Voya Introduces New Claims Model To Help American Workers Maximize Their Voluntary Benefits

Process proactively pays claims for covered events and can easily connect with a broad range of employer-offered medical plans

MINNEAPOLIS, March 18, 2021 — Voya Financial, Inc. (NYSE: VOYA), announced today that it has launched Voya Claims 360, an integrated and intuitive model designed to simplify the claims process for supplemental health insurance products. From the time an employee first enrolls in their benefits to when an eligible claim is submitted, reviewed and paid, Voya Claims 360 initiates a variety of proactive actions to help employees get the most from their supplemental health insurance offered by their employer. Support ranges from connecting the dots between coverages and notifying employees when they have a potential claim, to even paying certain benefits automatically.

“Industry research shows nearly 70% of American workers consider supplemental benefits as important as employer-based health insurance and retirement benefits.[1] However, even though employees value supplemental health benefits, it’s not uncommon for individuals to overlook them when it comes time to file a claim. For example, when Voya’s research team interviewed employees with current supplemental benefits coverage, only 1-in-10 responded they had ever filed a claim for those benefits[2],” explained Rob Grubka, chief executive officer of Health Solutions for Voya Financial.

“The goal of Voya Claims 360 is to simplify and streamline the process so employers can help support the health and wealth needs of their employees. We want to make it easy for employees to use and maximize the supplemental health benefits that they are often paying for during their time of need — even when they are unaware they may have a claim opportunity,” added Grubka.

Voya Claims 360 key features include:

  • Product-to-Product Claim Integration – When a claim is filed, Voya’s claims team cross-references to see if the same incident triggers benefits for other supplemental health insurance for which the claimant is covered. For example, if an employee files a short-term disability insurance claim when they cannot work due to injuries sustained from an accident, and also has accident and/or hospital indemnity insurance but did not submit a claim, the claims team will send that individual an email reminder. In some cases, the claims team will automatically open a claim and issue a benefit for a covered event — no paperwork required.
  • Intuitive Claims Payment – Employees are often frustrated with the amount of documentation needed for claims as they may need to provide documentation from several medical providers over the period of time they receive treatment for a covered event. Voya’s intuitive claims-payment model anticipates the needs of employees filing an initial claim and pays upfront for additional expected covered costs. For example, if an employee with accident insurance files a claim for a documented fracture, Voya understands they will also likely have follow-up doctor visits, receive an X-ray and need medical equipment like crutches. A benefit is automatically paid for those expected and covered events upfront at the time of the original claim without requiring the employee to submit more supporting documentation throughout their treatment.
  • Medical Claims Integration – Employers who meet specific criteria may be eligible to offer employees the option to get claims reminders based on their medical claims data. In the past, this was only possible when a medical carrier also offered supplemental health benefits. Voya now has the capability to look across carriers for claim opportunities. Voya’s carrier-agnostic medical claims integration connects with Voya-offered supplemental health insurance products and a broad range of medical plans. Once employees “opt in” during enrollment for their supplemental benefits, Voya can analyze their medical claims data to find claim opportunities that the employee may have overlooked or not even realized are possible covered events.

“Given the deeply personal and highly protected nature of our medical data, you would think most employees would be unwilling to share this private information. However, as we have started to launch medical claims integration with several employer clients, Voya discovered that nearly 50% of employees agreed to opt in and share their medical insurance data[3],” explained Mona Zielke, senior vice president of Claims and Operations, Voya Financial.

“At Voya, we employ leading cybersecurity and anti-theft tools and resources to keep the personal information of our customers safe and secure. For example, we use advanced predictive analytics — both in our call centers and in our digital tools — to help preemptively detect, identify and protect against cyber fraud,” added Zielke. “While each of us needs to determine our own comfort level when it comes to sharing private information, American workers appear to be willing — if it helps proactively identify, process and pay supplemental benefit claims on their behalf.”

Simplifying The Claims Process Helps Improve Customer Satisfaction

The goal of Voya Claims 360 is to simplify and streamline the process so employers can help support the health and wealth needs of their employees...

When employees learn they are receiving a paid benefit for a claim they never filed or something they never realized was a covered event, their reactions have ranged from disbelief to heartfelt gratitude. For example, a Voya employer client recently had an employee who suffered a serious motorcycle accident that prevented him from working for several months. The employee filed a short-term disability insurance claim, which was approved. However, thanks to auto-pay integration, Voya determined that this individual was also eligible for both accident and hospital indemnity benefits. As a result, the employee received an additional $13,365 in benefit payments for the covered events he experienced. Read more Voya Claims 360 customer stories.

“When our claims team notifies a person they’re about to receive a paid benefit for supplemental insurance coverage that they may not have even remembered they had, most are apprehensive at first. However, once we explain the Voya Claims 360 process, their gratitude and appreciation are overwhelming,” said Zielke. “As a result, our customer satisfaction scores reflect our proactive efforts — with 97% of claimants saying they agree that filing a claim with Voya is easy[4].”

The online Voya Claims Center makes the process to submit a claim straightforward and transparent with accessible, real-time monitoring. Once documentation is gathered, most claims can be filed in less than 15 minutes.

Through its Health Solutions business, Voya offers stop loss, group life, disability and supplemental health insurance products through the workplace, as well as health savings and spending accounts, to employers and their employees. Voya has extensive experience in the design, implementation and administration of benefit plans, and it offers a full range of supplemental insurance products, including critical illness/specified disease, accident, hospital indemnity and disability income insurance.

As an industry leader focused on the delivery of health, wealth and investment solutions to and through the workplace, Voya Financial is committed to delivering on its mission to make a secure financial future possible for all Americans — one person, one family, one institution at a time.




1) SHRM, “Using Voluntary Benefits to Support Workforce Strategy”; February 14, 2019
2) Voya “Medical Claim Integration” study conducted through Voya’s Online Consumer Community with n=65 consumers balanced by age and gender, January 2020.
3) Based on internal Voya data specific to the groups offering medical claims integration option, as of March 1, 2021.
4) Based on internal Voya data tracking customer claims satisfaction, January 1, 2021 – March 1, 2021. Approximately 97% out of a total of 3,193 respondents agreed that Voya made it easy to file their claim.
About Voya Financial®
Voya Financial, Inc. (NYSE: VOYA), helps Americans plan, invest and protect their savings — to get ready to retire better. Serving the financial needs of approximately 14.8 million individual and institutional customers in the United States, Voya is a Fortune 500 company that had $7.6 billion in revenue in 2020. The company had $700 billion in total assets under management and administration as of Dec. 31, 2020. With a clear mission to make a secure financial future possible — one person, one family, one institution at a time — Voya’s vision is to be America’s Retirement Company®. Certified as a “Great Place to Work” by the Great Place to Work® Institute, Voya is equally committed to conducting business in a way that is socially, environmentally, economically and ethically responsible. Voya has earned recognition as one of the World’s Most Ethical Companies® by the Ethisphere Institute; as the No. 1-ranked financial services firm among Barron’s 100 Most Sustainable Companies for three consecutive years; as a member of the Bloomberg Gender Equality Index; and as a “Best Place to Work for Disability Inclusion” on the Disability Equality Index. For more information, visit voya.com. Follow Voya Financial on Facebook, LinkedIn and Twitter @Voya.