Plan design extraction
Deductibles, copays, coinsurance, out-of-pocket max, and network — all extracted from the carrier document and mapped to the platform's plan-design schema.
The Operations Engine assembles a documentation-complete platform build — every plan design, contribution rule, eligibility class, and carrier feed — checked against the original carrier documents and a canonical schema before a senior specialist releases it.
A benefits agency's platform build is only as strong as the configuration behind it. Miss a contribution tier, mis-map an eligibility class, or skip a carrier-feed test — and the error propagates into payroll deductions, carrier bills, and denied claims, surfacing weeks later as furious employer calls and E&O exposure.
Most agencies run this by hand, from memory, during open-enrollment crunch. The carrier documents have not been read end-to-end since the renewal arrived. That is exactly where completeness gaps hide.
The Operations Engine exists to close that gap with a single, exhaustive standard applied identically to every file.
We do not summarize the renewal and hope. Every build is scored against a versioned rule pack tied to the exact text of the carrier's SBC, rate exhibit, and contribution schedule. These are the elements each build is held to.
Deductibles, copays, coinsurance, out-of-pocket max, and network — all extracted from the carrier document and mapped to the platform's plan-design schema.
Employee-only, employee+spouse, family tiers; employer contribution amounts or percentages; any waiting-period or hour-bank rules — verified to the penny.
Full-time, part-time, salaried, hourly, union, COBRA, and any class-specific benefit offerings — mapped to the platform's eligibility engine.
The 834 file is built per carrier spec, test-transmitted, and a discrepancy report is generated for every file cycle — before go-live.
Pre-tax election rules, Section 125 mid-year change events, and ACA affordability/coverage indicators — configured per plan.
Build completion, carrier-feed test, employee-facing portal preview, and go-live date — sequenced so nothing is missed.
AI extracts and drafts. Deterministic rules — running as code, outside the model — decide what is complete. A human specialist signs every release. That order is never reversed.
Upload three group renewal packets. We return a completeness read: which plan elements and carrier feeds you already have, and which are missing or misconfigured.
As your authorized clerical agent, we receive carrier renewals, SBCs, rate exhibits, and contribution schedules. LLM extraction converts them into a canonical plan-design schema.
Two independent extraction runs are compared. Discrepancies are flagged and resolved against the original documents before any configuration begins.
Every plan element is reconciled to the carrier document; contribution logic is verified to the penny; eligibility classes are mapped; the 834 test file is validated. Any failure blocks release.
A senior benefits-technology specialist reviews the exception queue and signs the release. High-complexity or high-value groups route to attorney review first.
You receive the build: platform configuration, carrier-feed test results, discrepancy report, and ongoing feed monitoring with a monthly discrepancy summary.
The deliverable is completeness itself — every plan element and carrier feed accounted for or explicitly exception-coded. Nothing is left implicit.
The gates that decide completeness are code, not a model's opinion. A drafting error cannot slip past a plan-design requirement.
We prepare builds and run feeds as your clerical agent. We never contact the employer group, give legal advice, or administer the plan.
Simple, predictable, and aligned with a documentation standard — not a cut of any premium.
Start with a free Build Audit. Send three renewal packets and we'll return a completeness read against every plan element and carrier feed requirement.
Documentation-completeness service · not legal advice · the agency retains all client relationships.