Personalized benefits with ICHRA & AI compliance
We helped a health-benefits platform let employers set budgets while employees pick plans they love—cutting admin time by 52%.
- Nationwide plan marketplace
- Card + reimburse flow
- AI receipt OCR & eligibility
- HIPAA-aware data paths
Healthcare Budget
$750.00
“Yes, humidifiers are eligible with a diagnosis. Upload the receipt and I’ll file it.”
Challenges
- Group-plan rigidity created poor regional fit and rising total cost.
- Reimbursements were slow; many receipts bounced for missing fields.
- Member support overloaded with coverage questions.
Our solution
We deployed agentic workflows across enrollment, claims validation, and reimbursements. The agent checks IRS-qualified expenses, requests missing fields, and auto-approves low-risk claims.
Agentic playbooks
Enrollment guidance
Doctor/Rx matching and transparent OOP projections.
Receipt automation
OCR extracts date, provider, diagnosis notes; eligibility rules applied.
- PHI minimization
- Duplicate detection
- Auto-approval thresholds
Finance exports
Payout files and GL mappings for payroll/accounting.
−52%
Admin time reduction
4.8/5
Member CSAT
72%
Receipt auto-approval
−61%
Average reimbursement time
“Our team finally stopped babysitting receipts. The agent handles 24/7 eligibility and members get answers instantly.”
Frequently asked questions
Deliver benefits your team actually loves
More choice for employees, more control for finance & HR.