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Accelerate and scale your product and benefits

Benefits1™ ensures collaboration across product, compliance, actuarial, and enrollment teams, enabling reduced cycle times, minimized manual errors, and enhanced accuracy for plan launches.
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Simplify Healthcare’s Benefits1™.Medicare Drives Over 30% of Nationwide PBP Submissions to CMS, Marking Over 7 Years as a Trusted Industry Leader
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Innovate and Scale Benefits Plan Operations

Connecting Compliance, Enrollment, and Benefits Integration
Effortless Compliance. Enhanced Accuracy. Measurable Cost Reduction.

Enterprise Product Catalog

Optimize Your Benefits Product Portfolio with Modular Tools

Streamline fragmented operations with configurable tools designed to improve compliance, boost data accuracy, and simplify implementations.

  • AI-Powered Plan Standardization
    Modernize plan configurations using AI to produce audit-ready, CMS-compliant designs and easily reproducible rate templates.
  • Unified Policy Catalog
    Centralize all plan forms, rate filings, and policy documents into one governed repository for improved data accessibility and consistency.
  • Rate Synchronization
    Automatically sync actuarial data and premium calculations directly with rate grids for flawless execution.

Automation for Compliance and Filing

Confident Compliance and Filing for Benefit Products

Manage filings effortlessly with automated workflows tailored to federal and state guidelines.

  • Automated Filings
    Submit required documents (including PBP, PBT, ANOC, EOC, SB) faster with AI-driven accuracy and format alignment.
  • 508-Compliant Accessibility
    Produce accessible, error-free documents ready for CMS approval with built-in compliance checks.
  • Template-Based Filing
    Ensure accuracy using DOI-aligned templates, minimizing the need for manual edits during validation processes.

Real-Time Insights and AEP Readiness

Stay Proactive with Dashboard Monitoring

Access real-time updates to ensure readiness for the Annual Enrollment Period (AEP) and eliminate operational surprises.

  • Operational Dashboard Insights
    Monitor plan configurations and filing readiness via AI-powered dashboards with built-in compliance trackers.
  • Compliance Risk Alerts
    Minimize submission risks with proactive notifications identifying discrepancies before audits occur.
  • Department Collaboration Features
    Streamline workflows across compliance, product, and enrollment teams without duplicating efforts.

End-to-End Integrations

Seamlessly Connect Plan Operations and Member Services

Deliver operational accuracy and improve workflows with integrated solutions.

  • Early ID Card Deployment
    Automate member ID card generation for newly enrolled participants, ensuring timely delivery.
  • Member Benefits Inquiry Integration
    Enhance member satisfaction with AI-powered tools for consistent answers across channels.
  • Claims Configuration Alignment
    Integrate policy and benefit data directly into claims systems like TriZetto® Facets® and QNXT™, NASCO, and more for streamlined accuracy.

Compelling Business Case. Proven Value.
ROI in Year One. Platform Advantage.

Benefits1™ is designed to align workflows, simplify operations, and deliver measurable outcomes across departments.

Web-hosting IconProduct

Streamline Plan Design and Validation

  • Leverage pre-built, CMS-compliant plan templates accelerate plan setup and eliminate manual errors in benefits configuration.
  • Eliminate file versioning issues, handoffs, and temporary staffing dependencies.
  • Improve transparency and quality control to scale flawlessly.
  • Achieve up to 30% cost savings  on configuration, validation, and submission processes.

Smart-contracts Icon Sales and Brokers

Empower Faster Plan Enrollment Decisions

  • Power your broker/agent systems with a clean and accurate product catalog for Individual, Small Group, and MA
  • Sales/Sales Ops teams can personalize/customize products while quoting for custom Mid-market, Large Group, and ASO.
  • Generate Pre-sales documents near real-time with integration to your choice of quoting/rating tools
  • Improve membership growth and retention with targeted benefits and offerings.
  • Achieve a 10+ NPS  (Net Promoter Score) improvement through user-friendly sales workflows.

Compliance IconMarketing and Compliance

Ensure Compliance and Enhance Efficiency

  • 508-compliant and print-ready mandated materials (SBC, SB, SOB, ANOC, EOC, CoC, and Contracts) and marketing documents (highlights, catalogs, etc.) through automated workflows.
  • Eliminate formatting bottlenecks and staffing constraints for document readiness.
  • Save up to 70%  on document management and compliance translations.

Statistics IconFinance

Increase Cost Efficiency for Plan Management

  • Lower administrative costs while achieving measurable ROI in plan operations during the first year.
  • Optimize TCO (Total Cost of Ownership): $1 invested = $9 in savings  compared to internal/competitor manual handling costs.
  • Automate financial workflows tied to filings and enrollment.

Data Sharing IconOperations

Fast-Track Enrollment and Claims Management

  • Powerful data services provide robust out-of-the-box reporting and enable Payer teams to create their own reports.
  • Improve service accuracy while reducing manual intervention and member inquiry escalations.
  • Achieve 80% faster implementation  of new groups and renewal setups.

System Administration IconIT

Support Scalable Operations with Advanced Integrations

  • Deploy a scalable SaaS platform, minimizing IT maintenance and support overhead.
  • Centralize high-value data on benefit products, filings, and member services.
  • Enable IT teams with a self-service integration toolkit for complete control of compatibility in your system ecosystem.

A Single Source of Truth for Products and Benefits Data

Benefits1™ enables a catalog for products and benefits data in a central repository, fulfilling all compliance and mandated document generation, and integration with selling, underwriting, and downstream systems. Explore how Benefits1™ can simplify product and benefits management across different lines of business.

Simplify Large Group Plan Management

Automate benefits from quotes to claims for Large, Midsize, Small Groups (Non-ACA), and ASOs.

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Simplify ACA Plan Management

Automate benefits from quotes to claims for Small Group and Individual Qualified Health Plans.

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Simplify Medicare Advantage Plan Management

Streamline end-to-end Medicare Advantage benefit management with an industry-leading solution

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Benefits1™.Medicare→

Simplify Medigap Plan Management

Streamline end-to-end Medigap benefit management with an industry-leading solution

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Benefits1™.Medigap→

Simplify Medicaid Plan Management

A fully automated and pre-configured benefit plan management solution for Medicaid Health Plans.

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Benefits1™.Medicaid→

Empower Benefits1™ with BNi (Ben-ny)
– Your AI Assistant for Smarter Plan Management

Meet BNi (Benefits1™ Native Intelligence)—an embedded AI assistant that enhances plan management through automation, insights, and context-aware guidance.
Tick Conversational AI Interface
Navigate plan configurations using intuitive, natural language commands.
Tick Document Intelligence
Search, compare, and summarize ANOCs, EOCs, SBCs, and other plan materials.
Tick Annual Readiness Monitoring
Track AEP milestones with real-time alerts to avoid delays and missed deadlines.
Tick Context-Aware Guidance
Surface plan-specific recommendations grounded in live configuration data.
Tick Proactive Design and Filing Insights
Receive strategic input on benefits design, actuarial data imports, and filing accuracy.
Tick Adoption Intelligence
Track feature usage, optimize workflows, and drive long-term platform value.
Experience a smarter way to manage benefits with BNi (Ben-ny). Read the Press Release

Leading Health Plans Are Already Transforming Plan Operations

Across the country, health plans are accelerating filings, improving compliance, and scaling with confidence—powered by automation, AI, and a smarter approach to managing products and benefits across all lines of business MA, Medicaid, ACA, Small Group, Mid-size, Large Group, ASO, Ancillary, Diversified benefits, Add-ons/Buy ups.

Leading Health Plans Are Already Transforming Plan Operations

Across the country, health plans are accelerating filings, improving compliance, and scaling with confidence—powered by automation, AI, and a smarter approach to managing products and benefits across all lines of business MA, Medicaid, ACA, Small Group, Mid-size, Large Group, ASO, Ancillary, Diversified benefits, Add-ons/Buy ups.

Trusted at Scale

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Recognized for Market Leadership

Simplify Healthcare is positioned in the Leaders Category of the 2023 IDC MarketScape for U.S. Health Plan Product/Plan Benefit Configuration Solutions.

Read the full IDC report
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Ready to Modernize Your Group Benefits Strategy?

Learn how leading payers are gaining a competitive edge by automating group benefits at scale—powered by AI, clean data, and modular workflows.

Get the IDC Spotlight
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Change What’s Possible in Benefit Plan Management

65+ health plans didn’t wait for the future—they built it. With Simplify Healthcare, they moved faster, stayed compliant, and scaled their operations with confidence.
Now it’s your move.
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Experience the Power of a Connected Ecosystem

Benefits1™ is part of the Simplify Health Cloud™. Seamlessly integrate with Simplify Healthcare’s full suite of intelligent solutions—spanning benefits, claims, service, and app development—to ensure accuracy, efficiency, and compliance across your product, benefits, and provider lifecycle.

Simplify Provider Lifecycle

Streamline network adequacy, contracting, credentialing, roster files, data management, and claims config with an advanced, modular solution that delivers efficiency and effectiveness.

Explore Provider1™ →

Simplify Claims Configuration

Configure benefits and provider data directly into claims systems like TriZetto® Facets® and QNXT™ using intelligent automation.

Explore Claims1™ →

Simplify Benefits Inquiry Experience

Deliver accurate, consistent benefits information across all channels—powered by AI-enhanced guidance that improves member experience and boosts NPS.

Explore Xperience1™→

Simplify Document Management

Auto-generate 150+ mandated and marketing documents with built-in 508-compliance, translations, and integrated print fulfillment.

Explore Simplify Docs™ →

Simplify Custom App Development

Design and deploy custom apps faster with embedded AI and low-code development—tailored to your organization’s unique needs.

Explore SimplifyX™ →

We don’t just deliver software—we work alongside your teams to guide implementations, simplify adoption, and ensure sustained success.

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Frequently Asked Questions (FAQs)

What our customers frequently ask about Benefits1™

What is benefit plan management?

Benefit plan management encompasses configuring, updating, and filing plans, generating compliant documents, and integrating regulatory data—all while maintaining CMS and state compliance standards. 

What are the challenges with traditional benefit plan build processes?

Traditional manual processes often rely on spreadsheets, email chains, and disconnected systems, resulting in errors, inefficiencies, and compliance risks. Key challenges include: 

  • Version Control Breakdown: Updates often result in mismatched documents and data silos due to fragmented tools. 
  • Lack of Integrated Repositories: Difficulty accessing essential documents like plan policies, premium rates, and enrollment forms. 
  • Labor-Intensive Filings: Manual workflows lead to delayed submissions and missed regulatory deadlines. 

What are the benefits of automating benefit plan management processes?

Automation delivers measurable outcomes by reducing administrative overhead, minimizing manual errors, and accelerating operational workflows. Benefits include: 

  • Speed to Market: Automate filings and updates to reduce submission delays by up to 75%. 
  • Accuracy: Ensure audit-ready documents like rate filings, handbooks, and compliance forms aligned with CMS and state mandates. 
  • Scalability: Simplify annual updates, renewals, and premium adjustments for faster lifecycle management. 

How does Benefits1™ streamline benefit plan management?

Benefits1™ provides a centralized hub for plan data, documents, and workflows. It eliminates dependency on spreadsheets and email chains, ensuring seamless collaboration, version control, and efficient filing workflows. Here’s how: 

  • Single Source of Truth: Consolidate plan data, rate filings, and documents into one unified system accessible across stakeholder teams. 
  • Pre-Built Templates: Auto-generate standard policy across all lines of business MA, Medicaid, ACA, Small Group, Mid-size, Large Group, ASO, Ancillary, Diversified benefits, Add-ons/Buy ups 
  • Decreased Errors: Reduce compliance risks through automated workflows and integrated validation tools. 

Can Benefits1™ help with CMS and State regulation compliance?

Yes. Benefits1™ was specifically developed to address both CMS and state regulatory compliance mandates. It automatically configures filings, produces accessible (508-compliant) documents, and syncs premium adjustments with validated actuarial grids—ensuring timely submissions.