Worksite Solutions

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© C2 Solutions 2020 Worksite Solutions Learn more about C2’s Worksite programs.

Transcript of Worksite Solutions

Page 1: Worksite Solutions

© C2 Solutions 2020

Worksite Solutions Learn more about C2’s Worksite programs.

Page 2: Worksite Solutions

C2 WORKSITE SOLUTIONS

© C2 Solutions 2020

Table of Contents

Under 400 Employees

Guardian Underwriting Offer........................................................................................................... 3

MetLife Underwriting Offer ............................................................................................................. 5

MetLife Critical Illness ...................................................................................................................... 7

MetLife Accident ............................................................................................................................... 9

MetLife Hospital Indemnity ......................................................................................................... 11

Standard Underwriting Offer ........................................................................................................ 13

Clarity Enrollment Solutions Slip Sheet ...................................................................................... 18

Employee Family Planning Overview .......................................................................................... 19

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Agreement Code:

Guardian Supplemental Health Underwriting Agreement & Plan

Design Defaults for:

C2 Solutions Member Firms

Start Date: 7/1/2020 Review Date: 10/1/2021 Annual Sales Production Goal: $750K Block Participation Goal: 15% by line of coverage Channel Partner ID, if applicable: No Rate Sheets: No

Sales Office: Milwaukee Sales Contact: Dan Heichel Broker Contact: Katie Ott UW Contact: Cheryl Carroll RPL Sponsor: Jamey Conway

Important Notice: The scope of this offer is limited to the plan designs and/or concessions below. Nothing in this offer is intended to waive Underwriting authority unless expressly stated. For example, SIC restrictions and commission guidelines will continue to apply unless exceptions are documented below. Guardian reserves the right to modify or terminate this offering at any time.

Special Instructions & Notes

All plans will be run in CPS so variations may occur, especially in takeover situations, but general plan designs below

Member firms of C2 include: The Partners Group, Scott Benefit Services, Holmes Murphy, M3 and McGohan Brabender.

For All Supp Health Coverages

Case Size Restrictions 25-399 lives

Commissions: up to 70/10 ML heaped for Acc/CI/Cancer – up to 60/10 ML heaped for HI and Dis Select

Ben Tech will vary case to case but standard 3% will be default.

Situs: Nationwide with the understanding that state variations apply including MLR states which have commission restrictions

Participation Requirements: Block will be managed annually at 15% participation per product line. Individual case standard participation requirements are waived to 5 enrolled apps per case.

Enrollment: This offer applies to C2 cases enrolled by Clarity and other similar 3rd

party enrollment firms approved by Guardian. Where a 3rd party is not enrolling, active self enroll/paper enrollment must utilize our in-house enrollment and tech consultant (Becky Johnson). This mandates an employer and broker have bought into solid enrollment conditions- 75% in group meeting, active decisions/completed enrollment, pre-communication campaign, etc…

Plan Design: See approved plan designs for Clarity/Preferred Partners

All plans will be run in CPS so variations may occur, especially in takeover situations, but general plan designs below

3 Year RTG

Accident Standard 2.0 plans, typically Gold

24 hour or Off job

College Tuition Benefit

$50 Wellness

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Critical Illness Pre x- waived

Conditions 1,2 and 3

GI- $30K

$50 Wellness

Attained age - Uni tobacco

Spouse Benefit 100%

Annual Open Enrollment

No age reductions

College Tuition Benefit

Hospital Indemnity

HSA plan design: Admission benefit amount $500 low plan, $1500 high plan

Daily Confinement benefit amount $100

Composite rates

Sickness and Accident

Pre-ex waived

9-month maternity exclusion included when pre-ex is waived

College Tuition Benefit

Annual Open Enrollment

Disability Income Select

Three plan designs: 7/7/13, 14/14/13 and 14/14/26

College Tuition Benefit

$300-$1000 weekly benefit in $100 increments

Attained age rates

Standard participation applies

Guardian Confidential 2

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C2 and MetLife Group Benefits

Let’s work together to benefit your clients

matters

When you work with C2 and

MetLife, you get the collective

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1. Coverage is guaranteed provided (1) the employee is actively at work and (2) dependents to be covered are not subject to medical restrictions as set forth on the enrollment

form and in the Certificate. Some states require the insured to have medical coverage. Additional restrictions apply to dependents serving in the armed forces or living

overseas.

2. MetLife’s Issue age product is subject to benefit reductions that begin at age 65. Coverage for Domestic Partners, civil union partners and reciprocal beneficiaries varies by

state. Please contact MetLife for more information.

3. In Washington state, the duration is 365 days.

4. Availability varies by state.

FOR BROKER USE ONLY metlife.com

The product information included in this piece are considered competitive advantages based on our standard offering.

Like most insurance policies, insurance policies offered by MetLife and its affiliates contain certain exclusions, exceptions, waiting periods, reductions,

limitations, and terms for keeping them in force. Please contact MetLife for complete details.

METLIFE’S ACCIDENT AND HOSPITAL INDEMNITY INSURANCE POLICIES ARE LIMITED BENEFIT GROUP INSURANCE POLICIES. The policies are not intended

to be a substitute for medical coverage and certain states may require the insured to have medical coverage to enroll for the coverage. The policies or their

provisions may vary or be unavailable in some states. Prior hospital confinement may be required to receive certain benefits. There may be a preexisting

condition limitation for hospital sickness benefits, if applicable. MetLife’s Accident and Hospital Indemnity Insurance may be subject to benefit reductions that

begin at age 65. And, like most group accident and health insurance policies, policies offered by MetLife may contain certain exclusions, limitations and terms for

keeping them in force. For complete details of coverage and availability, please refer to the group policy form GPNP12-AX, GPNP13-HI, or GPNP12-AX-PASG, or

contact MetLife. Benefits are underwritten by Metropolitan Life Insurance Company, New York, New York. In certain states, availability of MetLife’s Group

Hospital Indemnity Insurance is pending regulatory approval. Hospital does not include certain facilities such as nursing homes, convalescent care or extended

care facilities. See MetLife’s Disclosure Statement or Outline of Coverage/Disclosure Document for full details.

METLIFE CRITICAL ILLNESS INSURANCE (CII) IS A LIMITED BENEFIT GROUP INSURANCE POLICY. Like most group accident and health insurance

policies, MetLife’s CII policies contain certain exclusions, limitations and terms for keeping them in force. Product features and availability may vary by state.

In most plans, there is a pre-existing condition exclusion. After a covered condition occurs, there is a benefit suspension period during which benefits will

not be paid for a recurrence, except in the case of insureds covered under a New York certificate. MetLife’s Issue Age CII is guaranteed renewable, and may

be subject to benefit reductions that begin at age 65. Premium rates for MetLife’s Issue Age CII are based on age at the time of the initial coverage effective

date and will not increase due to age; premium rates for increases in coverage, including the addition of dependents’ coverage, if applicable, will be based on

the covered person’s age at the time of the initial coverage effective date. Rates are subject to change for MetLife’s Issue Age CII on a class-wide basis. A

more detailed description of the benefits, limitations, and exclusions can be found in the applicable Disclosure Statement or Outline of Coverage/

Disclosure Document available at time of enrollment. For complete details of coverage and availability, please refer to the group policy form GPNP14-CI or

contact MetLife for more information. Benefits are underwritten by Metropolitan Life Insurance Company, New York, New York.

MetLife’s Critical Illness Insurance is not intended to be a substitute for Medical Coverage providing benefits for medical treatment, including hospital,

surgical and medical expenses. MetLife’s Critical Illness Insurance does not provide reimbursement for such expenses is pending regulatory

approval.

Metropolitan Life Insurance Company | 200 Park Avenue | New York, NY 10166 L1119519950[EXP1220][ALL STATES][DC] © 2019 METLIFE SERVICES AND SOLUTIONS, LLC

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Critical Illness Plan C2 Plan Design

Policy Specifications Comments

Group or Individual Group Critical Illness

Rate Structure (Issue Age or Attained Age) Attained Age/Uni-tobacco

Guarantee Issue Yes

Benefit Amounts (Employee Choice) $15,000 or $30,000 Can be offered up to $50,000 guaranteed issue

Total Benefit Amount

500%

Effective January 1, 2021 - New Critical

Illness plan will have the option for no total

benefit

amount limit.

Spouse Coverage 100% of the Employee benefit amount

Child Coverage 100% of the Employee benefit amount

Pre-Existing Conditions None

Waiting Period None

Recurrence Benefit

100%: Heart Attack, Stroke, Full Cancer,

Coronary Artery Bypass Graft,

Partial Benefit Cancer

Suspension Period for same condition 365 days

Suspension Period for different condition None

Portability Yes

Benefit Reduction due to Age Attained Age: No Benefit Reduction

Covered Conditions Comments

Full Cancer 100%

Effective January 1, 2021 - New Critical

Illness plan will allow for 90 conditions

including COVID-19, Sudden Cardiac Arrest,

Occupational Post Traumatic Stress Disorder,

Mini-Strokes and Aneurysms.

Heart Attack 100%

Kidney Failure 100%

Stroke 100%

Major Organ Transplant 100%

Coronary Artery Bypass Graph 100%

Alzheimer's Disease 100%

Partial Cancer (Carcinoma in Situ) 25%

Addison's Disease; Lou Gehrig's Disease;

Cerebrosprinal Meningitis; Cerebral Palsy;

Cystic Fibrosis; Diphtheria; Encephalitis;

Huntington's Disease; Legionnaire's Disease;

Malaria; Multiple Sclerosis; Muscular

Dystrophy; Myasthenia Gravis; Necrotizing

Fasciitis; Osteomyelitis; Poliomyelitis; Rabies;

Sickle Cell Anemia; Systematic Lupus

Erythematosus; Systematic Sclerosis; Tetanus;

Tuberculosis.

25%

Additional Benefits Comments

Health Screening Benefit (HSB) $50

(45 tests) Effective January 1, 2021 - New Critical

Illness plan will have 52 covered exams

including dental & vision preventive services. Telephonic HSB Claim Capabilities Yes

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MetLife Advantages (offered at no additional charge)

Will Preparation Services

Online will prep provided by SmartLegalForms to

create a binding will, living will or assign a

power of attorney

MetLife VisionAccess

Discount program provides a discount on eye

exams, glasses and frames, and laser vision

correction when visiting a participating private

practice

Digital Legacy (MetLife Infinity)

Create an account and upload, store and share

digital assets including pictures, videos, audio

files and documents. Share with family and

friends and set up a "trusted" individual who can

release collections if the user becomes unable to

do so

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Accident Plan C2 Plan Design

Policy Specifications Comments

Group or Individual Group Accident

Rate Structure Composite Rates

Eligibility Full Time Employees Actively at Work. Spouse

& Dependent Children to age 26

Guaranteed Issue Yes

Waiting Period: No

Pre-Existing Condition No

Plan Design (Employer Choice) Off Job We can offer a 24 hour plan

Portability Yes - benefit and rates remain the same

Benefit Reduction by Age None

Duration of time between Accident and

Treatment

180 days for most benefits

Organized Sports Activity Injury Benefit

Rider

25%

If a covered person has an accident that is due

to organized sports activity, we will pay an

extra 25% of eligible benefits, subject to

limitations described in the certificate, under

the following benefit categories: Accidental

Injury, Accident - Medical Treatment and

Services, Hospital benefits.

Accidental Injury Benefits Category Comments

Fractures

All of the following benefit amounts can be

modified.

Closed $200 - $5,000

Open $400 - $10,000

Dislocations

Closed $200 - $5,000

Open $400 - $10,000

Burns Benefit

2nd Degree $100 - $1,500

3rd Degree $1,500 - $15,000

Laceration Benefit (varies by length of

laceration)

$75 - $700

Broken Tooth Benefit

crown $300

extraction $150

filling $50

Medical Treatment and Services Benefits Category Comments

Ambulance

Ground $400

Air $1,250

Emergency Care Benefit

ER: $200

Physician's Office: $100

Urgent Care: $100

Non Emergency Initial Care Benefit $100

Medical Testing Benefit $200

Physician Follow-Up Benefit $100

Therapy Services Benefit $50

Medical Appliance Benefit $150 - $1,000

($1,000 Limit = Total per covered person, per

accident)

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Surgery Benefits Comments

Surgical Repair: $400 - $2,000

exploratory surgery without repair

(for any Surgery Benefit Procedure)

$200

Accident - Hospital Benefits Category Comments

Admission $1,500

ICU Supplemental Admission

(paid in addition to Admission)

$1,500

Confinement $300

ICU Supplemental Confinement

(paid in addition to confinement)

$300

Inpatient Rehabilitation Benefit $200

Accidental Death Benefits Category Comments

Basic Accidental Death Benefit

Can be removed

Employee $50,000

Spouse $25,000

Child $10,000

Accidental Death - Common Carrier Benefit

Employee $150,000

Spouse $75,000

Child $30,000

MetLife Advantages Offered at no additional charge

Will Preparation Services

Online will prep provided by SmartLegalForms to

create a binding will, living will or assign a

power of attorney

MetLife VisionAccess

Discount program provides a discount on eye

exams, glasses and frames, and laser vision

correction when visiting a participating private

practice

Digital Legacy (MetLife Infinity)

Create an account and upload, store and share

digital assets including pictures, videos, audio

files and documents. Share with family and

friends and set up a "trusted" individual who can

release collections if the user becomes unable to

do so

Funeral Discounts and Planning Services

Convenient funeral services planning designed to

make funeral arrangements and final wishes

defined in advance of need.

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Hospital Indemnity C2 Plan Design

Policy Specifications Comments

Group or Individual Group Hospital Indemnity

Rate Structure Composite Rates

Eligibility Full Time Employees Actively at Work. Spouse

& Dependent Children to age 26

Guaranteed Issue Yes

Waiting Period: No

Pre-Existing Condition None

Plan Benefit Level (Employee Choice) High

Portability Yes - benefit and rates remain the same

Benefit Reduction by Age None

Hospital coverage due to an accident or Illness Comments

Hospital Admission Benefit $1,000

(1 x per year)

All of the following benefit amounts and

durations can be modified.

Hospital Supplemental Admission Benefit $1,000

(1 x per year)

Hospital Confinement Benefit $200 per day

(15 days annual)

Hospital Supplemental Confinement Benefit $200 per day

(15 days annual)

Newborn Nursery Care Confinement Benefit $50/2 days

Inpatient Rehab Benefit

(up to 15 days per covered accident not to

exceed 30 days per calendar year)

$200 per day

Pregnancy Comments

Pregnancy (Routine Childbirth and

Complications) Yes

Elimination Period No

Surgery Benefits Category Comments

Inpatient Surgery Yes

Outpatient Surgery Yes

General Anesthesia Yes

Spinal and/or Epidural Anesthesia Available

Additional Care Benefits Category Comments

Ground Ambulance Available

Diagnostic Procedure Available

Emergency Room Available

Hospice Care Available

Skilled Nursing Facility Available

Home Care Available

Outpatient Intravenous (IV) Infusion Therapy Available

Outpatient Therapy Available

Physician Visit Available

Prescription Drug Available

Other Benefits Category Comments

Health Screening Benefit Yes

Childcare Benefit Available

Lodging Benefit Yes

Transportation Benefit Yes

Waiver of Premium Available

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Benefit Supplement Rider (Designated

Facility) Available for Healthcare Prospects/Customers

MetLife Advantages Offered at no additional charge

Will Preparation Services

Online will prep provided by SmartLegalForms to

create a binding will, living will or assign a

power of attorney

MetLife VisionAccess

Discount program provides a discount on eye

exams, glasses and frames, and laser vision

correction when visiting a participating private

practice

Digital Legacy (MetLife Infinity)

Create an account and upload, store and share

digital assets including pictures, videos, audio

files and documents. Share with family and

friends and set up a "trusted" individual who can

release collections if the user becomes unable to

do so

Funeral Discounts and Planning Services

Convenient funeral services planning designed to

make funeral arrangements and final wishes

defined in advance of need.

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C2 Voluntary Benefits Offer 100-400 eligible lives segment

Thank you for including The Standard in the C2 Voluntary Benefits Strategy. Below please find an outline our offer for Accident, Critical Illness and Hospital Indemnity coverages along with our technology offerings.

Plan Design Highlights Accident Insurance Option 1: Enhanced Plan Eligibility: Employees working 20 hour per week or more

Employee and Spouses age 18-70; children birth through 26 No termination age while actively at work Non-Occupational Coverage $50 Annual Health Maintenance Screening $500 Auto Accident Benefit Unique product features

25% Youth Organized Sports Benefit Fractures and dislocations are paid as scheduled with no per accident cap

Commission: heaped or level 4 tiered rates 3 year rate guarantee – (case level claims experience not applicable on renewals; block managed)

Option 2: Same as Option 1 with 24-hour Coverage Line of Duty Benefit

Critical Illness Insurance Premier Plan

Eligibility: Employees working 20 hour per week or more Employee and Spouses age 18-70; children birth through 26

Coverage terminates at age 80 Employee $5,000 increments to $30,000 Spouse $5,000 increments to $15,000 Child covered at 50% of employee’s amount $30,000 GI for Employee $15,000 GI for Spouse Annual open enrollment with guarantee issue included No pre-existing conditions exclusion $50 Annual Health Maintenance Screening

Additional Occurrence Benefit included No Reoccurrence Benefit Unique product features

No lifetime maximum

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No benefit reduction schedule 21 childhood diseases covered

Commission: heaped or level Attained age / Blended tobacco rates

3 year rate guarantee – (case level claims experience not applicable on renewals; block managed)

Hospital Indemnity Plan Employees working 20 hour per week or more Eligibility: Employee and Spouses age 18-70; children birth through 26 Coverage terminates at age 80

Plan 1: $100 Daily Hospital Confinement Benefit (15 days per confinement) $500 Hospital Admission Benefit $50 Daily CCU Confinement Benefit ($15 days per confinement) Plan 2: $200 Daily Hospital Confinement Benefit (15 days per confinement) $1,000 Hospital Admission Benefit $50 Daily CCU Confinement Benefit ($15 days per confinement) Plan 3: $300 Daily Hospital Confinement Benefit (15 days per confinement) $1,500 Hospital Admission Benefit $50 Daily CCU Confinement Benefit ($15 days per confinement) Annual open enrollment with guarantee issue No pre-existing conditions exclusion $50 Annual Health Maintenance Screening

Unique product features No waiting period for maternity claims Admission criteria is 20 hours in the ER and/or inpatient room Daily hospital confinement benefit begins on day one

Commission heaped or level 4 tiered rates 3 year rate guarantee – (case level claims experience not applicable on renewals) Note: There may be some variance due to state specific requirements.

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Technology Offering Benefit Technology Support Benefit Administration Technology Offsets are included for both Standard BenTech Partners and other Benefit Technology vendors as outlined below:

BenTech Partners: The Standard has negotiated BenTech offsets and enhanced integration with several vendors. Below please find the list of our current partners. (We will update you as we add additional BenTech partners in the future)

Ease Employee Navigator Empyrean bswift PlanSource Paylogix

Other Benefit Technology vendors For vendors that are not a Standard BenTech Partners we will include our Benefit Administration Technology Offset detailed in the below chart:

Navigator Mobile If Accident Insurance, Critical illness and Hospital Indemnity coverages are purchased together we will include our Navigator Mobile app at no cost to the customer.

Enrollment Conditions Requirement and Participation requirement The above offer is provided on the condition that the products are enrolled via an active enrollment strategy using one of the chosen C2 enrollment firms. Each line of coverage requires a minimum of 10 employees enrolled for the plan to become effective.

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Ineligible Industries The below industries are ineligible for coverage or require the approval of underwriting to offer coverage.

Critical Illness and Hospital Indemnity DTQ Industries Exterminators/Pest Control Waste Disposal Seasonal Workers Fire Suppression Volunteer firefighters Mining Athletes and Entertainers Asbestos Offshore Oil &Gas Extraction

Accident Insurance Non- Occupational Coverage only can be offered to the following industries

Construction Companies Drilling Private Households Exterminators/Pest Control Sawmills Commercial Fishing Waste Disposal Roofing Companies Seasonal Workers Logging Agricultural Pilots Fire Suppression Pilots Search and Rescue Workers Sight-Seeing Pilots Railroad locomotive crews Riverboat Pilots / Captains Taxi services Volunteer firefighters Mining Athletes and Entertainers Asbestos Offshore Oil &Gas Extraction

High Turnover Industries – Require underwriting approval to quote AI CI or HI coverage Construction Liquor Stores

Taxi Services Trucking Gas Stations and convenience stores Florists Hotels Barber/Beauty Shops Nursing Homes Restaurants Long Haul Trucking Companies

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Enrollment Solutions: Creating a Streamlined Process for a Strategic Partner

Overall Client Strategy o Target Client Size – 100 to 400 lives o C2 Solutions / Clarity Carrier Partners - Guardian, Standard & MetLife

Enrollment Solutions o Face-to-face, Telephonic and Self-Service o Telephonic provides most streamlined approach and quickest turnaround o Calls are recorded and archived for 7 years o New Hire Onboarding Services at no cost to the client

Clarity’s Technology Solutions o Multiple Platform Options - Employee Navigator, Ease & TeemWurk o Leave-behind enrollment system can be included with 1 x 1 meetings o Ability to connect with carriers via carrier exchange connections or EDI o Inexpensive solution – options for free technology depending on client needs

Service o Single Point of Contact starting with Implementation o Support with technology – both onboarding and ongoing service o Dedicated carrier relationships to assist with escalated carrier issues

Pre-Enrollment Solutions o Implementation timeline developed to allow for ample time to set up event o Project management software can be used internally or shared with

external partners to help manage enrollment processes and procedures

o Tailored emails, brochures, posters, payroll stuffers o White labeled benefits landing page: https://onlinebenefitsguide.com o Simplified communication for easy employee understanding o Online scheduling which eliminates hassles of paper sign-up sheets

Post-Enrollment Solutions o Employee survey results provided to broker and employer o Electronic file delivery on carrier specific templates o Transition from Open Enrollment to New Hire Onboarding o Technology training and ongoing tech support

Clarity Enrollment Solutions | 7825 Washington Ave S, Suite 710 | Bloomington, MN 55439 | www.clarityenroll.com

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s

Company Profile

Background Capabilities Accreditations Stakeholders

- Founded in 1979

- Located in Glastonbury, CT

- 62 Operational Employees

- 61 Full-Time Counselors

- 32 Part-Time Counselors

- 121 Per Diem Counselors

- National in Scope

- Enrollment Services

- Onsite Counselors

- Benefit Service Center

- Self-Service

- Premium Services

- Reconcile & Remit

- Marketing Support

- Market Analysis

- Communication Support

- Development & Fulfillment

- Managed Services

- Technology

- Employee Navigator

- Selerix

- PlanSource

- Eligibility Management

- New Hire Onboard

- Offboard

- ACA

- Track, Measure, Report

- Compliance

- AICPA SOC 2 Type II

- HIPPA

- GDPR Compliant

- Security

- Encryption

- Audit Controls

- Isolated Control

- Privacy Control

- Preferred National

Enrollment Firm

- USI

- Brown & Brown

- C2 Solutions

- EFP

- Independently Owned

- Implementation Project

Team

- Account Manager Structure

- Domain Experts

- Broker/Consultant

- Primary distribution

channel

EFP at a Glance Mick Gebo, Senior Business Development Executive, EFP

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Virtual Multi-Channel Call Center

People Capabilities Size/Industry Communications

- Average 8-years’ experience

- Licensed (LA&H)

- Ongoing Training

- Per Diem

- Located throughout the US

- English/Spanish Staffed

- Inbound/Outbound

- Cloud Based Scheduling Tool

- Client Specific Hub Micro-

Site

- Monday-Friday 8am-9pm

EST

- Weekends available

- Call recording

- Co-browsing

- Live Chat

- Screen and control sharing

- Texting

- Voicemail messaging

- Up to 75 varied language

assistance

- Industries

- Government

- Schools

- Healthcare

- Retail

- Manufacturing

- Technology

- Case Size

- 100-400

- Locations

- US (Hawaii & Puerto Rico)

- Communications

- Print and Electronic

- Brainshark

- Benefit Guides

- Benefit at a Glance

- Video

EFP at a Glance Mick Gebo, Senior Business Development Executive, EFP