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Policy audits can be a time-consuming yet essential piece of the benefits placement process. ThreeFlow’s policy audit guide breaks down the most critical points to cover in your audits and provides you with a handy, printable checklist
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The insurance industry’s first quarter of the plan year is a busy, stressful time. Brokers are working on wrapping up last year’s business and already looking toward the next round of renewals. Carriers are issuing new policy documents and certificates of coverage. With barely any time to take a breath, one crucial task is often overlooked: the policy audit.
In general, you should verify these items:
A policy audit involves reviewing and comparing the terms and provisions in the selected carrier’s quote to the issued policy documents and certificate of coverage to ensure correctness and consistency. This essential step helps catch errors that can lead to costly mistakes post-implementation.
These errors are commonly known as ‘claims leakage’ and cost the industry $30B annually. Not to mention the effect that poor customer experience can have on business and the added work for employer clients, brokers, and carriers.
Policy documents and certificates of coverage can range from straightforward to complex. Depending on the product, the certificate you receive will be formatted differently, but it typically outlines the policy’s benefits, provisions, and limitations. If you do find errors between the quoted plan design and policy documents, it’s recommended that you work directly with the carrier to review and discuss any discrepancies.
In general, you should verify these items:
Catching discrepancies at the point of sale can help ensure your client’s smooth transition and implementation. ThreeFlow helps by offering policy audits to all new policies sold through ThreeFlow. These audits save time, reduce the occurrence of errors in claims processing, and help deliver a great member experience.
Our team will:
