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• Topic• Topic• Topic• Topic

Meeting Agenda

• Zurich Overview

• Claim Journey

• Program Features

• Q/A

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Life & AD&D

Short Term

Disability

Long Term

Disability

Leaves of Absence

ADAAA Ex-PatsMulti-

National Pooling

CaptivesGlobal

Programs

Zurich/BHIS Organizational Overview

• Zurich’s worldwide

reach provides

financial strength

and backing to our

products and

services

• 90% of the Fortune

500 insured by

Zurich

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The Zurich Difference

• Technology accessible from any digital

device

• One system for all claim data

• Cloud-based platform

• Real-time data and analytics

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Claim Journey – Case Initiation - Telephonic

Customer Care Center

– Team

– 1-2 years experience in case

management

– New case creation and case status

– Case management support team

– Availability

– (800) 206-8826

– Monday – Friday

– 8:00 am – 8:00 pm ET

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Claim Journey – Case initiation - Portal

Portal

– Available 24/7

– Accessible from any digital device

– www.zurchna.com/myzurichbenefits

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Portal Registration

Simple, 4-step process

Validate your identity

Create Account

Verify contact information

Login

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Portal Case Initiation

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Once logged in, select

“Report a Leave”

Complete intake

questionnaire

Reflexive Questions

Case number provided at

completion

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Portal Features

Electronic Medical

Authorization signature

5-star survey

Real-time

status updates

24/7 Access

through

any device

Direct contact to

Case manager

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The introductory call is the first contact made by the assigned case

manager after a case is created.

Claim Journey – Introductory call

Initial call made in an average of 1

business day

Summary of case details captured at

time of intake

Education provided on what to expect through

the claim journey

Information on how to register for the portal

Reminder given to

DocuSign the medical auth.

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Claim Journey – Initial decision

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Step 1

• Introductory letter sent to the employee is

visible immediately in the portal

• Initial claim email is sent to CPG

Step 3

• Review documents received

• Engage clinical team (as needed)

• Assess functionality

• Make decision. Any denial decisions require

2nd level review and approval

Step 2

• Provider contacted to get information

telephonically

• Employee can upload documents through

the portal

• Mail, Email, Fax upload are ways to get

information to the Case Manager

Step 4

• Contact employee to discuss decision

• Send decision letter to employee. The letter

is immediately available on the portal*

• Decision email is sent to CPG and

Employer

Educate

Gather

Evaluate & Decide

Communicate

*adverse decision letters are not available on the portal

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Claim Journey – Ongoing Management

5 days prior to certified date,

contact is made to employee to

confirm plans to return to work

Clinical Resources:

• Clinical Case Manager• Behavioral Health

Consultant• Vocational Rehab

Consultant• Care Manager

Extension RTW – Modified Duty RTW – Full Duty

Evaluate claim action

plan

Make claim decision

Discuss RTW plan with employee

Communicate outcome

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Claim Journey – Transition to Long Term Disability

Mid-claim review 01

Interdisciplinary roundtable:

• Clinician• Voc. Rehab• LTD and STD

Case Manager

Full claim assessment for LTD consideration

CM handoff 02

Decision 03

• Introduction to new case manager

• In-depth interview with employee to educate on expectations

• Claim co-managed through LTD transition

• Telephonic and written communication of decision

• Explanation of change in pay frequency

• Social Security assistance if applicable

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Clinical Resources – Behavioral Health

13 Week Transition Review Psychological Function

Behavioral Health Clinical

Review Benefit Integration

• Behavioral Health round table

claim discussion

• Established protocols to review

co-morbid conditions

• Review for Specialist vs.

Primary Physician involvement

• Ongoing coordinated

management discussions

• Assess Cognitive

Dysfunction, attention,

memory, reality testing

• Emotional Dysfunction,

affect stability and

appropriateness

• Behavioral Dysfunction,

impulse control, persistence

• Comprehensive clinical

review of psychological

functions, treatment plan

and optimal care

• Identify masked co-morbid

diagnosis related to

behavioral health conditions

• Utilize our dynamic

indicator model

• Engagement of Care

Manager for added

employee support in

identifying available Health

and Wellness programs

• Proactively educate

employees on additional

resources and make

proactive connections

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Program Features and Value-Added Services

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Care Manager Program

Master’s level, licensed Social

Workers

Proactively seek, identify and help

employees in need

– Federal benefits: VA, Social

Security

– Community resources: Dial-a-Ride,

Meals on Wheels

– Integration with other employer

programs

Provide proactive education on

Accelerated Death Benefit

provisions

– Specialize in end-of-life assistance

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Everest Funeral Concierge

CPG members have access to Everest, a consumer advocate who works on your employee’s behalf for funeral-related decisions

– Can negotiate better prices for CPG employees

– Provides price comparison tools

– Acts as liaison between the consumer and the funeral home

24/7 Advisor Assistance

– Can help plan all aspects of a funeral

– Can arrange halls, caterers, flowers, limos, and more

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Questions

John Servais

SVP, Benefits Policy and Design

Isabella White

AVP, Vendor Management Administration

January 14, 2020

2020 Disability Update

Enrollment — Employer-Paid Plans

Disability Coverage Options

(Plan Selections)

• Enrollment

• Changes from default plan

• Billing

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Employee-Paid (Voluntary) Plans — Enrollment

Employees need to complete the

Zurich employee-paid enrollment form

• Enrollment form is available on

the Administrators’ Resource

Center (ARC)

Employers will gather all completed

forms from their employees and

send them to Client Services (CS)

for processing

• Fax: (877) 432-9274

• Email: admin-assist@cpg.org

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Questions and Answers

Feedback

Survey

Disclaimer

Please note that this material is provided for informational purposes only and should not be viewed as

investment, tax, or other advice. It does not constitute a contract or an offer for any products or services.

In the event of a conflict between this material and the official plan documents or insurance policies,

the official plan documents or insurance policies will govern. The Church Pension Fund (CPF) and its

affiliates (collectively, CPG) retain the right to amend, terminate, or modify the terms of any benefit plans

described in this material at any time, for any reason, and, unless otherwise required by applicable law,

without notice.

Short-term disability and long-term disability insurance products and services are offered by Zurich

American Life Insurance Company, NAIC No. 90557, a New York domestic life insurance company.

The information provided here is a summary of the group disability income insurance coverage and

is for illustrative purposes only. A certificate with more complete policy information is available upon

request. Please refer to the certificate or the group policy for a complete description of coverage, terms,

conditions, exclusions, and limitations. If any conflict exists between the policy and the information

described here, the terms of the policy will govern. Other, self-funded disability benefits are provided

by The Church Pension Fund.

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