Meet Ava
Ava was 34 years old when they started to struggle with their mental health and miss days at work.
Ava’s provider confirms a diagnosis of major depressive disorder and Ava immediately files a short-term disability (STD) leave.
Ava receives our welcome email,
which includes key information and education.
After reviewing the claim, the Case Manager notes that Ava could benefit from support from an Aflac Care Manager.
The Case Manager shares information about the Aflac Care Manager role with Ava. Ava is interested in working with the Care Manager, and they are open to the reach out.
Aflac Care Manager reaches out through Ava’s preferred communication method – text.
Aflac:
Hi, Ava. This is Nancy at Aflac. Could you take a call at 9 in the morning tomorrow? If not, please let me know what works for you.
They find a time that works best for Ava
and they both agree to a phone call for an
initial discussion.
morning tomorrow? If not, please let me know what works for you.
Ava:
Yes, that time works. TTYT.
Ava and Nancy meet and Nancy develops an individualized support plan based on Ava’s needs.
Aflac sends a text message to evaluate Ava’s satisfaction with the Care Manager interaction.
Ava’s claim transitions from short-term to long-term disability (LTD).
The STD Case Manager and Behavioral Health Case Manager work together and make the claim transition seamless, including giving Ava a heads up about upcoming communications.
Swati, an Aflac Behavioral Health Case Manager, reviews Ava’s claim and texts Ava to schedule a call.
Aflac:
Hi. This is Swati from Aflac. Are you available for a phone call tomorrow morning at 10:30?
Ava:
Sure.
Swati and Ava meet for the first time.
After the call, Swati connects with some of Ava’s providers.
At Aflac, Nancy and Swati connect and coordinate during the weekly claims huddle.
Swati connects with Ava’s provider and determines that Ava can return to work (RTW) if they can work from home or a quiet room.
Swati starts a workplace accommodation request for Ava, and it is approved by Ava’s employer.
Ava’s LTD claim is approved and Swati texts Ava to set up time to discuss the details.
Aflac:
Hi, it’s Swati. I have some information to share with you. Are you available tomorrow at 10am for a phone call?
Ava and Swati meet and review the claim approval and accommodations.
Ava receives the LTD benefits via electronic funds transfer (EFT).
Ava receives a text requesting their level of satisfaction with Swati.
Three weeks later ...
Swati and Ava connect to check in. Ava shares that it’s going very well.
Swati and Ava’s provider touch base to develop a RTW plan to increase Ava’s work hours.
Swati keeps Ava and her employer up to date on the RTW plan and progress.
Soon, Ava is back to work full time.
Mohammad’s mental health journey.
See next story
Aflac assigns the claim to an LTD Behavioral Health Case Manager for review.
These examples are for illustrative purposes only. The plans have limitations and exclusions that affect benefits payable. Refer to the plans for complete details. Continental American Insurance Company (CAIC), a proud member of the Aflac family of insurers, is a wholly-owned subsidiary of Aflac Incorporated and underwrites group coverage. CAIC is not licensed to solicit business in New York, Guam, Puerto Rico, or the Virgin Islands. In California, coverage is offered by Continental American Life Insurance Company. Products may not be available in all states and may vary depending on state law. Absence services are not insurance and are not legal advice. Continental American Insurance Company | Columbia, SC.
AGC2301101 EXP 9/24
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An Aflac Journey
Customer Care and Claim Submission
25%
claims initiated online
64%
of members opt in
for texting.
68 TNPS
STD/Leave coordinated case load.
64%
opt-in for texting
94%
calls answered within
30 seconds.
100%
of LTD claim decisions made prior to benefit start date.
<7%
attrition rates for customer care center and case managers.
85%
In their time of need
“No matter how big Aflac becomes and no matter how well-known our brand is, what Aflac stands for will never change — helping people through times of great financial crisis. That is the founding concept our company and our products are built upon, and we never forget that."
— Daniel P. Amos
Aflac Chairman and CEO
4.9/5 stars
from our members for our customer care center.
An Aflac Journey
at member intake
of claim.
After reviewing the claim, the Case Manager notes that Ava could benefit from support from an Aflac Care Manager.
The Case Manager shares information about the
Aflac Care Manager role with Ava. Ava is interested
in working with the Care Manager, and they are open to the reach out.
Aflac Care Manager reaches out through Ava’s preferred communication method – text.
They find a time that works best for Ava
and they both agree to a phone call for an
initial discussion.
morning tomorrow? If not, please let me know what works for you.
Ava:
Yes, that time works. TTYT.
Aflac:
Hi, Ava. This is Nancy at Aflac. Could you take a call at 9 in the morning tomorrow? If not, please let me know what works for you.
Ava and Nancy meet and Nancy develops an individualized support plan based on Ava’s needs.
Committed to care and service
68 TNPS
25%
online configurable intake.
“No matter how big Aflac becomes and no matter how well-known our brand is, what Aflac stands for will never change — helping people through times of great financial crisis. That is the founding concept our company and our products are built upon, and we never forget that."
— Daniel P. Amos
Aflac Chairman and CEO
68 TNPS
In their time of need
at member intake of claim.
100%
book of business
PGs met.
94%
4.9/5 stars
calls answered within
30 seconds.
100%
of LTD claim decisions made prior to benefit start date.
<7%
attrition rates for customer care center and case managers.
from our members for our customer care center.
85%
STD/Leave coordinated case load.
64%
of members opt in
for texting.
Committed to care and concierge service
at member intake of claim
Overarching approach
Flexible, conversational approach.
No handle time restrictions.
Configurable call intake/scripting with NPS Survey sent post all intakes.
We provide education about Employer specific information, programs available, and benefits and time available.
Advance claims system helps to automate all the available benefits to the claim.
Web
Available 24x7.
Real-time claim intake options.
Options to upload documents, e-sign forms and message case manager.
Configurable intake enables consistent experience between telephonic and
on-line.
Telephonic
Customer care advocates trained on your program and able to communicate other programs (i.e., Voluntary Benefits, EAP).
We set expectations including next steps and self-service to simplify the process.
Web
Overarching approach
Telephonic
Customer Care and Claim Submission
25%
claims initiated online
68 TNPS
64%
opt-in for texting
4.9/5 stars
from our members for our customer care center.
Meet Mohammad
Mohammad is 37 when they have the first of many panic attacks. Not only is Mohammad’s personal life impacted, they are also having trouble being present at work.
Mohammad has access to a program called Neuroflow, which was designed to help people keep track of their moods and build their mental wellness skills.
Mohammad completes an online Neuroflow assessment and notes that they are having panic attacks.
The Aflac Care Manager learns that Mohammad is stressed about finding the right treatment program. They help Mohammad find a local in-network provider and help schedule their first appointment.
Aflac’s Care Manager reaches out to Mohammad each week to offer emotional support and to ensure that the treatment plan is helping.
With the support of the Aflac Care Manager, Mohammad is able to avoid additional days out of the office while managing stressors and reducing panic attacks.
Aflac helps Mohammad focus on the most important thing – getting back to work and back to life.
Mohammad receives a text message to help evaluate their level of satisfaction with their Care Manager.
These examples are for illustrative purposes only. The plans have limitations and exclusions that affect benefits payable. Refer to the plans for complete details. Continental American Insurance Company (CAIC), a proud member of the Aflac family of insurers, is a wholly-owned subsidiary of Aflac Incorporated and underwrites group coverage. CAIC is not licensed to solicit business in New York, Guam, Puerto Rico, or the Virgin Islands. In California, coverage is offered by Continental American Life Insurance Company. Products may not be available in all states and may vary depending on state law. Absence services are not insurance and are not legal advice. Continental American Insurance Company | Columbia, SC.
AGC2301101 EXP 9/24
Ava’s disability journey.
See next story
The Aflac Care Manager is notified, and they reach out to Mohammad to see what they can do to help.
An Aflac Journey
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These examples are for illustrative purposes only. The plans have limitations and exclusions that affect benefits payable. Refer to the plans for complete details. Continental American Insurance Company (CAIC), a proud member of the Aflac family of insurers, is a wholly owned subsidiary of Aflac Incorporated and underwrites group coverage. CAIC is not licensed to solicit business in New York, Guam, Puerto Rico, or the Virgin Islands. In California, coverage is offered by Continental American Life Insurance Company. Products may not be available in all states and may vary depending on state law. Absence services are not insurance and are not legal advice. Continental American Insurance Company | Columbia, SC
AGC2301101 EXP 9/24