The GLOBO Blog

The month of April introduced new procedural requirements for private sector employee benefit plans.

On April 1, 2018, the final rule amending the claims procedure for disability benefits plans under Section 503 of the Employee Retirement Income Security Act (ERISA) took effect.

Section 503 of ERISA outlines procedural requirements for employee benefit plans regarding the filing of benefit claims, notification of benefit determinations and appeal of adverse benefit determinations. The final rule amends the procedural requirements to include additional rules and protections for disability claimants, comparable to the protections for group health plan claims under the Affordable Care Act (ACA). 

An undeniably essential element in a successful claims management operation is happy customers and agents. And that only comes to fruition when you’ve got a solid customer service model in place. (We’re not saying anything new here.) But let’s get a bit more specific and drill down into your multilingual solutions so we can answer two important questions:

• What role does your language services provider play in your customer service model?
• How does the quality of your telephone interpreting impact the success of your claims processing operation?

Read on to find out how trailblazing interpreting services aid in your company's customer retention and outreach and promote business growth.

When your insurance business depends on properly handled claims, you've got to be conscientious of communication barriers. These barriers will throw some nasty wrenches in your processes.

The language barrier isn’t just a “communication thing.” It’s an everything  thing, threatening aspects of your business that you may not have anticipated – converting unsuccessful interactions into mishandled claims, inflated overhead, poor reputation and scant customer retention.

That serious possibility is now a serious reality – becoming more so every single day, in fact, due to the 61.8 million (and growing) Americans speaking a language other than English at home. So the odds are undeniable: Your business likely has policyholders who don’t speak English well enough to communicate effectively with your call center agents and claims adjusters.

(And if you haven’t seen it, it’ll happen tomorrow. Or the next day. Or it’s already happening and you’re just not aware – which begs the question, how are your agents and adjusters handling these fragile situations?)

The Affordable Care Act is changing the health insurance landscape:

The Affordable Care Act (ACA) was created to reduce the number of uninsured Americans, while improving quality measures and containing costs. Another goal of the ACA is to reduce disparities among underserved populations, including individuals with limited English proficiency.

Claims management looks very different than it did 20 years ago, and the industry will continue to change dramatically over the next decade. That's because the number of Americans who speak a language other than English at home is on a hard climb – more than doubling since the 1980s, and currently coming in at over 60 million. That’s one in five Americans. And according to the 2010 U.S. Census, about 41% of this group is considered Limited English Proficient (LEP) – i.e., 25 million people who speak English “less than very well.”

The health insurance exchanges created by the passage of the Affordable Care Act (ACA) have pushed new consumers into the market and increased the pressure on health insurance providers to become more competitive.

Additionally, the law has imposed regulatory requirements on insurers that want to participate in exchanges. Many of these requirements are related to language access for Limited English Proficient (LEP) individuals, who make up the fastest growing segment of the U.S. population. 

If your company is currently participating in a health insurance exchange, or considering whether to participate, here are four language access facts you need to know: