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Absence & Disability

We addressed a telecommunications client’s absence management issues through an innovative strategy that resulted in significant improvements, including reduced errors, enhanced training, and improved efficiency across all metrics.

Current State

A 60,000-employee telecommunications/wireless client was experiencing significant issues with leave-of-absence reporting from its newly appointed vendor. The managers of each business unit were seeing negative impacts due to a lack of knowledge regarding leave and return-to-work dates. Further, local HR professionals were inundated with employee complaints about claims service deficiencies.

Issues Addressed

Poor design and execution of the absence management model and failure to align the model with the needs of multiple business units and employee populations.

Innovative Strategy

ABC worked with our client and their chosen vendor to:

Document process flows for every conceivable absence event

Addressed STD, FMLA, Statutory Plans, Paid Family Leave Plans, ADA, Company Leave Plans, and Military Leaves

Developed a process to listen to recorded customer service calls weekly to gauge the competency of dedicated Customer Service Representatives

Assessed the vendor’s staffing model to determine if they assigned the right number of people with the right skill sets for our client

Assessed the vendor’s staff training process design and execution

Completed an end-to-end audit of 150 leave and disability claims

Developed and monitored a weekly dashboard of over 20 key metrics, including call center and timeliness metrics, as well as new and backlog activity, etc.

Worked with the vendor to develop a remediation plan based on the results of our efforts noted above

Resources

We deployed our expert consulting team using the following ABC-developed/enhanced tools: project management, document sharing technology, process mapping, audit tools, claim team staffing guidelines, and customer service call monitoring guides. What differentiates ABC’s approach from others? It’s not just the tools, but the team we use to deploy them, analyze the results, and effect improvements.

For this client, in addition to their existing team of three senior consultants and additional support (actuarial, underwriting, communications, etc.), we added three additional senior staff, with direct disability and leave management expertise, ranging from 10+ to 30+ years of experience, across multiple firms — at no additional expense.

Recommendations

After a thorough review of our findings, we advised our client to:

  • Refine the claim management and reporting process.

  • Make both additions and deletions to the dedicated claim team including Customer Service.

  • Modify the vendor’s claim system to support increased automation.

Outcomes

The results of our efforts have included:

  • Revisions to the design of the claims management model

  • Dramatically reduced claims processing errors

  • Refined Performance Guarantees

  • Enhanced claim team training

  • Improved local HR satisfaction

  • Achievement of target or better across all metrics, including:

    • 50% improvement in abandon rate and call waiting times

    • 50% improvement in timeliness of returned calls

    • 60% improvement in timeliness of decisions

Request a Consultation

Like any great relationship, ours will start by getting to know your business. We’ll listen to what your benefit needs are and then work to find a suite of solutions that matches your objectives.

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