Gen Re recently completed its latest U.S. Group Medical Evidence of Insurability (EOI) Underwriting Survey. The full report, only for participating companies, focused on the staff provided by companies to process applications as well as how they process them. Twenty-one companies participated and all companies reported that they track EOI data for their Group Term Life, Short Term Disability and Long Term Disability products.

For analysis, participating companies were grouped into three segments based on the number of EOI applications received in 2024, namely:

• Low volume (<25,000 applications) – 6 companies reported
• Medium volume (25,000 – 100,000 applications) – 6 companies reported
• High volume (>100,000 applications) – 9 companies reported

Over 2.7 million EOI applications were received by participating companies in 2024. This averages to 136,771 applications for all companies reporting this data.

Here are some takeaways from the latest Gen Re survey:

On average, companies reported that 36% of EOI applications were submitted via web-based interface in 2024. An additional 36% of EOI applications were submitted via web-based interface that included reflexive questions.

Methods Offered for Submitting EOI Applications

Companies reported an average of 57% of the EOI applications were submitted using a long form in 2024. Companies in the low volume segment received 25% of their EOI applications via a short form, compared to the high-volume segment which had 62% of EOI applications submitted using a short form.

Percentage of EOI Applications Submitted by Type of Form

Top Challenges Facing Group Medical Underwriting Departments

Managing volume during peak times continues to be the greatest challenge facing group medical underwriting departments. Other reported top challenges include inefficient underwriting systems, technology deficiencies, and updating or developing applications for improved underwriting risk selection and to meet marketing needs.

Challenges for Group Medical Underwriting Departments

Use of Automated Systems for Approving Coverage

Over three quarters (81%) of participating companies have an EOI system that can automatically approve coverage without a medical underwriter’s review – this is also known as straight-through processing (STP). Of the four companies that don’t have STP, three are planning to develop the capability within 12 months.

Of the 16 companies with an automated underwriting system, 10 developed it in-house and six purchased it from an outside vendor, with four then modifying it internally.

For companies that provided both the number of EOI applications received in 2024 and the number processed through their automated system, on average, 69%  were processed through their STP system. Low and medium volume companies processed over half (61% and 55%, respectively) of their EOI applications through their STP system, while high volume companies processed 82% through STP.

For more insights on EOI application processes and automation, please see the full summary report.