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AI Contract Review Agent

Insurance contract review automation for ASO, BAA, producer & stop‑loss—AI redlines and compliance checks
Overview
Employee Benefits
Workflow

Automating Insurance Contract Review with AI

Automate your entire insurance contract review workflow across intake, playbook-driven redlining, compliance verification, and obligation tracking for ASO, BAA, producer, and stop-loss agreements.
001
Playbook-Driven Redlines in Minutes, Not Days

The agent applies your calibrated playbooks—required clauses, preferred language, acceptable fallbacks, and no-go positions—to automatically generate tracked changes that conform counterparty paper to your standards.

002
Compliance Gates That Catch What Humans Miss

Automated checks verify HIPAA BAA required elements, NAIC stop-loss attachment thresholds, ERISA claims procedure alignment, and producer anti-rebating provisions, flagging gaps before they become coverage disputes.

003
Cross-Document Alignment That Prevents Reimbursement Gaps

AI analysis detects misalignments between ASO agreements, plan documents, and stop-loss policies—catching definitional conflicts, run-out mismatches, and exclusion discrepancies that create costly coverage gaps.

How Cassidy automates this using AI

Step 1: Ingest and classify incoming contracts

The Workflow triggers when a new contract arrives—whether counterparty paper or carrier paper in Word or PDF. Cassidy automatically classifies the agreement type (ASO, BAA, producer, or stop-loss), detects exhibits like fee schedules and endorsements, and extracts key metadata including parties, jurisdiction, effective dates, and term.

Step 2: Apply playbook and clause library

Cassidy pulls from your Knowledge Base to retrieve the relevant playbook for that contract type, including required clauses, standard positions, acceptable fallbacks, and escalation triggers. The clause library provides approved templates and defined negotiation levers specific to benefits carrier agreements.

Step 3: Analyze and extract domain-specific terms

The AI performs deep extraction tailored to each contract type—services matrices and SLA metrics for ASO agreements, permitted PHI uses and breach timeframes for BAAs, commission schedules and appointment prerequisites for producer agreements, and attachment points, lasering, and mirroring terms for stop-loss policies.

Step 4: Generate automated redlines with rationale

Cassidy drafts tracked changes in Word to conform the contract to your playbook, swapping in approved clause language, adding required endorsements, and providing positioning notes that explain each change with fallback options for negotiation.

Step 5: Run compliance checks and risk scoring

Automated verification confirms all HHS-required BAA elements, checks stop-loss attachment points against NAIC thresholds, validates ERISA claims procedure incorporation in ASO agreements, and flags producer anti-rebating gaps—generating a risk score, heatmap, and "must fix before signature" list.

Step 6: Route for approval and track negotiation

Cassidy routes flagged issues to legal, compliance, underwriting, or privacy teams based on your approval thresholds. The system maintains version control, tracks counterparty concessions, and updates your clause library with accepted fallbacks to improve future automation.

Step 7: Finalize and create obligation register

Once approved, Cassidy generates clean and redline execution sets, collects required exhibits and certifications, and creates an obligation register with reporting deadlines, breach notice SLAs, renewal periods, and audit windows—with calendar entries for critical dates.

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  • Proven playbooks to get started fast

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Our implementation experts work hands-on with your team to make sure you see real value - fast. From setup to optimization, we’re here to help every step of the way.

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