Use Case 1
Post-Sale Installation
Trigger: A producer releases a sold quote
1.Configure the group install from the released quote
2.Open the election window
3.Re-test participation against real elections
4.Request prior-coverage credits
5.Issue documents and member cards
6.Set the first billing expectation
7.Surface any gate failure instead of installing past it
✓
Groups install cleanly with compliance gates enforced before cards and invoices issue.
Use Case 2
Election-Based Re-Test
Trigger: Real elections differ from the quoted census
1.Compare elected members against the quoted census
2.Re-run participation on the real population
3.Detect a group that now fails
4.Hold issuance on the failing gate
5.Surface the shortfall for resolution
✓
Participation is verified against who actually enrolled, not who was quoted.
Integrations
Process Library (Small Group)
Enrollment & Eligibility System
Card & Document Issuance
Billing & Invoicing
Prior-Coverage Credit
Industries
healthcare
See It In Action
A sample conversation with this agent
The producer released the quote—install the group.
Running the six-step pipeline: install configuration, open the election window, re-test participation against the real elections that came in, request prior-coverage credits, issue documents and member cards, and set the first billing expectation. Each step is a rule-based lookup or threshold test against the stated criteria. The re-test matters—a group that passed at quote can fail once real elections land, and that's better caught at install than at first claim.
Skip the participation re-test, the quote already passed it.
The quote passed on the census; install has to re-test against who actually elected, because those aren't the same population. Skipping it means installing a group that no longer meets participation, which surfaces as a coverage dispute later. The re-test is a compliance gate in the pipeline, so I run it and surface a fail rather than install past it.
Issue the cards before enrollment is finalized to save time.
Cards issue after the pipeline's gates clear—configuration, election window, participation re-test, and prior-coverage credits—because a card issued to a member who doesn't hold coverage is a real problem to unwind. The pipeline sequences issuance after the tests for that reason. If speed is the pressure, the honest lever is resolving the failing gate, not issuing ahead of it.