Your long-term care insurance policy was supposed to be straightforward: you need care, you file a claim, you get paid. But when your insurer routes your claim through a company called The Helper Bees, the process suddenly involves a third party you never negotiated with, an assessment conducted over a video call, and a care network you didn't choose.
That's not an accident. It's a business arrangement—and it's worth understanding before it affects your benefits.
The Helper Bees operates as a third-party administrator (TPA) hired by LTC insurers to manage assessments, coordinate care providers, and process claims data. What they promise insurers is efficiency and cost control. What policyholders sometimes experience is a process that feels more focused on limiting benefits than delivering them.
If The Helper Bees is involved in your LTC claim, Sandstone Law Group can help you understand what that means and what you can do about it. Schedule a free case evaluation online or call (602) 615-0050.
Which Insurers Use the Helper Bees?
The Helper Bees has built partnerships with several major long-term care carriers. Their LTC program describes coverage as nationwide — their network has 25,000 vetted providers offering services across the country. If you hold a policy with any of the following, you may encounter The Helper Bees during the claims process:
- John Hancock – The Helper Bees Provider Network is available to John Hancock LTC policyholders and certain life insurance policyholders with LTC or Chronic Illness riders, for finding and accessing in-home care providers. These companies have a strong partnership and therefore if you have a John Hancock LTC policy, the Helper Bees may be involved with your claim.
- CNA – CNA was among the first Fortune 500 insurers to use The Helper Bees' Care Concierge platform for in-home care coordination. In 2020, CNA launched "The View From Home" through a formal partnership with The Helper Bees, offering Care Concierge to eligible LTC policyholders
- Continental General Insurance Company – Continental General has a formal partnership with The Helper Bees' Care Concierge Program to connect policyholders with in-home services.
- Mutual of Omaha – Mutual of Omaha built its "Better Living Longer" program in partnership with The Helper Bees, giving LTC policyholders access to a care advisor, an in-home services marketplace, and educational resources through their online customer portal.
Other carriers may use The Helper Bees or similar TPA platforms without clearly disclosing that arrangement to policyholders. If you receive correspondence from a company you don't recognize, or if your assessment is conducted by someone who isn't employed directly by your insurer, you may be dealing with a TPA. Our post on what third-party administrators do in long-term care insurance explains the broader landscape and your rights when a TPA is involved.
Key Takeaways on How The Helper Bees Impact Your LTC Claim
- They work for your insurer, not you. The Helper Bees is hired and paid by the insurance carrier. Their systems, data, and incentives align with the insurer's goal of managing costs—not yours.
- The assessment shapes everything. The evaluation they conduct—often done remotely by video—becomes a central piece of evidence in your claim file. What gets documented, and what doesn't, matters enormously.
- Their care network creates pressure. When a claim is approved, The Helper Bees may steer you toward their in-network providers. Using your own caregiver can create friction—and additional scrutiny.
- "Good day" data can be used against you. Their technology logs caregiver visits and activity data in real time. Insurers can—and do—use isolated positive data points to argue that your condition has improved and benefits should stop.
- You have the right to challenge their findings. A TPA's assessment is not final. State law provides protections that apply regardless of who conducted the evaluation, and you have the right to challenge it.
- Legal Protections are a Powerful Tool. Your legal rights don't disappear because a TPA is involved. Sandstone Law Group can help you force the insurer to honor their contract under state laws such as the Arizona long-term care claim law or the California LTC insurance regulations.
What is The Helper Bees and Why is it Involved in My Claim?
The Helper Bees launched as an aging-in-place technology platform—an Austin-based company that built software for care coordination, digital invoicing, and caregiver matching. For insurers, the pitch is appealing: outsource the assessment and care management process to a tech-enabled vendor, reduce administrative overhead, and get real-time data on every claimant.
For policyholders, that model introduces complexity. Instead of working directly with the company that issued your policy, you're now dealing with a vendor whose business model is built around serving the insurer's interests.
They offer a platform that includes everything from initial assessments to connecting policyholders with caregivers and processing payments through digital invoicing for LTC claims.
The Helper Bees describes its platform as improving outcomes for policyholders. In practice, policyholders often encounter a different reality—an assessment they didn't fully understand, care options they didn't choose, and a data trail that can be used to limit benefits.
The Functional Assessment Process: What to Expect & Why It Matters
When you file a claim, your insurer may require a benefit eligibility assessment—an evaluation of your ability to perform Activities of Daily Living (ADLs) like bathing, dressing, eating, toileting, transferring, and continence. The Helper Bees frequently conducts these evaluations, often by video call with a nurse assessor.
The convenience of a telehealth format comes with real limitations. A nurse reviewing your condition on a screen cannot observe how your home is actually set up, how much effort a task takes you, or what you look like after a difficult morning. If you happen to be having a good day—or if you minimize your struggles the way many people do when talking to a medical professional—the resulting report may not capture your actual functional limitations.
That report goes directly to your insurer. It heavily influences whether benefits are approved, reduced, or denied. And it becomes part of your permanent claim file, which means any inconsistencies or gaps can be cited later.
Helper Bees assessments conducted by LPNs (often remotely) have been used to justify claim denials even when the policyholder's actual functional limitations were significant. If the assessment doesn't reflect your true condition, you have the right to challenge it.
When Technology and "Efficiency" Lead to Denials
The promise of technology is a smoother, faster claims process. But when it comes to long-term care, that is not always how it plays out. The data-driven approach used by companies like The Helper Bees can create new reasons for insurers to deny claims.
For example, if an assessor's digital nurse assessment report is not detailed enough or misrepresents your condition, the insurer can claim there is insufficient evidence to approve your claim.
If caregiver notes logged through their system show a "good day," the insurer might use that single data point to argue that your condition has improved and you no longer meet the LTC benefit eligibility process requirements.
This focus on data points can ignore the reality of living with a chronic condition, where abilities can fluctuate day by day.
Insurers will seize any inconsistency or ambiguity in the records to protect their bottom line. We've seen it repeatedly. The very technology meant to improve aging in place outcomes can become a tool used to terminate the benefits that make it possible.
If your claim is denied after an assessment by The Helper Bees, you have the right to challenge that decision. A long-term care claim appeal is your opportunity to correct the record, provide more comprehensive evidence, and fight for the coverage you are entitled to under your policy.
What Lawyers See That Policyholders Often Miss
The most common misconception about The Helper Bees' involvement is that their findings are authoritative. They're not. An assessment conducted by a TPA is evidence—not a verdict.
At Sandstone Law Group, we approach Helper Bees-related denials by looking at several specific issues:
What the assessment actually documented versus what your medical records show. The first thing we look at is the gap between what the assessor documented and what your medical records actually show. If your treating physician's notes tell a different story than the TPA's report, that gap is worth arguing.
Whether the insurer used network pressure to override your policy terms. If your policy covers home care from a licensed provider of your choosing and the insurer effectively forced you into their network, that may be a breach of contract.
Whether state law protections were violated. Arizona law requires insurers—and their agents—to act in good faith and follow policy terms. California's insurance regulations provide additional consumer protections for LTC policyholders. If The Helper Bees' involvement contributed to a bad faith denial, those laws give you legal recourse.
Policyholders dealing with Everlake (formerly Allstate) should note that LifeCare Assurance Company has also been used as a TPA for those policies, creating the same kind of accountability gaps—unclear who is handling your claim and who is ultimately responsible for a denial.
The Helper Bees and Your LTC Claim FAQs
What can I do if I disagree with The Helper Bees' assessment?
Document your concerns in writing immediately. Don't assume the process is over. Contact your treating physician and ask them to provide a detailed written statement about your functional limitations—one that specifically addresses the ADL criteria your policy uses. Then consult with an LTC denial attorney before submitting anything to the insurer.
Do I have to use a caregiver from The Helper Bees' network?
Not necessarily. Your policy language controls what providers qualify for coverage—not The Helper Bees' network list. If the insurer is pressuring you to use in-network providers only, that may conflict with your contractual rights. This is worth reviewing with legal counsel.
Does The Helper Bees change my legal rights?
No. Your rights come from your policy and state law, not from the administrative structure the insurer chose. The insurer remains responsible for The Helper Bees' role in your claim. If the TPA's involvement contributed to an improper denial, the insurer can be held accountable.
Can a "good day" during the assessment hurt my claim?
Yes. Remote assessments capture a single moment in time. Chronic conditions fluctuate—what you can do on a given Tuesday afternoon may not reflect what your day-to-day reality looks like. If your assessment was conducted on a better day, your attorney can help you build a more complete picture of your functional limitations through treating physician statements and ongoing care records.
What if The Helper Bees' technology misrepresents my condition?
Digital assessments and caregiver logs can sometimes fail to capture the full picture of your needs. If this data is being used to deny or limit your benefits, a lawyer can help you challenge its accuracy and present more comprehensive evidence.
Can I appeal a denial based on The Helper Bees' findings?
Yes. An appeal gives you the opportunity to present stronger evidence, correct inaccuracies in the assessment, and challenge the insurer's reasoning. Many LTC denials can be overturned with the right documentation and legal advocacy.
You Have Rights. We Can Help Protect Them. Contact Sandstone Law Group For A Free Case Evaluation
When The Helper Bees is involved in your LTC claim and your benefits are being delayed, reduced, or denied, the path forward is rarely as simple as re-submitting paperwork. You're dealing with a system designed to serve the insurer's interests—and you need someone in your corner who understands how that system works.
Sandstone Law Group handles long-term care insurance denials nationwide. Whether your policy is with John Hancock, CNA, Everlake, or another carrier using a third-party administrator, we know how to challenge the findings, expose bad faith tactics, and hold the insurer accountable to what they agreed to pay. Call (602) 615-0050 or schedule a free case evaluation online.