Ever wanted to “apply” for IEEE insurance but weren’t sure what it entailed? Or maybe you already have, but still don’t know what really happened after you sent in your application? IEEE takes a closer look at the underwriting process for its sponsored insurance coverage, and discovered it can be a relatively simple process with a little information, preparation and help from you …
You’ve taken an important first step in obtaining insurance coverage.
You’ve completed the application and mailed it. Then what happens?
At the other end of the mailbox is Mercer Consumer, a service of Mercer Health & Benefits Administration LLC* ("Mercer Consumer"), the IEEE Member Group Insurance Program Administrator.
Once your application arrives at Mercer Consumer, an application processor will be assigned to your file and will review your application to make sure all the information requested is completed and readable. Then he or she will load the application onto an electronic imaging system.
If specific information is missing on your application, the processor will contact you either by phone or mail to obtain the information.
“It is really important that the member fully complete the application from the beginning and make sure it is easy to read,” says Graham Fuller, Principal at Mercer Consumer.
“If the IEEE member number is missing, if the member forgets to sign and date it, or if medical information isn’t disclosed or is hard to read, it will cause a delay because we have to go back out to the member to get this information before we can proceed,” he explains.
Once the application is considered complete from an administrative perspective, it is securely transmitted electronically to the insurance carrier for the product.
In situations that the insurance product is “guaranteed acceptance,” the certificate of insurance will be sent to the member within a short period of time without any additional information needed from the member. It’s important to note that coverage isn’t in force until the first premium is paid. However, for products requiring additional information beyond reviewing the application, the insurance company will need to underwrite your application.
Underwriting is the process used by insurance companies to determine your life expectancy (mortality) and/or your likelihood of sickness or disease (morbidity) to assess whether you should be accepted or declined coverage and what premium you should pay. The term “underwriting” is often used interchangeable with “risk selection” which is using actuarial projections (i.e., likelihood of death, sickness or disease) and expected or anticipated claims experience to determine your risk for the coverage and your premium.
“IEEE has a variety of insurance carriers it works with—depending on the product applied for,” says Fuller. “Each insurance carrier has different guidelines for underwriting and they vary by product and amount of coverage a member requests.”
During the underwriting process, most companies review your application for the following factors:
In addition, insurance companies may need to employ additional underwriting “tools” before they can accurately determine your overall risk. Such information and tests, which are paid for completely by the insurance company and scheduled at your convenience, may include:
The insurance company may also contact the Medical Information Bureau, Inc. (MIB) to see if you’ve applied for other insurance in the past. MIB (www.mib.com) is a membership corporation owned by member life insurance companies in the United States and Canada. Its primary purpose is to protect its member insurance companies and consumers from insurance fraud.
Unfortunately, there are individuals who purposely omit information on an application in the hopes of either receiving a lower rate for coverage or for obtaining coverage they otherwise would not qualify for.
This not only puts the insurance company at a higher risk of a claim—but also puts you at risk for higher rates. The more claims a company experiences, the more likely the company may need to charge higher rates or increase rates in the future to cover the claims.
Once all of the required information is obtained by the insurance company, a highly trained underwriter will review it and develop a risk profile on you. This profile is then evaluated against the insurance company’s standards for accepting your risk.
Although each insurance company has different standards, here are four examples of risk categories that you may fall within:
Once the insurance carrier makes its decision on your application, it is provided to Mercer Consumer. Mercer Consumer then communicates the decision to you.
If you’re approved for the coverage you applied for, Mercer Consumer will send you a packet of information, including a letter congratulating you on acceptance, the official certificate to review, your bill and other paperwork you may need now or in the future (such as claim forms). Remember, as mentioned earlier, your coverage isn’t in force until you actually pay the premium.
If you’re denied coverage, you will receive a letter stating why your application has been declined. In most cases, applications are denied due to age or medical reasons. If you question the decision, you can appeal the process. There have been instances where additional medical information has been requested from a member’s physician and a more favorable decision has been made for the member.
In addition, the decision may not be permanent. If you quit smoking, lose weight, bring your cholesterol level or blood pressure down, your risk for the insurance applied for may decrease.
Depending on the insurance applied for, the underwriting process can take anywhere from 30 to 90 days to complete. But throughout the process, you won’t be kept in the dark.
“At Mercer Consumer, we immediately notify the member when we’ve received the application,” says Fuller. “The letter informs the member that their application is pending and is being sent to the carrier for underwriting.”
Once the application is in the insurance company’s hands, “they’re all very good at keeping the member up to date on where they’re at in the underwriting process and what is required to proceed,” explains Fuller. “For example, each time a request is made to a doctor’s office, the member is kept up to date via a letter.”
If at any point in the process, the member wants to know where their application is in the process, they may call Mercer Consumer for a status update.
“We have access to the carrier’s system that will inform us where the process is at and what the member can expect next—all this is provided without supplying any medical information to comply with privacy standards,” states Fuller.
Sanger believes the process can go smoother if the member:
“The biggest delays with any underwriting are trying to schedule exams or tests and receiving information from doctors’ offices,” explains Fuller. “Sometimes this takes several weeks to get worked out.”
No matter who you choose for your insurance coverage, the actual underwriting process will only differ by the standards the insurance company sets. But in general, most insurance companies follow the same basic process of needing and obtaining the information in order to determine your risk.
The benefits of choosing IEEE insurance expand beyond the underwriting process:
For more information including features, costs, eligibility, renewability, limitations and exclusions on the insurance products available through the IEEE Member Group Insurance Program, you can call toll-free 1-800-493-IEEE (4333) or visit IEEEinsurance.com.
This coverage is available to residents of Canada (except Quebec). Mercer (Canada) Limited, represented by its employees Nicole Swift, Pauline Tremblay and Suzanne Dominico, acts as broker with respect to residents of Canada.
*Mercer Consumer is a registered trade name of Mercer Health & Benefits Administration LLC.
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Help protect you and your family with the IEEE Member Group Disability Income Insurance Plan.
IMPORTANT: Any information you provide on your application and throughout the underwriting process is kept in the strictest confidence. All providers of IEEE insurance coverage comply with all privacy, HIPAA and other state and federal regulations designed to protect your records and information.
Tips to help you save time and get the best results on your tests:
Refrain from alcohol eight hours before your testing, and nicotine and caffeine for at least one hour before.
Limit salt and high cholesterol foods as well as strenuous exercise 24 hours before your testing.
Have your medical information, including any prescriptions handy.
Drink a glass of water one hour before.
Note: Fasting for 4 to 12 hours before blood testing is also recommended.