Benefits decision support is software that helps an employee choose the best health plan during the yearly enrolment window, by estimating what each plan would cost them. It is used mainly by American employers, inside their benefits administration portal. More and more, it is run by an AI model that reads the employee's past medical claims.
The choice is harder than it looks. An American health plan has several costs. The premium is the fixed amount paid every month. The deductible is the amount the employee pays each year before the plan starts to pay. Coinsurance is the share of each bill that the employee still pays after the deductible, such as 20%. The out-of-pocket maximum is the most the employee can pay in a year. A plan with a low premium usually has a high deductible. Many employees pick the plan with the lowest deductible out of habit, and pay more than they need to.
Decision support compares the plans for one employee. It estimates how much medical care they are likely to use, from their past claims or from a few questions. Then it works out their total yearly cost under each plan.
Here is a typical case. An employee of a bank in North Carolina had $1,200 of medical bills last year. Plan A costs her $2,400 a year in premiums, with a $500 deductible and 20% coinsurance. Plan B costs $900 a year, with a $3,000 deductible. With Plan B, the employer also puts $500 into her health savings account (HSA). If her bills are $1,200 again, Plan A costs her $2,400 + $500 + 20% of $700, which is $3,040. Plan B costs her $900 + $1,200 − $500, which is $1,600. The software recommends Plan B. It also shows her worst year. Plan A's out-of-pocket maximum is $3,000 and Plan B's is $4,500. So if she had a serious illness, Plan A could cost $5,400 in total, and Plan B $4,900.
The newer tools use a language model. The employee can ask questions in plain words, such as "Is my regular doctor covered by Plan B?" The model can read the employee's past claims, with her permission, to estimate next year's costs. Medical claims are protected health information under HIPAA, an American privacy law, so the tools must follow strict rules on who may read them. The page on HIPAA compliance software covers these rules.
The employee makes the final choice. The software only shows the numbers and recommends one plan, a pattern called human in the loop.