AI agent for benefits administrators
Leave Benefits Premium Tracking Agent
Premiums for employees on leave are paid on time and coverage does not lapse.
What it does
Employees on unpaid leave still owe premiums, and coverage can lapse when no one collects them. The agent tracks leave dates, calculates the premiums owed for each period, sends payment instructions, and checks that payments arrive. If a payment is missed, it escalates before the grace period ends and prepares the notice. It also rechecks the amounts when the leave dates change, since a longer leave means a larger bill. Every message to an employee is clear about what is owed, by when and how to pay. It never cancels coverage. The administrator approves each notice. Edge case: a leave extended by two weeks, so the premium for the extra weeks must be added.
How it works
Follow the arrows from top to bottom. The orange dashed arrow is the loop: when a check fails, the agent goes back and tries again.
Read the steps as a list
- Unpaid leave starts
- Read leave dates and plan rates
- Calculate the premium owed by period
- Draft payment instructions
- Administrator approves the instructionsThe agent waits here for your OK.
- Read payment records on the due date
- Has the full amount been received?If not: Send a reminder and flag the grace period. Back to step 6.
- Recalculate if leave dates changed
- Do the amounts match the current leave dates?If not: Correct the amount and notify the employee. Back to step 3.
- Administrator approves any notice of lapseThe agent waits here for your OK.
- Premium tracker
How it decides
It calculates the employee share for each leave period and escalates when the grace period is within a set number of days.
- Escalate 5 days before the grace period ends
- Recalculate when leave dates change
- Check employer share rules by plan
- Send a reminder 3 days before the due date
Make it yours
Every agent is a starting point. You choose these settings for your own situation.
- Grace period days
- Reminder timing
- Employer share rules
- Payment methods
What keeps you in control
It always asks you first
- Administrator approves instructions and every notice of lapse
Hard limits
- Never cancel coverage itself
- Do not send notices without approval
It stops when
- Done: premiums paid through the leave period
- Stop: the employee cannot pay and the administrator decides on options
Set it up
We guide you through the set-up, step by step
Members get the full set-up guide for this agent. No technical skills needed: you copy, paste and upload.
- One set of instructions to paste into your AI, with the clicks for ChatGPT, Claude, Microsoft 365 Copilot, Gemini and Grok
- The agent then walks you through connecting your own data, one source at a time
- A downloadable copy with the flow chart, the rules and the full guide
