For HR Teams
From plan setup to enrollment completion — everything automated, nothing manual. Ben does the talking with employees; you keep the control panel.
Open enrollment
Acme Corp · 2026
Ben·answered 214 employee questions today. 3 need HR.Sample data
AI Plan Setup
Upload a Summary of Benefits and Coverage as a PDF. Ben reads every field — deductibles, out-of-pocket maximums, copays, coinsurance, Rx tiers, and rate tables — then structures them into plan data with a confidence score for each extraction.
No data entry. No spreadsheet mapping. Review the extracted values, adjust any low-confidence fields, and publish.
Summary of Benefits and Coverage
Extracted plan data
Gold PPO 500
Enrollment Management
Configure your enrollment period once — dates, eligibility rules, contribution strategies, waiting periods — and the platform handles everything. Real-time tracking shows exactly where every employee stands.
Enrollment timeline
Acme Corp · 2026 plan year
Oct 20
Plans published
Nov 1
Window opens
Nov 8
Ben nudges non-starters
Nov 15
Window closes
Nov 18
834s to carriers
Jan 1
Coverage effective
Open enrollment progress
Acme Corp — 2026 benefits enrollment
0%
132 of 156 enrolled
Automatically determines who is eligible based on employment status, hire date, hours worked, and waiting periods. Handles new hires, rehires, and status changes.
Define employer contributions by plan, tier, salary band, or department. Supports flat dollar, percentage, defined contribution, and composite rating models.
Employees who don't make active elections are automatically renewed into their current plans. Changed rates and new plan mappings are handled without HR intervention.
AI-Powered Employee Guidance
No extra cost. No scheduling. No hold queues. Every employee in your organization gets Ben — an AI benefits coach that guides them through enrollment with recommendations based on their actual health profile.
The result: higher completion, fewer HR tickets, and employees who are confident they picked the right plan.
Recommends plans from each employee's real data — age, family, medications, planned procedures, prior-year claims. Personalized math, not generic advice.
Employees talk through options in plain language. Ben listens, navigates the screen, selects plans, and completes elections while they watch.
Every plan choice shown per paycheck, not per year — with the employee's actual pay frequency, tax bracket, and pre-tax elections.
Ben explains WHY it recommends each plan in plain English. Employees understand the trade-offs and feel sure of their choice.
Ben
Voice · listening
We’re planning a baby next year. Does that change things?
It does. With a delivery, Gold PPO’s $1,000 family deductible beats the HSA plan by about $1,140 over the year — even after the higher premium. That’s $47.50 less per paycheck than the alternative.
Before & after
Illustrative targets for a 340-employee group
Enrollment completion rate
64%
94%
Avg. time to complete
35 min
8 min
HR support tickets during OE
340
45
Employees confident in choice
38%
89%
HR Test Mode
What if you could rehearse open enrollment as many times as you want — and shape the experience for your employees — before going live?
No engineering tickets. No prompt files. No consultants. Just you, Ben, and a stage.
The journey · three stages
01
HR sees what employees see
Every screen. Every Ben prompt. Every decision point. You experience the enrollment end-to-end, exactly as your employees will.
02
Feedback chat in real time
“Slow down.” “Use ‘health plan’ instead of ‘medical.’” “Skip the surgery question.” Ben categorizes your feedback and applies it on the spot.
Slow down a bit.
Applied
Got it. Pacing adjusted.
Use “health plan”
Applied
Updated throughout.
03
Approve and go live
When it sounds like you, click Approve & Launch. Your tuned experience goes live for every employee — not a single line of code changed.
Acme · 2026 experience
LiveApplied to 156 employees · no code changed
Per-employer customization
Every company is different. Ben should be too.
HR can train Ben to match your culture — the language you use, the pace your employees prefer, the topics that matter, the questions to skip. Same code, different behavior. Ben sounds like a coworker who already understands your company.
Formal or casual. Plain English or industry shorthand. “Health plan” or “medical insurance”. Ben matches your workplace voice.
Quick and decisive for engineers, thorough and educational for new grads. Ben adjusts how much he explains and how fast he moves.
Skip questions that don’t fit your culture. Highlight benefits employees actually use. Avoid jargon that confuses your population.
Context-aware greetings
Ben knows whether it’s open enrollment, new-hire eligibility, or a qualifying life event — and greets each employee accordingly. No generic intros.
“Congratulations Sarah — you qualify for benefits at Acme as of April 1, 2026. Let’s walk through your options.”
“It’s open enrollment time at Acme. I’ll show you what’s changed and help you decide if your current plan is still the right fit.”
“I see you’ve had a qualifying life event. You have 30 days to update your coverage. Let’s figure out what changes make sense.”
Billing & Reconciliation
Monthly premium billing is generated automatically with pro-rating for mid-month changes. When carrier invoices arrive, Ben compares every line item to your enrollment data and flags discrepancies — missing employees, rate mismatches, retroactive adjustments.
Enrollment data
Elections finalized
Premium calc
Pro-rated billing
Carrier invoice
Received monthly
Ben reconciles
Flagged variances
Payroll file
ADP / Paychex / Gusto
Reconciliation · November
BlueCross invoice vs. enrollment
| Member | Plan · tier | Your data | Carrier invoice | Status |
|---|---|---|---|---|
| J. Martinez | Gold PPO · EE+SP | $1,184.00 | $1,184.00 | Matched |
| K. Chen | Silver HSA · EE | $512.00 | $512.00 | Matched |
| R. Okafor | Gold PPO · EE+CH | $0.00 | $986.00 | Termed 10/31 · still billed |
| L. Park | Bronze HSA · EE | $438.00 | $462.00 | Rate mismatch · 2025 rate |
2 discrepancies found. Corrective 834 drafted for R. Okafor; rate dispute queued for BlueCross.
The reconciliation engine compares your enrollment records to carrier invoices line by line. It identifies rate variances, missing members, duplicate charges, and retroactive adjustments — then generates a resolution report.
Mid-month enrollments, terminations, and plan changes are pro-rated automatically. The platform tracks effective dates down to the day and calculates partial-month premiums based on carrier billing rules.
Track outstanding balances by carrier, payment due dates, and payment history. The platform generates remittance reports and flags overdue payments before they trigger coverage lapses.
Generate payroll deduction files in the format your payroll provider expects — ADP, Paychex, Paylocity, Gusto, and generic CSV. Pre-tax (Section 125), post-tax, HSA and imputed-income deductions are categorized automatically.
EDI 834 & Carrier Connectivity
Upload a carrier's EDI requirements and Ben configures the connection — field mapping, loop structure, segment qualifiers, and transmission protocol. No EDI expertise required.
834 files are generated in your carrier's format; SFTP/AS2 delivery is configured per carrier at onboarding, on your schedule. When carriers send back 999 acknowledgments, the platform processes accepted and rejected transactions and surfaces issues that need attention.
Compliance Automation
Benefits compliance is complex — ACA reporting, COBRA administration, ERISA filings, nondiscrimination testing, and 50-state mandates. The platform tracks every obligation and generates the filings so your team never misses a deadline.
Compliance calendar
2026 key deadlines — auto-tracked
JAN
31
ACA W-2 reporting deadline
ACAFEB
28
1095-C distribution to employees
ACAMAR
31
1094-C / 1095-C electronic filing
ACAAPR
15
Section 125 plan year begins (common)
ERISAJUL
31
Form 5500 filing deadline
ERISASEP
30
PCORI fee payment due
ACAOCT
15
Medicare Part D creditable coverage notice
CMSNOV
01
Open enrollment period begins (typical)
OEProactive monitors
9 checks run on schedule
J. Martinez approaching 30 hrs/wk
2 hrs ago
Emma Johnson turns 26 in 6 months
Today
COBRA election deadline in 3 days
Urgent
Section 125 NDT — passed
Yesterday
SPD distributed to 156 / 156
Oct 12
Reporting & Analytics
Every report HR teams run regularly is built in — enrollment summaries, premium billing, ACA 1095-C preview, census data, claims summaries, and more. Export to CSV or schedule automated delivery.
Need something custom? Ask in plain English — “Show me enrollment by department for employees hired in the last 12 months who selected the Gold PPO” — and Ben generates the query, runs it, and formats the results.
Enrollment summary
Active enrollment counts and premiums by plan, tier, and line of coverage
Employee census
Full roster with demographics, department, salary, and eligibility
Payroll deductions
Per-employee benefit deduction amounts for payroll
Plan participation
Participation rates by plan — elected vs. eligible
Premium billing
Monthly premium totals by plan with employer/employee split
COBRA report
Qualifying events, election status, and payment tracking
ACA 1095-C preview
1095-C form data by employee and month
Dependent audit
Covered dependents with relationship, age, and verification status
Claims summary
Aggregate claims data by plan and service category
Confirmation statements
E-signature records for every enrollment signature
Year-over-year comparison
Enrollment and premium data across plan years
Ask Ben for a report
Plain English in, formatted report out
“Show me employees in Engineering who selected HSA plans and their average contribution rate”
Generated report
4 rows · 0.8s| Employee | Plan | Tier | Contribution |
|---|---|---|---|
| J. Martinez | Bronze HSA 3000 | EE+SP | $3,850 |
| K. Chen | Bronze HSA 3000 | EE | $4,150 |
| R. Okafor | Silver HSA 2000 | EE+CH | $2,900 |
| L. Park | Bronze HSA 3000 | EE | $4,150 |
Avg. contribution: $3,762/year across 4 Engineering HSA enrollees
Security & Privacy
Benefits data includes protected health information, Social Security numbers, and compensation details. Ben AI is built with HIPAA-compliant architecture from the ground up — not bolted on after the fact.
PHI is encrypted at rest (AES-256-GCM) and in transit (TLS 1.3). Minimum-necessary access enforced across every API endpoint. BAAs being signed with covered subprocessors.
Field-level encryption for Social Security numbers and sensitive identifiers. All PHI access is logged to an immutable audit trail.
Fine-grained permissions by role — super admin, TPA admin, broker, employer admin, HR manager, and employee. Each role sees only what it needs.
Every PHI access, election change, and admin action is logged with user, timestamp, and IP. Immutable trail with 7-year retention for HIPAA and ERISA.
New in 2026
Compliance
9 compliance checks run on schedule and flag issues before they become violations. ACA hour thresholds, dependent aging, COBRA deadlines, nondiscrimination risk — with one-click ACA offer-letter drafting from any alert.
J. Martinez approaching 30 hrs/wk
2 hrs agoEmma Johnson turns 26 in 6 months
TodayCOBRA election deadline in 3 days
UrgentBilling
Detects discrepancies between your enrollment and carrier invoices — then generates corrective 834 files automatically.
Your data
$56,812
247 members
Carrier invoice
$57,340
249 members
Analytics
Compare your enrollment patterns against industry benchmarks. Actionable insights, not just data.
Industry benchmark (KFF/SHRM 2025)
Reach
SMS enrollment for deskless workers. Phone for those who prefer a call. Voice AI in the browser. Text chat. Spouse portal.
Typical channel mix across enrolled employees
See how Ben AI replaces manual enrollment workflows with AI-powered automation. Book a demo with your actual plan data.