Streamline Compliance and Delivery of Medigap Plans

A configuration of the Benefits1™ platform for end-to-end management of MediGap (Medicare Supplement) Plans
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Simplify Healthcare is positioned in the Leaders Category in the 2023 IDC MarketScape for U.S. health plan product/plan benefit configuration solutions.

Read the full IDC report

Empower Benefits1™ with BNi (Ben-ny)
– Your AI-Powered Assistant

Meet BNi (Benefits1™ Native Intelligence), your AI-powered assistant designed to enhance benefits plan management
with intelligent automation, real-time insights, and seamless plan navigation.
Tick Conversational AI interface for intuitive plan navigation
Tick Document intelligence to search, compare, and summarize ANOCs, EOCs, and SBCs
Tick Annual readiness monitoring to track timelines and ensure compliance
Tick Context-aware responses grounded in real-time data
Tick Proactive insights for benefits design, actuarial imports, and filing strategies
Tick Adoption intelligence to optimize feature use and drive long-term value
Responsive Styled Button Explore how BNi is set to reshape benefits plan management Read the Press Release

Accelerate Your Growth in the Medigap Market

Power your benefits journey for Medicare Supplement Plans with Benefits1™.Medigap — purpose-built for standardized plan design, rate configuration, and document generation.

Automated Medigap Documents

Easily generate Medicare Supplement documents, including rate books, policy summaries, and other regulatory materials—streamlining delivery and compliance. 

Out-of-the-Box Plan Templates (Plans A–N)

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

Rate Management and Calculations

Effortlessly upload, organize, and manage rates, and integrate them seamlessly into Medicare Supplement documents, rate books, and other materials.

Seamless Integration Capabilities

Integrate effortlessly with downstream systems, sales platforms, and enterprise components to enhance speed, accuracy, and efficiency. 

Advanced Reporting and Analytics

Track performance with advanced reporting tools that empower data-driven insights into plan adoption, pricing strategy, and member engagement. 

Power your connected benefits journey with integrations

Extend the capabilities of Benefits1™.Medigap with a host of integrations to achieve end-to-end lifecycle management of your Medigap Health Plans
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.IntegrationHub

Use API and events to communicate data in a model that is easily consumable by target systems

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.SuperUser.Studios

Empower superusers to maintain design, rules, and workflow configurations while also establishing governance

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.DataServices

Use a relational database to drive reports and analytics on the source of truth data or communicate it in a model that is easily consumable by target systems

.AI

Leverage the power of Generative AI to incorporate periodic code set changes published by the CMS into Benefits1™ and provide context-aware help from the product assistant

Benefits1-Group_Service
Service1™

Deliver accurate and complete answers to members, providers, employer groups, and brokers/agents for benefit inquiries

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Claims1™

Enable automated claims configuration, code set level configuration of benefits, and testing to support claims adjudication

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Experience1™

Automate dynamic content generation and stream accurate, compliant, and consistent benefits data across the enterprise

Simplify Healthcare is positioned in the Leaders Category in the 2023 IDC MarketScape for U.S. health plan product/plan benefit configuration solutions.

Frequently Asked Questions (FAQs)

Here is what our customers usually ask us

What is Medigap benefit plan management?

Medigap benefit plans solution encompasses the entire Medigap benefit plan management process, including configuring and updating the plans, generating documents, and integrating that information across the organization while maintaining CMS and State compliance

What are the challenges with traditional Medigap benefit plan build processes?

The traditional, manual Medigap benefit plan management processes, based on benefits grids, are prone to errors. These processes involve back and forth that ultimately result in version control issues and erroneous information being manually entered into Core-Admin and other systems. With traditional processes, it usually takes weeks to configure a market-ready Medigap benefit plan. Moreover, managing Medigap benefit plans with spreadsheets and communicating via emails means last-minute changes, which often pose challenges for already overburdened product teams. Some of the critical challenges with legacy benefit plan configuration processes are:

  • Data-driven Excel grids with repetitive data entry into Core-Admin and other systems leads to a lack of version control with data redundancy
  • Lack of a central repository to manage Medical, Dental, Hearing, Vision services, and multiple States’ product requirements
  • Handling CMS and State compliance become a challenge
  • Lack of data integration and workflow collaboration across other systems and stakeholders
  • There is no single source of truth methodology to update/manage all product data, including handbooks, booklets, and other marketing materials
  • Disparate legacy Medigap plan management processes result in low data accuracy, high risk of errors, and data redundancy
  • Processes were labor-intensive, prone to human error, and improving speed to market was a massive challenge

What are the benefits of automating your Medigap plan management processes?

Here are some of the key benefits of automating your Medigap benefit plan management processes:

  • Reduce turnaround time and improve speed to market
  • Reduce errors, improve data accuracy, and consistency
  • Create a single source of truth for Hearing, Medical, Dental, and Vision services and manage single or multiple States’ product requirements in a single integrated system
  • Promote data reusability and reduce the risk of errors due to manual processes
  • Use the market-leading single source of truth approach as a central repository to make changes to your plan data. Apply changes in one location and have them reflect in all aspects of your plan
  • Easily update Medicaid plan data and auto-generate documents, handbooks, and booklets in just a few clicks
  • Automate your CMS and State regulation compliance processes with a more robust quality audit and easy mandate update incorporation

How does Benefits1™.Medigap, an automated Medigap benefit plan management solution, fix issues seen in legacy processes?

Benefits1™.Medigap provides a single source of truth to Medigap Managed Care plans and Medigap Fee-For-Service programs to manage plan data, documents, systems integration while handling each State’s requirements. It utilizes an advanced single source of truth methodology that acts as a central repository for the Medigap benefit plan data making it accessible across the enterprise. When changes are applied to the master template, it reflects the changes across all sections. An automated solution means stakeholders do not have to communicate via emails and spreadsheets. There is better version control, and it’s easier to implement last-minute changes

Here are some ways Benefits1™.Medigap solves the issues with legacy processes:

  • A single source of truth solution to manage Medigap benefit plans data, documents, systems integration while handling each State’s requirements
  • Efficiently manage last-minute changes with Benefits1™.Medigap’s workflow management, enabling collaboration across all stakeholders, and data changes are seamlessly applied across the enterprise
  • A proven platform with benefit plan management capabilities for Medigap Managed Care plans and Medigap Fee-For-Service programs
  • Health Plans can now easily manage CMS, State mandate updates, auto-generate documents, handbooks, and booklets with just a few clicks.
  • Reduce turnaround time to fewer calendar days and thus significantly improve your speed to market by up to 70%
  • Ensure a single source of truth for multiple States’ products and quickly decrease admin costs by up to 75%

Can Benefits1™.Medigap help with CMS and State regulation compliance?

Yes, it absolutely can. Benefits1™.Medigap is the only solution developed by Health Plan professionals keeping in mind the specific requirements of Health Plans. With Benefits1™.Medigap, you would be able to implement CMS and State regulations, update, and be ready to roll out the product in just a few days. You would also be able to auto-generate Medigap benefit plan-related communication documents like handbooks, booklets, and other marketing materials with only a few clicks