AI Qualifying Life Event Processing Agent

How Cassidy automates this using AI

Step 1: Trigger on QLE submission

The Workflow activates when an employee submits a qualifying life event through your benefits portal, HRIS, or a connected intake form capturing event type, date, and initial documentation.

Step 2: Classify event and open enrollment window

Cassidy identifies the event type (marriage, birth, loss of coverage, etc.), calculates the special enrollment period deadline, and initiates document checklists and employee notifications.

Step 3: Verify documents and dependent eligibility

The Agent reviews uploaded documents, validates names and dates against the event, checks dependent eligibility rules, and routes exceptions to HR for manual review with clear reason codes.

Step 4: Apply eligibility and election rules

Cassidy evaluates plan eligibility, enforces Section 125 consistency requirements, calculates the correct effective date, and flags any EOI requirements for life or disability coverage.

Step 5: Capture elections and calculate deductions

The Workflow guides the employee through allowed plan changes, recalculates premiums and employer contributions, and determines proration or retro catch-up amounts for payroll.

Step 6: Sync to HRIS, payroll, and carriers

Cassidy writes updated benefits and dependent data to your HRIS, pushes deduction changes to payroll, and transmits enrollment updates to carriers via EDI 834 or API tracking acknowledgements and surfacing errors.

Step 7: Reconcile and close the case

The Workflow monitors carrier responses, resolves discrepancies, and closes the QLE case once all systems are in sync generating audit-ready logs and employee confirmations.