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AI agent for benefits administrators

Open Enrollment Readiness Agent

A benefits system ready for enrollment with tested rates and eligibility

Quality controlHuman resources
See how it worksGet access
Open Enrollment Readiness Agent: what goes in, what the agent does and what you get

What it does

Before open enrollment, plan options, rates, contributions and eligibility rules must be set up correctly in the benefits system, or thousands of employees see wrong prices. Six weeks out, this agent pulls carrier rates and plan details and compares them with the system setup; rates must match carrier sheets exactly. It runs test scenarios that cover each tier and region. If any test does not match the expected cost and eligibility, it lists setup fixes for the vendor or administrator and re-tests. It also checks each employee's eligibility data for gaps. It drafts employee communications from the confirmed setup. The administrator approves the launch. Edge case: employees on a pending leave of absence are checked against the plan's eligibility rules separately.

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.

Start and resultWhat it doesA check on its own workWaits for your OKGoes back and retries
Yes, continueApprovedNo 1 STARTS WHEN Six weeks before enrollment 2 USES A TOOL Pull carrier rates and plan details 3 USES A TOOL Compare with system setup 4 DOES Run employee test scenarios 5 CHECKS THE RESULT Do all tests match expected costs and eligibility? If not: list setup fixes for the vendor or admin andre-test. Back to step 3. 6 USES A TOOL Draft employee communications 7 YOU APPROVE Administrator approves launch 8 RESULT Enrollment opened
Read the steps as a list
  1. Six weeks before enrollment
  2. Pull carrier rates and plan details
  3. Compare with system setup
  4. Run employee test scenarios
  5. Do all tests match expected costs and eligibility?If not: list setup fixes for the vendor or admin and re-test. Back to step 3.
  6. Draft employee communications
  7. Administrator approves launchThe agent waits here for your OK.
  8. Enrollment opened

How it decides

Each plan and rate must match carrier documents, and test cases must produce the expected cost.

  • Rates must match carrier sheets
  • Test cases cover each tier and region
  • Leave cases are checked separately

Make it yours

Every agent is a starting point. You choose these settings for your own situation.

  • Test scenarios
  • Weeks before launch
  • Communication format
  • Approval steps

What keeps you in control

It always asks you first

  • Administrator approves launch and communications

Hard limits

  • Never changes system settings
  • Never sends communications

It stops when

  • Done: launch approved
  • Stop: carrier rates not final

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.

10 minto set it up in your AI
5 AIsChatGPT, Claude, Copilot, Gemini, Grok
  • 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
Get access to this agent

An example run

What happensTesting 40 scenarios on Oct 1, the agent found the dental family rate showing $112.40 instead of $121.40, so the check failed. The vendor fixed the table and the re-test passed on Oct 3. Eleven employees were missing birth dates needed for life insurance pricing, and HR collected them. The benefits administrator approved the launch for Nov 1.

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