Mutual of Omaha Partners with Claritev to Streamline Supplemental Health Claims

Automating Claims: A Strategic Move

Mutual of Omaha's Workplace Solutions division is collaborating with Claritev to modernize the supplemental health benefits claims process through integration of their platforms. This partnership aims to utilize Claritev's medical claims data to pinpoint policyholders who are eligible to file under accident, critical illness, or hospital indemnity coverage, subsequently notifying them to take action. The streamlined approach not only saves time but also significantly enhances the chances that eligible policyholders will take advantage of their benefits.

Addressing Underutilization of Benefits

The integration comes in response to persistent issues highlighted in NFP's 2026 US Benefits Trend Report. This survey reveals that only about one-third of employees fully engage with their supplemental benefits, while 13% are entirely unaware of their existence. Many employees fail to connect qualifying medical events with the supplemental coverage they opted for during open enrollment. Such disconnect results in lost opportunities for both employees and employers, as funds allocated for these benefits often go unclaimed.

The service aims to rectify this disconnect by scanning medical claims data to identify these events and prompting employees to file claims. This predictive approach may well be the key to driving up the engagement levels employees have with their benefits. If you're working in this space, you know that fostering better awareness can shift significant financial burdens away from employees during difficult times. Greater utilization of benefits not only supports the employee's financial well-being but also strengthens the overall perception of the employer's benefits package.

Enhancing Employee Experience

Andy Gibson, Mutual of Omaha's senior vice president of workplace solutions claims, indicates that employers often overlook the value of voluntary benefits. He notes, "Claim integration streamlines the process at every stage, from identifying potential supplemental claims to notifying employees to help them file claims and receive benefits even faster." This streamlined approach goes beyond mere efficiency; it alleviates friction for employees navigating the emotional challenges of medical events. The psychological burden of filing claims can often deter eligible individuals from seeking their rightful benefits, and by taking proactive measures, this collaboration intends to mitigate those challenges.

It's almost ironic how something so necessary can also become a source of stress. That's where this integration shines; by simplifying the claims process, it turns a once-daunting task into a manageable one. Employers looking to foster a supportive workplace culture can greatly benefit from this change. Research shows that the perception of employee care often links directly with benefits engagement, adding another layer of significance to this partnership.

The Role of Claritev

Travis Dalton, president and CEO of Claritev, emphasizes the importance of reducing the burden on employees during challenging times: "Employees want to focus on recovery, not on the challenges that can come when medical events occur." With over 45 years of claims processing experience, Claritev provides services to more than 750 healthcare payers, 100,000 employers, and 60 million consumers. The long-standing expertise he references isn't just talk; it speaks volumes about the trust built over decades in this space.

Claritev’s technology could play a pivotal role in reshaping how employees interact with their benefits. By leveraging extensive data to uncover insights, Claritev aims to craft a smoother claims experience. This partnership reflects a broader trend in health benefits: technology is increasingly being used to reduce redundancy and enhance user experience. That said, there’s skepticism about how quickly companies can adapt to such systems and whether they will be able to provide necessary training and support to employees.

Impact on Renewal Strategies

For brokers managing voluntary benefits, demonstrating claims utilization is critical at renewal time. Employers unable to show employees' active use of coverage face challenges in client retention. The adopting of automated claims triggers by carriers can diminish renewal risks, as it boosts utilization without necessitating additional employer communication efforts. During negotiations, data showing high engagement rates with supplemental benefits can be a persuasive tool in discussions with leadership teams.

As healthcare costs escalate, more employers are looking towards supplemental coverage as an economical enhancement to their benefits packages. It’s also a competitive edge for attracting talent. When prospective employees evaluate job offers, the benefits package frequently stands out as a factor that can tip the scales for their decision-making. Thus, fostering a system that encourages existing employees to engage with their benefits is more than just a financial issue; it’s about building a desirable work environment.

Future Outlook and Implications

The implications of this partnership between Mutual of Omaha and Claritev extend well beyond just claims processing. By aiming to enhance the engagement among employees, they may very well shift the industry standard regarding how supplemental benefits are managed and communicated. If this initiative succeeds, it could lead to significant overhauls in how voluntary benefits are integrated into corporate wellness programs, transforming them into essential features of an employee's work experience rather than ancillary options.

As employers face ongoing pressures to manage costs while also providing meaningful benefits, expect other companies to take note. They'll likely explore similar automation partnerships, setting the stage for greater competition in claims processing efficiency and user engagement. While this collaboration shows promise, the challenges of implementation should not be underestimated. Scale, adoption rates, and employee willingness to engage with such technologies remain uncertainties that could affect the outcome of the initiative. Only time will tell if this will reshape perceptions of supplemental coverage, but signs indicate a shift that could have lasting effects across the workforce.