BenAIX delivers everything a traditional benefits administration BPO does for healthcare TPAs — enrollment, EDI data management, member support, compliance — executed by orchestrated AI agents and supervised by licensed benefits experts.
Traditional benefits administration firms scale by hiring more analysts. BenAIX scales by deploying more agents — with experts reviewing the work, not doing it.
Each service line maps to a dedicated AI agent team, orchestrated centrally and supervised by benefits domain experts.
Open enrollment, new hire onboarding, qualifying life events, eligibility management, and COBRA administration — processed automatically with exception routing to humans.
Enrollment AgentEDI 834 enrollment feeds, carrier file translation, census reconciliation, and error resolution. Every file validated on arrival; discrepancies flagged and fixed before carriers reject them.
Data & EDI AgentMedical, life, dental, and vision plan information unified in one place. Real-time census, plan documents, and rates — one source of truth for brokers and groups.
Plan Data AgentFrom 50-life groups to 10,000+, self-funded clients get accurate claims data, stop-loss reporting, and funding analytics at their fingertips — refreshed continuously, not monthly.
Analytics Agent24/7 conversational support across chat, email, and voice. Resolves ID card requests, coverage questions, and status checks instantly; escalates complex cases with full context.
Support AgentACA 1094/1095 reporting, HIPAA safeguards, ERISA notices, and nondiscrimination testing — monitored continuously across every transaction, not sampled quarterly.
Compliance AgentWork enters from any channel, is routed by the orchestrator to the right specialist agent, executed against your systems, and verified — with humans approving anything sensitive.
Human-in-the-loop by design. Licensed benefits experts review every agent decision above a confidence threshold, approve all irreversible actions (terminations, carrier submissions, PHI disclosures), and continuously train the agents on edge cases. AI does the work; people own the judgment.
We integrate with your ben-admin platform, carrier feeds, and payroll systems — read-only at first.
Agents run in parallel with your current team, and we measure accuracy against every human decision.
Agents take over routine work category by category, with human approval gates on every sensitive action.
Add groups, carriers, and service lines without adding headcount. Your experts move up the value chain.
End-to-end encryption, minimum-necessary access, and BAAs with every client and subprocessor.
Every agent action — every read, write, and decision — is logged immutably and exportable for audits.
Named experts own every account. Sensitive actions require explicit human approval, always.
Independently audited security, availability, and confidentiality controls, renewed annually.
Bring us one group, one carrier feed, or one week of support tickets. We'll show you — side by side — what an AI-native back office looks like.
Book a Demohello@benovia.ai · 30-minute walkthrough · No commitment
