Common use of Customer Service Call Center Clause in Contracts

Customer Service Call Center. a) During Open Enrollment Period, Contractor’s call center hours shall be, unless otherwise agreed by the Exchange, Monday through Friday eight o’clock (8:00) a.m. to eight o’clock (8:00) p.m., and Saturday eight o’clock (8:00) a.m. to six o’clock (6:00) p.m. (Pacific Standard Time), except on holidays observed by the Exchange. During non-Open Enrollment Periods, the Contractor shall maintain call center hours Monday through Friday eight o’clock (8:00) a. m. to six o’clock (6:00) p.m., and Saturday eight o’clock (8:00) a.m. to five o’clock (5:00) p.m. (Pacific Standard Time), however, Contractor may adjust hours as required by customer demand with prior agreement of the Exchange. Contractor shall inform the Exchange of its standard call center hours and any changes to the call center hours during non-Open-Enrollment Periods. b) Contractor’s call center shall be staffed at levels reasonably necessary to handle call volume and achieve compliance with Performance Standards set forth in Article 6. Contractor shall staff the Call Center with highly trained individuals to provide detailed benefit information, answer Enrollee questions about QHP benefits and coverage, and to resolve claim and benefit issues. c) Contractor shall use a telephone system that includes welcome messages in English, Spanish, and other languages as required by State and Federal laws, rules, and regulations. d) Contractor shall make oral interpreter services available at no cost for non-English speaking or hearing-impaired Enrollees during regular business hours as required by Federal and State law. Contractor shall monitor the quality and accessibility of call center services on an ongoing basis. Contractor shall report to the Exchange monthly, in a format determined by the Exchange, on the volume of calls received by the call center and Contractor’s rate of compliance with related Performance Standards as outlined in Attachment 14. e) Contractor shall meet all State requirements for language assistance services for all of its commercial lines of business.

Customer Service Call Center. a) During Open Enrollment Period, Contractor’s call center hours shall be, unless otherwise agreed by the Exchange, Monday through Friday eight o’clock (8:00) a.m. to eight o’clock (8:00) p.m., p.m. and Saturday eight o’clock (8:00) a.m. to six o’clock (6:00) p.m. (Pacific Standard Time), except on holidays observed by the Exchange. During non-Open Enrollment Periods, the Contractor shall maintain call center hours Monday through Friday eight o’clock (8:00) a. m. to six o’clock (6:00) p.m., p.m. and Saturday eight o’clock (8:00) a.m. to five o’clock (5:00) p.m. (Pacific Standard Time), however, Contractor may adjust hours as required by customer demand with prior agreement of the Exchange. Contractor shall inform the Exchange of its standard call center hours and any changes to the call center hours during non-Open-Enrollment Periods. b) Contractor’s call center shall be staffed at levels reasonably necessary to handle call volume and achieve compliance with Performance Standards set forth in Article 6. Contractor shall staff the Call Center with highly trained individuals to provide detailed benefit information, answer Enrollee questions about QHP benefits and coverage, and to resolve claim and benefit issues. c) Contractor shall use a telephone system that includes welcome messages in English, Spanish, Spanish and other languages as required by State and Federal laws, rules, rules and regulations. d) Contractor shall make oral interpreter services available at no cost for non-English speaking or hearing-hearing impaired Enrollees during regular business hours as required by Federal and State law. Contractor shall monitor the quality and accessibility of call center services on an ongoing basis. Contractor shall report to the Exchange monthly, in a format determined by the Exchange, on the volume of calls received by the call center and Contractor’s rate of compliance with related Performance Standards as outlined in Attachment 14. e) Contractor shall meet all State requirements for language assistance services for all of its commercial lines of business.

Customer Service Call Center. (a) During Open Enrollment Period, Contractor’s call center hours shall be, unless otherwise agreed by the Exchange, be extended Monday through Friday eight o’clock (8:00) a.m. to eight o’clock (8:00) p.m., p.m. and Saturday eight o’clock (8:00) a.m. to six o’clock (6:00) o’clock p.m. (Pacific Standard Time), if call volume warrants, except on holidays observed by the Exchange. During non-Open Enrollment Periodsperiods, the Contractor shall maintain call center hours Monday through Friday eight o’clock (8:00) a. m. ) a.m. to six o’clock (6:00) p.m., p.m. and Saturday eight o’clock (8:00) a.m. to five o’clock (5:00) p.m. (Pacific Standard Time), however, Contractor may adjust Saturday hours as required by customer demand with prior agreement of the Exchangedemand. Contractor shall inform the Exchange of its standard call center hours and any changes to the call center hours during non-non- Open-Enrollment Periodsperiods. Dental Plan Issuers in Covered California for Small Business are not required to provide customer service support on weekends. (b) Contractor’s call center shall be staffed at levels reasonably necessary to handle call volume and achieve compliance with Performance Standards set forth in Article 6. Contractor shall staff the Call Center their call center with highly trained individuals to provide detailed benefit information, answer Enrollee questions about QHP QDP benefits and coverage, and to resolve claim and benefit issues. (c) Contractor shall use a telephone system that includes welcome messages in English, Spanish, Spanish and other languages as required by State and Federal laws, rules, rules and regulations. (d) Contractor shall make oral interpreter services available at no cost for non-English speaking or hearing-hearing impaired Enrollees during regular business hours as required by Federal and State law. Contractor shall monitor the quality and accessibility of call center services on an ongoing basis. Contractor shall report to the Exchange monthly, in a format determined by the Exchange, on the volume of calls received by the call center and Contractor’s rate of compliance with related Performance Standards as outlined in Attachment 14. e) . Contractor shall meet all State requirements for language assistance services for all of its commercial lines of business.

Customer Service Call Center. (a) During Open Enrollment Period, Contractor’s call center hours shall be, unless otherwise agreed by the Exchange, be Monday through Friday eight o’clock (8:00) a.m. to eight o’clock (8:00) p.m., p.m. and Saturday eight o’clock (8:00) a.m. to six o’clock (6:00) o’clock p.m. (Pacific Standard Time), ) except on holidays observed by the Exchange. During non-Open Enrollment Periodsperiods, the Contractor shall maintain call center hours Monday through Friday eight o’clock (8:00) a. m. ) a.m. to six o’clock (6:00) p.m., p.m. and Saturday eight o’clock (8:00) a.m. to five o’clock (5:00) p.m. (Pacific Standard Time), however, Contractor may adjust Saturday hours as required by customer demand with prior agreement of the Exchangedemand. Contractor shall inform the Exchange of its standard call center hours and any changes to the call center hours during non-Open-Open- Enrollment Periodsperiods. Dental Plan Issuers in SHOP are not required to provide Customer Service support on weekends. (b) Contractor’s call center shall The Call Center will be staffed at such levels as reasonably necessary to handle call volume and achieve compliance with Performance Measurement Standards set forth in Article 6. Contractor shall staff the their Call Center with highly trained individuals to provide detailed benefit information, answer Enrollee questions about QHP benefits and coveragethe QDP, and to resolve claim and benefit issues. (c) Contractor shall use a telephone system that includes welcome messages in English, Spanish, Spanish and other languages as required by State and Federal laws, rules, rules and regulations. (d) Contractor shall make oral Oral interpreter services shall be available at no cost for non-English speaking or hearing-hearing impaired Enrollees during regular business hours as required by Federal and State law. Contractor shall monitor the quality and accessibility of call center services on an ongoing basis. Contractor shall report to the Exchange monthlyExchange, in a format and frequency to be determined by the Exchange, but no more frequently than monthly, on the volume of calls received by the call center and Contractor’s rate of compliance with related ability to meet the Performance Standards as outlined in Attachment 14Measurement Standards. (e) As required under Section 3.16, the Contractor shall meet all State requirements for language assistance services for all of its commercial lines of business. The Exchange and Contractor agree to assess the adequacy of the language services during 2015, both phone and written material, and consider the adoption of additional standards in 2016.