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Claims and customer-service trends: approvals rising, weekly payments near $9.6M
Summary
Staff reported growing claim volumes and higher approval rates, with program payments totaling nearly $1.6 billion to date and average weekly payments of about $9.58 million over the prior 26 weeks; staff credited portal improvements and Aflac’s call‑center maturity for better service and lower live-call demand.
Staff presented February 2026 claims-administration data to the board on March 12, describing continued program growth, rising approval rates and improvements in customer service metrics.
John, who presented the claims update, said the three‑month claims trend was 27,357 claims (a monthly moving average of 9,119) and noted year‑over‑year increases in both claims filed and approvals. He said cumulative claims since program inception are approaching 410,000 and that the program has paid nearly $1.6 billion to Connecticut workers. "The number of unique employees paid by Connecticut paid leave has risen to over 197,000 and the total amount the program has paid to Connecticut workers is now almost $1.6 billion," he said.
Board members asked about the roughly 20 percent denial headline. John said the "lion's share" of denials are for missing required paperwork — about the mid‑70% range of denial reasons — and described steps Aflac and staff have taken to assist claimants in assembling employment-verification and medical documentation. Erin noted that Connecticut allows claimants to start claims before leave begins, which increases counts of incomplete filings relative to states that require all documents at submission.
On customer service, John said call-center volume declined modestly while speed-to-answer improved: average monthly calls for 2025 were a little over 30,000 with 88% answered within 30 seconds. He credited portal self‑service, IVR automation, and growing maturity of call‑center staff for lower live-call demand and faster handling. He also described quality-assurance audits: random audits of 1.5–2% of case decisions showed 93.7% pass in 2024 and 94.64% pass in 2025.
Board members and staff discussed how bonding cases are counted for reporting (bonding segments of pregnancy cases are included to align with other states' counting) and the implications of rising weekly payment amounts, which staff tied to increased claim volumes, slight approval-rate increases and minimum-wage-driven higher benefit rates.
Staff said they will continue to refine reporting and pursue a more detailed study of claims experience to inform projections.
