AI Group Benefits Implementation Agent

How Cassidy automates this using AI

Step 1: Ingest carrier requirements

Cassidy pulls in the carrier's 834 Companion Guide, API specs, and operating rules into the Knowledge Base, building a carrier-specific rule profile for mapping and validation.

Step 2: Configure trading partner connectivity

The Workflow automates credential provisioning, SFTP/PGP key exchange or OAuth setup, IP whitelisting, and ISA/GS identifier configuration based on carrier requirements.

Step 3: Map and validate enrollment data

Cassidy translates HRIS/ben-admin exports into compliant 834 transactions mapping to INS, HD, DTP, and REF segments while pre-validating syntax, maintenance codes, and effective dates against TR3 and companion guide rules.

Step 4: Execute test scenarios

The agent generates representative test files covering adds, terms, plan changes, COBRA, and reinstatements, then transmits to the carrier's test environment and parses TA1/999/864 acknowledgments to identify and remediate errors.

Step 5: Monitor production transmissions

Once live, Cassidy monitors daily delta and periodic full-file transmissions, ingests acknowledgments, alerts on rejects, and triggers automatic resubmission for transient failures.

Step 6: Reconcile and resolve variances

Cassidy compares ben-admin census against carrier enrollment on a scheduled cadence, highlights discrepancies by member, coverage, and effective dates, and drafts corrective transactions for Human-in-the-Loop approval.