AI Union Eligibility Determination Agent

How Cassidy automates this using AI

Step 1: Trigger on employer remittance submission

The Workflow activates when employer contribution reports arrive whether via portal upload, electronic file, or parsed from structured submissions and begins validating employee identifiers, CBA mappings, and contribution rates.

Step 2: Normalize and post contributions

Cassidy matches reported hours to member records using fuzzy matching and SSN validation, applies the correct CBA rate tables and class codes, posts contributions to member accounts, and routes exceptions (missing SSNs, invalid class codes, negative adjustments) to a review queue.

Step 3: Process reciprocity transfers

For members working outside their home fund's jurisdiction, Cassidy consumes ERTS feeds or host fund files, applies member reciprocity elections, prorates contributions per your fund's rules (hour-for-hour for H&W, dollar-based for DB pension), and posts credits to the home fund hour bank.

Step 4: Run eligibility determination

On your defined cadence, Cassidy executes look-back calculations against your fund's thresholds, applies bank draws for members below minimums, enforces Reserve Hour Bank caps and freeze rules, and marks members for active coverage, self-pay offers, or COBRA notifications.

Step 5: Generate and transmit 834/820 EDI files

Cassidy builds carrier-specific 834 enrollment transactions reflecting only net changes (adds, terms, dependent updates), transmits via AS2 or SFTP per each carrier's companion guide, and generates 820 premium remittances with TRN trace numbers for EFT reassociation.

Step 6: Monitor acknowledgments and reconcile

The Workflow tracks TA1/999 responses, automatically requeues failed transactions, surfaces carrier error reports for remediation, and reconciles carrier rosters against fund eligibility producing exception dashboards and audit trails for trustee reporting.