Revolutionizing Supplemental Health Claims: Mutual of Omaha and Claritev Join Forces

In an era where healthcare costs are rising steadily and employee benefits are becoming increasingly vital, the collaboration between Mutual of Omaha's Workplace Solutions division and Claritev marks a significant advancement in the insurance sector. By integrating their platforms, these two entities are automating the supplemental health benefits claims process, a move that could reshape how policyholders access their benefits. This innovative approach addresses a critical issue: the underutilization of voluntary benefits among employees.

According to NFP's 2026 US Benefits Trend Report, fewer than one in three employees fully utilize their supplemental benefits, while a staggering 13% remain unaware that such benefits even exist. This disconnect is particularly concerning, as employees often fail to associate qualifying medical events with the supplemental coverage they selected during open enrollment. The new integration promises to bridge this gap by scanning medical claims data to identify eligible policyholders and notifying them to file claims, thereby simplifying the entire process.

Understanding the Gap in Voluntary Benefits Utilization

The challenges surrounding the utilization of supplemental health benefits are multifaceted. Many employees enroll in voluntary benefits such as accident, critical illness, or hospital indemnity coverage without fully understanding their value or how to access them when needed. Often, it is only when a medical event occurs that employees realize they have the coverage, leading to frustration and missed opportunities for claims.

Mutual of Omaha's integration with Claritev aims to tackle these issues head-on. By leveraging Claritev's extensive medical claims data, the program proactively identifies events that qualify for supplemental claims, sending timely notifications to employees. This not only helps employees understand their coverage better but also encourages them to take action at critical times. Andy Gibson, senior vice president of workplace solutions claims at Mutual of Omaha, emphasizes that the integration streamlines the entire claims process, thus enhancing employee experience and ensuring they receive the benefits they deserve.

The Role of Automation in Claims Processing

Automation is key to modernizing the claims process in the insurance industry. With Claritev's advanced technology, the integration allows for the identification of potential claims at the moment they arise, which is a significant improvement over traditional methods that rely on employees to take initiative in filing claims. This proactive approach is particularly beneficial during stressful medical events when individuals may not be in the right frame of mind to navigate the complexities of insurance paperwork.

Benefits of Automated Claims Integration

• Efficiency: Reduces the time and effort required for employees to file claims.
• Increased Awareness: Notifies employees of their eligibility for benefits, increasing the likelihood of claims submission.
• Improved Utilization: Enhances the overall uptake of supplemental benefits, which is crucial for both employers and employees.
• Better Client Retention: Helps employers demonstrate the value of their benefits package, making it easier to retain clients during renewal periods.

Why Employers Should Care

Employers play a pivotal role in the adoption and utilization of supplemental health benefits. As healthcare costs continue to rise, providing robust voluntary benefits has become an attractive option for companies looking to enhance their employee value proposition without incurring substantial additional expenses. However, simply offering these benefits isn't enough; employers must also ensure that their employees are aware of and can easily access them.

The integration between Mutual of Omaha and Claritev not only addresses this need but also reduces the burden on employers regarding communication and education about their benefits. By automating the claims process, employers can demonstrate actual claims activity to insurance carriers. This is becoming increasingly important for brokers who need to illustrate how benefits are being utilized during renewal discussions. Improved claims utilization can ultimately lead to lower costs and better negotiations with insurance providers.

The Impact on the Healthcare Landscape

This collaboration arrives at a crucial juncture in the healthcare landscape, where the increased focus on affordability, transparency, and quality is paramount. Travis Dalton, president and CEO of Claritev, highlights that the goal is to reduce friction for employees during medical events, allowing them to concentrate on what truly matters: their recovery.

Moreover, as more employers recognize the importance of supplemental health coverage, the partnership between Mutual of Omaha and Claritev could set a new standard for how insurance companies approach voluntary benefits. By utilizing data analytics effectively, the integration might pave the way for future innovations in the industry, ensuring that employees receive the maximum benefit from their coverage.

Key Takeaways

• The integration between Mutual of Omaha and Claritev automates the supplemental health claims process.
• Less than one-third of employees fully utilize their supplemental benefits, highlighting a significant gap.
• Automation enhances efficiency, awareness, and overall utilization of supplemental benefits.
• Employers can better retain clients by demonstrating actual claims activity during renewals.
• Proactive claims notifications can significantly improve employee experience during medical events.

Frequently Asked Questions

What are supplemental health benefits?

Supplemental health benefits are additional insurance coverages that help cover out-of-pocket costs associated with medical events. These include accident insurance, critical illness insurance, and hospital indemnity insurance, which provide financial assistance for specific situations that may not be covered by primary health insurance. They are particularly valuable in mitigating the financial impact of unexpected health issues.

How does the integration between Mutual of Omaha and Claritev work?

The integration utilizes Claritev's medical claims data to automatically identify policyholders who qualify for supplemental benefits based on their medical events. When a qualifying event is detected, employees receive notifications prompting them to file claims, effectively simplifying the claims process and increasing the likelihood of benefits being utilized.

Why is utilization of supplemental benefits important?

Utilization of supplemental benefits is critical for both employees and employers. For employees, it means receiving financial support during challenging medical situations. For employers, demonstrating high utilization rates can lead to better negotiations with insurance carriers and improved retention of clients. Additionally, it can enhance employee satisfaction and loyalty, making it a win-win for all parties involved.

How can employers improve awareness of supplemental benefits among employees?

Employers can improve awareness by providing clear communication about the available benefits during open enrollment and throughout the year. Incorporating automated solutions like the Mutual of Omaha and Claritev integration can also help by directly notifying employees of their eligibility for benefits as qualifying medical events occur, thereby enhancing their understanding and encouraging utilization.