Autumn marks the transition from summer to winter during which time temperatures gradually decrease. For Group Life carriers, however, a different type of season is heating up, with Evidence of Insurability (EOI) application submissions on the rise. For some companies, this means receiving and processing 75% of their annual EOI applications during their “peak season” which generally begins during the last four months of the year.

The front end of peak season comprises of managing applications coming in the door, with the back half spent securing medical underwriting requirements and assessing risk. The increase in EOI applications at peak season is typically triggered by employees electing coverage levels requiring medical underwriting.

Per Gen Re’s 2023 U.S. Group Life Rate & Risk Management Survey, as a standard open enrollment practice, just over 40% of carriers require EOI for elections greater than one level, with roughly a third requiring EOI for any level increase at annual open enrollment on inforce Group Life policies.

Main Challenges

Gen Re’s U.S. Group Medical Evidence of Insurability (EOI) Underwriting Survey has consistently ranked managing volumes during peak season as the number one challenge facing Group Life medical underwriting departments.

Challenges Currently Facing Group Medical Underwriting Departments

To manage increased peak season application volume, carriers implement several things to enhance workflow.

• On average, companies have seven internal and one external year-round full-time underwriters who support their medical underwriting function during the off-peak season. An average of four additional internal and three additional external temporary underwriters are added during peak season.
• Almost all companies introduce paid overtime and extra hours during this time with about half of companies restricting underwriter’s time off.
• Temporary job reassignment or borrowing staff from other teams are other ways to increase production.

How to Optimize Workflow?

In addition to enhancing staffing resources, we’ve seen an increase in utilization of digital underwriting tools and data sources as carriers seek to optimize workflow and underwriting efficiencies.

• 83% of carriers have an automated underwriting system where decisions can be made without the review of a medical underwriter.
• 78% of carriers utilize some form of medical data such as Lab, Pharmacy and Medical Claims.
• Use of web-based enrollments have doubled over the past decade.

Outcomes of EOI Applications

Although the industry has made strides on this front, roughly half of applications processed with an automated underwriting system are kicked out requiring further medical underwriter review.

Outcomes of EOI Applications

Underwriting Suggestions

Despite improvements made in recent years, managing volumes during peak season continues to be reported as the greatest challenge facing Group Life medical underwriting departments today.

Of course carriers will take note from this year’s open enrollment strains to see what improvements should be made next year. For more ideas, read the summary report on our last EOI Survey.