Create, administer, and scale group health insurance programs from quotes to policies, enrollment, care access, claims, billing, and reporting. The platform supports large employee groups, multi‑plan benefit structures, employer‑specific eligibility rules, provider networks, digital health cards, and many more.
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The platform supports all participants involved in selling, administering, and servicing group health insurance programs.
Manage issued group health policies and schemes across their lifecycle.
Support group health insurance with guided quote creation, census intake, plan selection, and more.
Centralize employer accounts, corporate health programs, contracts, contacts, organizational structures, servicing history, renewals, and account lifecycle data.
Configure and maintain the health plan structures that define what members are covered for and under what conditions.
Handle individual and bulk enrollment for employees, dependents, beneficiaries, and covered members.
Give HR teams and members controlled self‑service access to everyday group health actions.
Manage provider networks and help members, HR teams, and operations users find eligible in‑network care.
Manage health claims, reimbursements, supporting documents, insurer dispatch, status tracking, service requests, and complex operational cases.
Support premium billing and claim‑related financial operations for employer groups, members, providers, and accounting teams.
Provide executives, account teams, underwriters, claims and finance teams, and operations managers with the visibility they need to track group health performance.
Executive overview dashboards for policies, claims, billing, collections
Underwriting and portfolio dashboards for quotes, conversion, premiums
Claims dashboards for FNOL volume, open claims, paid and incurred amounts
Financial and billing dashboards for billed, collected, aging, and overdue accounts
Provider performance dashboards for volume, average cost, approval and denial
Operational workload dashboards for open tasks, cases, queues, backlog, etc.
Standard reports, scheduled reports, exports, and drill‑down to source records
Guide teams from quote and proposal to policy, scheme setup, plan selection, member enrollment, digital health cards, and billing using connected workflows and reusable structures.
Give account teams, brokers, and HR users instant access to employer programs, active policies, schemes, members, coverage, documents, renewals, open claims, invoices, and service activity.
Use employer structure, member attributes, waiting periods, eligibility rules, required documents, and effective dates to validate enrollment and plan assignment before coverage goes live.
Maintain health plans, coverage limits, cost sharing, exclusions, provider access, and historical versions so teams can answer coverage questions accurately for any member and any date.
Capture claims and service requests through guided intake, validate documents, track SLA risk, manage status updates, coordinate with insurers, and keep members informed through self‑service views.
Integrate employer invoicing, billing schedules, member reimbursements, provider settlements, payment exceptions, and reconciliation into one operating model.
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