How will AI move the benefits needle?

I recently wrote a column about Chat GPT and artificial intelligence. So, why am I writing more about it this month? The previous article talked in generalities about the pluses and minuses of artificial intelligence, but it did not go into all the specifics of how using AI to help market and manage employee benefits will “move the needle” – how it will create value for us and our customers. This month, we will consider some use cases that show how this tool can add value.

To start with an immediate example, how many times has something been missed in plan design when a group product is being moved to a new insurance company? Artificial intelligence is great at reviewing documents, and comparing them. A prior carrier’s benefit description and contract can easily be analyzed and compared with the proposed new product. This will help make sure the transition is accurately handled. Many employers (and their brokers and advisers) have experienced painful issues when the new product does not match the employer’s expectations. AI can help avoid this pain.

Natural language processing AI can provide major improvements in new business turnaround times. Front-end processes such as obtaining and delivering product proposals can be streamlined. AI, when properly trained, can be the perfect detail clerk. It can instantly analyze the information being submitted to an insurance company by the broker, and, on the insurance company side, can immediately analyze whether the submission is complete. Delays in proposal turnaround usually come from missing or incomplete information; AI eliminates the problem. 

There is a similar need for complete information to set up benefit administration for case implementation on sold new business, and again, AI can provide appropriate triage to identify incomplete or missing items.

Time delays are also an issue for employees when they are required to complete and submit forms such as insurability forms and claims forms. AI can help ensure that forms are complete when submitted. This sounds like a little thing, but an incomplete form results in unnecessary “form tag” between the individual and the insurance company. On the insurance company side, AI systems can be trained to evaluate these forms and auto process them without delay. So, employees and their employer know immediately whether an evidence of insurability form is approved or denied (which also eliminates many frustrating gaps between the employer’s deductions and the insurance company’s bill). Claimants know immediately whether their claim is approved, and when to expect payment, if approved. In either case, there may be a need for additional information, such as hospital or physician records, and the customer will know about this without delay.

Brokers will find many uses for AI that improve their sales and marketing efficiency. For example, it can help advisors identify prospects and can also help employers and their advisors identify gaps in benefit programs. AI can be trained to study employee demographics and determine unmet employee benefit needs. Meanwhile, medical claims analysis by AI can point out beneficial plan design tweaks with goals of improved plan performance for employees and savings for employers.

In the enrollment process, AI recommendation engines can assist employees in making better enrollment decisions. AI can also help improve understanding and use of employee benefits by utilization reminders. Family understanding can also be improved via AI helping employees bring benefits home to their participating dependents. There have been many news reports recently that schoolchildren need mental health services; it is very likely that a good share of these students are eligible for mental health services through a parent’s access to an employee assistance program (EAP). In the future, AI will remind employees about these overlooked benefits.

In a recent webinar, an AI expert, speaking of the use of AI in the insurance business, said: “If you’re not in it; you’re missing out.” It does not take AI analysis to understand the point!

Marty Traynor is an Omaha based consultant in the benefits field.  He may be reached at currentbenefits@gmail.com