AI Open Enrollment Coordinator Agent

How Cassidy automates this using AI

Step 1: Trigger on enrollment period launch or file receipt

The Workflow activates when open enrollment begins, when employee elections are submitted through PrismHR Employee Portal, or when carrier acknowledgment files arrive ensuring every stage of the OE cycle is captured in real time.

Step 2: Validate elections and flag exceptions

Cassidy reviews incoming enrollments against eligibility rules, PCP format requirements, dependent relationship logic, and single-active-plan constraints, routing exceptions like missing EOI or invalid coverage tiers to the appropriate queue with clear remediation guidance.

Step 3: Generate and validate carrier files

Cassidy assembles 834 transactions or proprietary file formats using carrier-specific companion guide mappings, applies SNIP-level validation and business rule checks, and prepares files for secure transmission via SFTP flagging any records that would trigger rejection before they're sent.

Step 4: Monitor acknowledgments and remediate rejects

When TA1/999 acknowledgments or carrier acceptance reports arrive, Cassidy parses the results, matches them to transmitted records, and surfaces rejected members with root-cause context so your team can correct and retransmit without manual file comparison.

Step 5: Reconcile rosters and invoices

Cassidy compares carrier enrollment rosters to PrismHR records and matches invoice line items to payroll deductions, identifying discrepancies in effective dates, coverage tiers, retro adds/terms, and rate mismatches then generates exception reports with recommended corrections.

Step 6: Sync payroll and close out enrollment

Once reconciliation is complete, Cassidy ensures payroll deduction codes align with approved elections, posts any arrears or refunds, and archives all files, acknowledgments, and approval trails for audit-ready documentation.