Voya Claims 360: Claims that come to employees

Enhanced experience is easy, intuitive and integrated

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At Voya, we think the future of benefits starts today. That’s because Voya Claims 360 makes it easier for covered employees to remember and use their benefits. In fact, as of March 31, 2022, $1.3 million in claims have been paid using our Voya Claims 360 claims integration procedures.1 These are benefits covered employees may not have realized they were even eligible for.

“This milestone shows that we’re succeeding in our meaningful work of reducing — and even eliminating in some cases — the effort our customers have to put forth to receive the claim dollars they’re due,” says Sarah Thacker, vice president of Voya’s Enterprise Claims. “With Voya Claims 360, we’re able to leverage available data to return value to those customers when they’ve experienced a covered event and hopefully without adding stress to their situation.” 

From the time an employee first enrolls in their benefits to when an eligible claim is submitted, reviewed and paid, Voya Claims 360 uses intuitive claims models, product-to-product integration, and medical claims integration to help anticipate and identify eligible benefit opportunities — so enrolled employees are using their supplemental health insurance offered by their employer.

This is just one way we are helping employers realize greater value by getting their workplace benefits and savings in sync. Our hope is that through more simplified employee experiences, companies can boost engagement, save time and help improve outcomes.

According to Thacker, low claim utilization has been an ongoing issue in the supplemental health benefits space. And often, the greatest barrier to paying an eligible claim is the employee remembering they have coverage.

“By prompting them to submit a claim when we see they’re experienced a covered event or even automatically adjudicating a claim they never filed but have been able to identify through one of our integration processes, we make it as easy as possible for employees to find value in their coverage,” says Thacker.

“We’ve shifted our focus to ways in which we can both deliver on our commitment to pay claims while helping to make the lives of our customers — employer and employee — easier through our integrated claims processing. This willingness to shape innovation around customer ease is what sets us apart here at Voya.”

Why Voya Claims 360?

When employers utilize comprehensive claims tools like Voya Claims 360, it can help deliver a straight-forward and transparent experience when an employee files a claim. Our enhanced claims model is simple in terms of how claims are filed and paid.

Voya Claims 360 connects the claims process when employees have one or more of these four insurance coverages when offered through their employer and Voya:

The support our claims integration processes offer ranges from connecting the dots between coverages and notifying employees when they have a potential claim, to even paying certain benefits automatically when we see a covered event has been experienced. The innovative claims process makes claims more approachable – and offers these three primary advantages:

Processes that can help employees feel like the insurance practically claims itself. Accident Insurance pays benefits for specific injuries and events resulting from a covered accident. When we can see that an accident has happened, we can automatically open and pay a claim. Whether that means filing a claim for Accident Insurance or paying for an anticipated follow-up doctor’s visit when a claim has already been filed, Voya Claims 360 helps to make the supplemental insurance claims process easier on employees.

It’s integrated and digital. Employees can skip the hassle of “print, sign and submit” thanks to online claims submission. And with medical claims integration, employees who have opted can get automatic reminders for potential eligible benefits based on permissioned medical claims data.

Employees help receiving their benefits. Supporting utilization is easier because Voya Claims 360 actually helps and encourages covered employees to claim their eligible benefits.

Multiple process models uncover claim opportunities

To reveal potential claims across an employee’s active coverage, Claims 360 uses several process models including: intuitive claims payment model; product-to-product integration; STD-to-Accident autopay; and medical claims integration.

These claim models are used to send reminders to covered employees when we can see they have experienced specific covered events and help encourage utilization. Voya Claims 360 also features:

  • Comprehensive support
  • Data-driven messaging
  • Formless claims submission
  • Online Claims Center

Both employers and employees benefit from Voya Claims 360 — an experience that appears simple on the surface yet is comprehensive underneath:

Easier for employees. Employees can benefit from time savings and reduced effort, as when they are filing a claim, we offer a guided digital experience to file and track progress of employee claims. The intuitive claims payment model can reduce the amount of documentation required or even the need for them to file their own claim.

For example, when a paid Short-Term Disability Insurance claim is the result of a covered accident or illness and the employee also has active Accident Insurance or Critical Illness Insurance but hasn’t yet filed a claim, we may automatically pay a claim if we identify specific covered events based on the documentation already received through the Short-Term Disability claim.

Innovation is standard. We connect claims through data-driven processes and medical claims integration is available to self-administered groups with specific size, data and plan design requirements. Employers meeting specific criteria may be eligible to offer employees the option to opt in to get claims reminders based on medical claims data. Our carrier-agnostic medical claim integration is available for use with Voya-offered supplemental health insurance products and can accommodate a broad range of medical insurance providers and plans.

Integrated advantages. Employers may realize administrative and claims process efficiencies which can positively impact the time and effort required to support employees. Plus, they can offer competitive benefits that work together behind the scenes. And employees get consolidated, consistent service as we proactively seek ways they can receive their eligible benefits.

Claims 360 real-life example

When employees learn they are receiving a paid benefit for a claim they never filed or something they never realized was a covered event, their reactions have ranged from disbelief to heartfelt gratitude.

For example, in 2020, one of our clients seriously injured himself on his way home from work. His injuries — a leg and hip fracture — were the result of an accident, and as a result, he was unable to work for several months. He was enrolled in short-term disability income insurance offered by Voya, so he filed a claim. As the claims team handled the case, they realized that this individual was also enrolled in accident and hospital indemnity insurance.

As a result, a claims adjustor proactively reached out to this individual and notified him that based on the documentation we already had from the STD claim, he would receive a $19,125 accident insurance benefit payment and a $1,800 hospital indemnity insurance benefit payment for the covered events he experienced.2

“During difficult circumstances, filing a claim may be the last thing on a person’s mind, yet the very thing that could help lessen the financial impact they may experience after something like an accident or illness,” says Valya Johnson, customer experience consultant at Voya. “Not only are our customers surprised at the opportunity of receiving a benefit they may not have anticipated, but they also appreciate the availability of their eligible benefits.”

According to a recent Voya Employee Benefits Paid Claims Satisfaction Survey (based on 9,974 Paid Claims Surveys completed January 1-May 31, 2022), here’s what customers are saying about their experience with Voya Claims 36

Overall satisfaction

  • 91% satisfied (all claims types)
  • 94% satisfied (Supplemental Health claims)

Voya made it easy to file my claim

  • 94% agree (all claims types)
  • 94% agree (Supplemental Health claims)

Voya processed my claim in a timely manner

  • 92% agree (all claims types)
  • 94% agree (Supplemental Health claims)

“The ease of our enhanced claims experience, and the fact that we take initiative to file and process claims when we can see someone may be eligible for a benefit, has our customers grateful at how conveniently we can help improve their situation,” adds Johnson. “The people we serve can be emotional at receiving unexpected paid benefits that they are then able to use as they chose.”

Conclusion

Voya Claims 360 offers a client-centric approach to help meet the needs of employers and employees. From the time employees enroll to when a claim is anticipated, filed and/or processed, Claims 360 kicks off a variety of proactive actions that can help employees get their eligible supplemental insurance benefits sometimes whether they even realize they have a claim opportunity.

Plus, this innovative claims process is yet another tool that can help employers offer an integrated workplace benefits and savings experience to their employees — which can encourage better outcomes, higher engagement and ultimately, improved efficiencies through a simplified claims experience.

For more information about Voya Claims 360, visit go.voya.com/claims360 or contact your Voya representative.

This is the third article in a three-part “Future of benefits” series, where we explore how companies can realize greater value by syncing their workplace benefits and savings. Read related articles:

Related Items

  1. 1. Combined total amount of benefits paid using STD-supplemental health auto pay claims integration and reminders. Paid claims for critical illness, accident and hospital indemnity insurance. 466 total paid claims. January 2019–March 2022.
  2. 2. This example is based on an actual 2020 paid claim that utilized the STD to Supplemental Health Insurance claims integration process. The average Accident Insurance benefit amount paid in 2020 was $1,100. The average Hospital Confinement Indemnity Insurance benefit amount paid in 2020 was $1,500. This is provided for illustrative purposes only. A complete description of benefits, limitations, exclusions and termination of coverage will be provided in the certificate of insurance and riders. Actual results may vary.

This material is provided for general and educational purposes only; it is not intended to provide legal, tax or investment advice. All investments are subject to risk. Please consult an independent legal or financial advisor for specific advice about your individual situation.

Insurance products are issued by ReliaStar Life Insurance Company (Minneapolis, MN) and ReliaStar Life Insurance Company of New York (Woodbury, NY). Both companies are members of the Voya® family of companies. Voya Employee Benefits is a division of both companies. Within the State of New York, only ReliaStar Life Insurance Company of New York is admitted, and its products issued. Product availability and specific provisions may vary by state.

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