May I show you where to find that? C. Yes, you can use the Health Plan Comparison Chart on the YBR site to compare up to 3 medical plans side-by-side, including copays, coinsurance, and premiums. Do you have the web address? D. You can use YBR site to compare medical plans only one at a time, if you would like me to help you with that.
What is C. Yes, you can use the Health Plan Comparison Chart on the YBR site to compare up to 3 medical plans side-by-side, including copays, coinsurance, and premiums. Do you have the web address?
300
Hi, I am a Premier employee. I want to make my annual enrollment elections today, but I'm worried that I might change my mind later and be committed to elections that I don't really want. Will I be able to make changes after today? A. The elections you make today will not go into effect until tomorrow, so you have 24 hours from the time of the enrollmentto make changes if you should change your mind. B. I suggest that you take time to do some more research, as you have until the end of the annual enrollment period to enroll in your benefits. The you won't have to worry about making changes at a later date. C. It sounds like you're not certain about what benefits you would like to elect. Can I answer any questions to help you feel more comfortable with your decisions? D. You can make your annual enrollment elections today, and if you change your mind you can access the website any time up until the end of annual enrollment period to make changes. After the annual enrollment period period has ended you will not be able to make changes to your coverage until the next annual enrollment or if you experience a qualified status change.
What is D. You can make your annual enrollment elections today, and if you change your mind you can access the website any time up until the end of annual enrollment period to make changes. After the annual enrollment period period has ended you will not be able to make changes to your coverage until the next annual enrollment or if you experience a qualified status change.
300
Lynette Fogarty calls the SC and says: "Hello I am signing up for COBRA benefits for the first time. When will I get my first bill? A.Your first bill will be create on the 10th of the next month B.The first bill will be created and sent within one wek of the enrollment date C.Your first bill will be mailed some time in the next couple of weeks, but don't worry the bill isn't due for 45 days. D. Your first bill will be created and mailed within 10 days of when it is due
What is B.The first bill will be created and sent within one wek of the enrollment date
300
Diane recently gave birth to her second child. She calls the SC to make changes to her benefits and add her new child to her medical plan. Diane thinks the plan rules for a qualified status change will work the same way it did with her former employer. Is she right to make this assumption? A. Yes, all companies have to follow the same rules B. No, the employer rules may differ from one company to another C. The federal law requires all employer plans to work the same D. None of the above
What is B. No, the employer rules may differ from one company to another
400
I'm looking at all of the different medical plans that are available, and it's difficult to compare them. Can you just tell me which one is best for me? A. Only you can determine that. When you choose the plan that best suits your needs, you can use YBR to enroll or we'll be happy to help you make your election B. Most customers like HMOs. Would you like me to tell you about the benfits of HMOs compared to other plans? C.Well, it depends on how much you spend on health care each year. Have you tried talking to another employee about what plan they choose? D. I can definitely go over the medical options with you to help you find the best fit for your needs. Or would you like me to walk you through a comparison of the available plans in the YBR site?
What is D. I can definitely go over the medical options with you to help you find the best fit for your needs. Or would you like me to walk you through a comparison of the available plans in the YBR site?
400
So you finished makeing all of my selections, right? Is there anything else I need to know? A. Check notices in TBA B. Counsel the customer following the describe process section of callflows C. Verify information as indicated in the "Do" section of your callflow D. Confirm choices and review cost E. A,B,C F. All of the above
What is E. A,B,C *D is incorrect because you would confirm choices and total costs before completing the enrollment
400
I'm divorced and my daughter lives with my wife now. The court issued an order saying that I have to provide her medical coverage. She doesn't qualify as a dependent. How can my plan cover her? A. Your daughter cannot be covered if she doesn't qualify as an eligible dependent. B. You must have a sworn affidavit that your wife is unable to provide your daughter's medical coverage. C. If the court has issued a Qualified Medical Child Support Order/ QMCSO, you may be required to cover her through your employer's group plan. D. Your daughter is considered a dependent no matter the circumstances and she is always eligible for medical coverage.
What is C. If the court has issued a Qualified Medical Child Support Order/ QMCSO, you may be required to cover her through your employer's group plan.
400
Janice needs to go on a leave of absence next month, so she can take care of her daughter who is having surgery. She asks, "Do I need to talk to anyone before I start my leave? Is there any paperwork that I need to complete?" A. Yes, I'll be glad to revie all the paperwork that needs to be completed before you can start an approved leave of absence B. No, there is no paperwork required once you notify your manager C. I can transfer you to a leave administration team, who can review the process to start a leave of absence and any required paperwork D. I can transfer you to a member of the Qualified Order Unit Specialist team, who can help you start the leave of absence paperwork
What is C. I can transfer you to a leave administration team, who can review the process to start a leave of absence and any required paperwork
400
If a customer is hired near the end of the plan year, the CSA may need to complete a dual year enrollment. What is that? A.Dual enrollment means you have to make initial enrollment elections twice B. Dual enrollment refers to customers needing to make separate elections for their spouse. C. Dual enrollment refers to customers needing to make separate elections for their children/other dependents. D. Dual year enrollment refers to customers who need to make their initial new hire elections as well as elections for the upcoming plan year
What is D. Dual year enrollment refers to customers who need to make their initial new hire elections as well as elections for the upcoming plan year
500
"Hello, I am getting divorced and need to remove my spouse as a dependent for all of my benefits. Can you help me? A. "Sure I'll be happy to help you. Just give me one moment to bring up your account and review your employer's plan provisions. B. Have you contacted your employer to advise them of this change in status? After you have done that, please call back and we will be happy to assist you. C. I will need to transfer you to an associate who can assist you with the changes to your benefits based on your divorce. Before I transfer you, may I offer any assistance with annual enrollment elections? D. I'm sorry, I am only able to assist with you annual enrollment. Do you need help enrolling in any of your benefits today?
What is C. I will need to transfer you to an associate who can assist you with the changes to your benefits based on your divorce. Before I transfer you, may I offer any assistance with annual enrollment elections?
500
Before I enroll, I want to figure out how much life insurance I might need. Is there some place on YBR where I can find that information without having to enroll? A. Yes, under the health and insurance tab on YBR click on beneficiaries, you can get the answer there B. No you have to enroll C. No, it is not available on the website, but you can pull up that information in your SPD D. Yes, under the health and insurance tab on YBR click on insurance and other benefits. This will allow you to estimate insurance and spending account needs prior to enrollment
What is D. Yes, under the health and insurance tab on YBR click on insurance and other benefits. This will allow you to estimate insurance and spending account needs prior to enrollment
500
I chose the highest level of life insurance coverage, but the website shows that I selected one level lower. Why? A. You may ot be eligible for that option. Let me check the Plan summary description to see the highest level of coverage that is available to you. B. If the system does not confirm your election, then it is probably not available based on your employer's requirements. You'll need to check with your plan administrator. C.You must submit a form to provide evidence of insurability to confirm your election. Until the form is received and approved by the insurance company, you will be assigned the highest level of coverage available without evidence of insurability. D. I'll be happy to make and confirm that election for you today. It'll be just a minute while I open your account and access your life insurance options.
What is C.You must submit a form to provide evidence of insurability to confirm your election. Until the form is received and approved by the insurance company, you will be assigned the highest level of coverage available without evidence of insurability.
500
I am confused about beneficiaries. What's the difference between a primary beneficiary and a secondary beneficiary? A. A primary beneficiary must be a family member. But a secondary beneficiary can be anyone- for example, a friend B. A primary beneficiary is the first named beneficiary. There can only be one primary beneficiary. A secondary beneficiary is any person who receives benefits other than the primary beneficiary. C. A primary beneficiary is the person who distributes money to the secondary beneficiaries after the customer dies. D. A primary beneficiary is the first named beneficiary or beneficiaries. Any primary beneficiary are first in line to receive benefits if the customer dies. The secondary or contingent beneficiary or beneficiaries receive plan benefits if all primary beneficiaries die before the customer.
What is D. A primary beneficiary is the first named beneficiary or beneficiaries. Any primary beneficiary are first in line to receive benefits if the customer dies. The secondary or contingent beneficiary or beneficiaries receive plan benefits if all primary beneficiaries die before the customer
500
I'm no longer a Premeir employee. The health plan at my new job is requesting proof of my previous health care coverage. What document can I provide for them? Base on information in Premeir's SPD/ Callflows, what would be the best response? A. Preexisting conditions exclusion B. COBRA rights notice C. Certificate of Group Health Care Coverage D. COBRA enrollment worksheet
What is C. Certificate of Group Health Care Coverage This document is automatically sent out upon separation, it provides evidence of the customer's prior health coverage.