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Streamline Compliance and Delivery of Medicare Supplement Plans

Accelerate Speed to Market for Medigap Plans
Transform Medigap operations with AI-powered tools for standardized plan design, rate configuration, and document generation—integrated into one platform.
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Innovate and Scale Medigap Plan Operations

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

Medicare Supplement Plan Configuration

Optimize Your Medicare Supplement Portfolio with Modular Tools

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

  • Out-of-the-Box Plan Standardization
    Streamline plan configurations leveraging pre-built CMS-compliant plan templates for Plans A–N.
  • Unified Policy Catalog
    Centralize all Medigap 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 Medigap rate grids for flawless execution.

Automated Document Generation

Manage effortless and accurate document generation with automated workflows.
  • Automated Medigap Filings
    Submit required documents (including rate filings and policy amendments) faster with data accuracy and format alignment.
  • 508-Compliant Accessibility
    Produce accessible, error-free documents ready for distribution to members and portals.
  • Template-Based Filing
    Ensure accuracy using Global templates, minimizing the need for manual edits during validation processes.

Real-Time Insights and Readiness Tracking

Stay Proactive with Dashboard Monitoring

Access real-time updates to ensure annual readiness and eliminate operational surprises

  • Operational Dashboard Insights
    Monitor plan configurations via intuitive dashboards with built-in trackers.
  • Compliance Risk Alerts
    Minimize risks with proactive notifications identifying discrepancies with state guideline 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 Medigap workflows with integrated solutions.

  • Member Communication Channels
    Push approved content—such as Medicare Supplement documents, rate sheets and other materials—into member portals, contact centers, and mailing vendors.
  • 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.
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Product

Streamline Plan Design and Validation

  • Leverage pre-built, CMS-compliant plan templates for Plans A–N to accelerate plan setup and eliminate manual errors in Medigap configuration.
  • Eliminate plan 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.

Sales and Brokers

Empower Faster Medigap Enrollment Decisions

  • Enable brokers with self-service tools for quick Medigap plan customization and proposals.
  • Improve membership growth and retention with targeted Medigap benefits and offerings.
  • Achieve a 10+ NPS  (Net Promoter Score) improvement through user-friendly sales workflows.

Marketing and Compliance

Ensure Medigap Compliance and Enhance Efficiency

  • Generate Medicare Supplement documents, including rate books, policy summaries, and other regulatory materials through automated workflows.
  • Eliminate formatting bottlenecks and staffing constraints for document readiness.
  • Save up to 70%  on document management and compliance translations.

Finance

Increase Cost Efficiency for Medigap Plan Management

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

Operations

Fast-Track Medigap Enrollment and Claims Management

  • Upload, organize, and manage rates, and integrate them seamlessly into Medicare Supplement documents, rate books, and other materials.
  • Improve service accuracy while reducing manual intervention and member inquiry escalations.

IT

Support Scalable Medigap Operations with Advanced Integrations

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

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 Medigap Plan Operations with the Platform Advantage

Across the country, Medigap health plans are accelerating filings, improving compliance, and scaling with confidence—powered by automation, AI, and a smarter approach to managing Medigap Fee-for-Service and Medigap Managed Care programs.
See What’s Possible

Leading Health Plans Are Already Transforming Medigap Plan Operations with the Platform Advantage

Across the country, Medigap health plans are accelerating filings, improving compliance, and scaling with confidence—powered by automation, AI, and a smarter approach to managing Medigap Fee-for-Service and Medigap Managed Care programs.
See What’s Possible

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.

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Change What’s Possible in Medigap 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 Medigap operations with confidence.
Now it’s your move.
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Experience the Power of a Connected Ecosystem

Benefits1™ is just the beginning. Seamlessly integrate with Simplify Healthcare’s full suite of intelligent solutions—spanning product, provider, claims, benefits inquiry, documents, and custom app development—to ensure accuracy, efficiency, and compliance at every stage of the 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™.Medigap

How does Benefits1™.Medigap support plan design and standardization?

It enables centralized setup and management of Medigap standardized plans (A–N), including high-deductible options. The platform ensures regulatory compliance across states and supports rapid plan updates during rate or benefit changes.

Can it handle multi-state Medigap filings?

Yes. Benefits1™.Medigap supports state-specific plans, timelines, and validation rules. It can manage unique requirements across states, including rating justifications, benefit variations, and approval workflows.

Does it generate Medigap-specific documents?

Yes. The platform auto-generates Outline of Coverage (OOC), Rate Sheets, policy documents, forms, and customer-facing enrollment kits. Documents are available for download, translation, and fulfillment.

How does the platform improve accuracy and reduce rework?

Benefits1™.Medigap automatically incorporates changes in Original Medicare values and auto-calculates what Member Pays. Additionally, it validates plan data in real-time against business rules. It flags gaps and inconsistencies before submission—reducing rework, filing rejections, and resubmission delays.

Is Benefits1™.Medigap integrated with actuarial and document systems?

Yes. It connects with actuarial tools for rate modeling, and document engines for compliant generation and printing—enabling a seamless plan-to-filing workflow.

How does it help with compliance tracking and version control?

It includes built-in approval workflows, version history, and audit trails for every plan and document—ensuring readiness for DOI audits and internal governance reviews. 

Can we customize documents for brokers and sales teams?

Yes. Benefits1™.Medigap generates tailored materials like state-specific OOCs, and enrollment forms for broker channels—automatically branded and compliance-ready.

Does it support bulk updates across plans and states?

Yes. Users can perform centralized updates to rates, templates, or benefits and apply them across selected states or plans—minimizing manual effort and accelerating go-to-market.