AI in Employee Benefits Brokerages - Part 2

In our previous blog, we discussed the problem of manual data entry in employee benefits brokerages, and how AI models could help alleviate that problem. AI’s application spans well beyond manual data entry. In the realm of employee benefits brokerage, communication with clients and carriers predominantly occurs via email. This practice gives rise to several noteworthy implications, all of which AI can solve.

The Communication Challenge

To begin, the reliance on email correspondence often necessitates extensive searches through email archives. This difficulty is compounded by the limited search functionality inherent to email platforms. Locating specific files or tracking the origins of messages can prove cumbersome.

Secondly, critical documents frequently find their way into individual inboxes, which can pose challenges when team members are unavailable due to vacations or other commitments.

Thirdly, there exists a need for managerial oversight to ensure that issues receive timely and accurate responses. Account managers, who are typically engaged in demanding renewal processes, may struggle to address day-to-day concerns promptly, but managers historically have had little visibility into what their team members are doing throughout the day unless they get delegated access to their inboxes. This is tedious and unscalable. 

Furthermore, the recurring nature of issues communicated via email results in the redundancy of answering the same questions from scratch on multiple occasions.

PlanYear proactively alleviates these challenges with our automated issue-tracking system. This system automatically logs incoming emails, allowing individual account managers to monitor their status, age, and assignments. Managers gain visibility into their teams' workload and response times. This collaborative platform significantly enhances efficiency compared to relying solely on email communication.

However, a persistent query emerged: Is there a means to catalog frequently asked questions and establish templates for addressing common inquiries?

AI Benefits Assistant

At PlanYear, we recognized the potential of large-language AI models when appropriately trained and prompted to provide automated responses to such inquiries.

This does not imply the wholesale replacement of human interaction with chatbots. Instead, it envisions a scenario where, upon receiving an issue, benefits consultants can invoke an intelligent assistant to draft a response. The consultant can subsequently review and send the reply.

Our testing indicates that over 50% of questions can be answered directly by the AI model, while in another 35%, the AI model can provide a response that is approximately 90% accurate. In the remaining 15%, human intervention may still be necessary. These statistics are poised for substantial improvement over the next 12 to 18 months, as computational capabilities strengthen, and models accrue larger datasets for learning.

Consider an example where a client inquires about coverage details for durable medical equipment, including copays and co-insurance. An AI assistant can swiftly analyze the coverage certificate, ascertain what is covered, delve into the Summary of Benefits and Coverage (SBC) to identify deductibles and co-insurance rates, and compile a coherent response.

While humans can perform this task, it consumes time, limits the number of accounts they can service, and often results in delayed responses that detract from the client experience. In contrast, an AI-powered system categorizes and queues incoming issues, extracts information from relevant documents, and drafts precise answers. The benefits consultant merely reviews and approves the response, enabling them to manage more issues with greater accuracy and promptness.

Ultimately, this operational enhancement contributes to client retention by affording consultants the time to focus on strategic initiatives and other endeavors currently overshadowed by day-to-day tasks. It elevates the client experience and augments retention over the long term, benefiting account managers, clients, and brokerage leadership alike.

Automation has long been in existence, but AI infuses it with contextual intelligence, enabling the full potential of automation to be harnessed. In our forthcoming blog, we will explore the third major benefit AI offers to brokers, which lies in the realm of support.

Want to elevate your employee benefits experience? Schedule a demo of the PlanYear full-lifecycle benefits solution, powered by AI.