Predictika · Group dental insurance quotes

An AI sales agent's group dental quote, checked before it goes out

An AI sales agent prepares a group dental quote for DentalGuard, with a plan, a funding type, a state, orthodontia and Early Smiles options, a waiting-period waiver, an annual maximum, a rate guarantee and a stated annual premium. Before it goes out, the agent sends it to Predictika, which checks it against a declarative model of the product and returns a verdict and every reason.

Scope: Guardian DentalGuard group dental quotes: Core, Buy Up and Plus plans; voluntary, contributory and noncontributory funding; orthodontia, Early Smiles, annual maximums, waiting-period waivers, rate guarantees and the annual premium. See everything this validator covers

This validator models DentalGuard group dental quotes, not just the scenarios shown below.

  • Plan features — which plans offer orthodontia and Early Smiles, the annual maximum each plan allows, and the state where group dental is not offered.
  • Group size and participation — employees enrolled against employees eligible, the participation each funding type needs, and the minimum headcount.
  • Rate guarantee — one, two or three year guarantees and the enrollment each longer guarantee needs.
  • Approvals and stated premium — waiting-period waivers and the Plus plan for small groups, large cases, and the stated annual premium against the premium computed from the plan and enrollment.

Any DentalGuard group quote that touches these rules is in scope — not only the scenarios pictured here. Not covered: vision, life, disability and other lines. The product, plan, annual maximum, orthodontia and Early Smiles names and features follow public Guardian pages; the Plus plan, participation minimums, rate guarantee thresholds, monthly rates and approval thresholds are modeled, not published by Guardian, and the rates are illustrative.

The AI sales agentBuilds the group dental quote from the conversation and says it is ready.
Predictika validatorChecks every rule at once and returns the verdict, each finding, and the computed figures.

6 scenarios in 3 groups · each group runs from the agent’s first attempt to the outcome · click one to switch

What the agent proposes

The AI sales agent says

Illustrative agent statement. The validator receives the structured request below.

Proposing agent: AI sales agent (scripted)

Before sending, the agent must call Recorded run

Predictika validator


      

        
        
        
      

      
Waiting for the call.

      
    

  

  
  

    
Where rules-based CPQ gets it wrong
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Our assessment of what a typical rules-based CPQ (product rules, price rules and validation rules, as in Salesforce CPQ) does with the same cases. It is a judgment about effort and reliability, not a claim that nothing can be built.

    
What the validator caughtTypical rules-based CPQPredictika
Plan features by planOnly with care
Orthodontia, Early Smiles and the annual maximum each depend on the plan, and Plus is a plan the other two do not share.		The plan and every feature are fields of one quote and are checked together on every call.
Participation by funding typeOnly with workarounds
Voluntary, contributory and noncontributory groups each need a different share of eligible employees, and a minimum headcount.		The funding type, the enrolled count and the eligible count are checked together, whatever order they were entered in.
Rate guarantee by enrollmentOnly with workarounds
A longer guarantee needs more enrolled employees, and some lengths are not offered at all.		The guarantee and the enrollment are checked together on every call.
Approvals for small and large groupsOnly with care
A waiver, the Plus plan and a large case each need a person at a different group size.		Every size threshold is checked on every call and the approvals come back with the blocks.
Stated premium against computed premiumOnly with workarounds
The premium depends on the plan, the enrolled count and the rate, so any change has to be recomputed.		The stated premium is a field of the quote and is compared with the computed one on every call.
Every problem returned in one answerOnly with workarounds
Rules tend to fire as a step is completed, so a rep often fixes one error and meets the next.		All findings come back together, whatever order the choices arrived in.

  

  

    
What this validator catches: findings from its test cases
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Every rule is checked on every call, in any order the choices arrive; one problem never hides another. Blocking findings stop the quote; approval findings need a person to sign off; everything else is computed.

    
1Orthodontia coverage is not available on this plan.
2Early Smiles is not available on this plan.
3The customer asks for a 2,000 dollar annual maximum; this plan offers 1,750 dollars.
4Group dental is not offered in the state of New Mexico.
560 employees are enrolled but only 50 are eligible.
624 of 50 eligible employees enrolled; this funding type needs at least 50 percent participation.
712 of 50 eligible employees enrolled; this funding type needs at least 25 percent participation.
849 of 50 eligible employees enrolled; this funding type needs at least 100 percent participation.
9The group has only 4 enrolled employees; this funding type requires a minimum headcount of 5.
10A 3 year rate guarantee is not available for a group with 49 enrolled employees.
11A 4 year rate guarantee is not available for a group with 40 enrolled employees.
12A 2 year rate guarantee is not available for a group with 24 enrolled employees.
13The quote states an annual premium of 18,000 dollars; the quoted plan and enrollment give 18,240 dollars.
14Waiving waiting periods for a group with 20 enrolled employees needs underwriting approval.
15The Plus plan for a group with 20 eligible employees needs underwriting approval.
16A group with 600 eligible employees is a large case; underwriting should review it.

  

  

    
Scenarios and results
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The recorded result of the validator for each scenario on this page: the request the AI agent sent, the verdict, and every finding, in the order they appear above.

    
1. Plan features and state: A quote on the Core plan with orthodontia, Early Smiles, a higher annual maximum and a New Mexico group

    
The agent's request. Please quote DentalGuard group dental on the Core plan for a contributory group in New Mexico with 50 eligible employees and 40 enrolled, with an annual maximum of 2,000 dollars, and orthodontia and Early Smiles, with a 1-year rate guarantee. The quote states an annual premium of $18,240. It is ready to send.

    
Verdict: Blocked.

    
    
      
  • Not offered in the state. Group dental is not offered in the state of New Mexico.
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  • Annual maximum above the plan. The customer asks for a 2,000 dollar annual maximum; this plan offers 1,750 dollars.
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  • Orthodontia not on this plan. Orthodontia coverage is not available on this plan.
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  • Early Smiles not on this plan. Early Smiles is not available on this plan.
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2. Plan features and state: The agent resubmits after fixing the errors

    
The agent's request. Please quote DentalGuard group dental on the Buy Up plan for a contributory group in California with 50 eligible employees and 40 enrolled, with an annual maximum of 2,500 dollars, and orthodontia and Early Smiles, with a 1-year rate guarantee. The quote states an annual premium of $24,960. It is ready to send.

    
Verdict: Allowed.

    
    
      
  • Quote summary. 40 enrolled of 50 eligible, monthly rate 52 dollars per employee, annual premium 24,960 dollars.
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3. Participation and guarantee: A quote for a voluntary group with low enrollment, a three-year rate guarantee and a wrong premium

    
The agent's request. Please quote DentalGuard group dental on the Core plan for a voluntary group in California with 50 eligible employees and 12 enrolled, with an annual maximum of 1,500 dollars, with a 3-year rate guarantee. The quote states an annual premium of $18,000. It is ready to send.

    
Verdict: Blocked.

    
    
      
  • Participation below the minimum. 12 of 50 eligible employees enrolled; this funding type needs at least 25 percent participation.
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  • Rate guarantee not allowed for this group. A 3 year rate guarantee is not available for a group with 12 enrolled employees.
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  • Stated annual premium does not match. The quote states an annual premium of 18,000 dollars; the quoted plan and enrollment give 5,472 dollars.
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4. Participation and guarantee: The agent resubmits after fixing the errors

    
The agent's request. Please quote DentalGuard group dental on the Core plan for a voluntary group in California with 50 eligible employees and 13 enrolled, with an annual maximum of 1,500 dollars, with a 1-year rate guarantee. The quote states an annual premium of $5,928. It is ready to send.

    
Verdict: Allowed.

    
    
      
  • Quote summary. 13 enrolled of 50 eligible, monthly rate 38 dollars per employee, annual premium 5,928 dollars.
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5. Small-group approvals: A quote on the Plus plan for a 20-employee group with a waiting-period waiver and a four-year guarantee

    
The agent's request. Please quote DentalGuard group dental on the Plus plan for a contributory group in California with 20 eligible employees and 15 enrolled, with an annual maximum of 3,000 dollars, and orthodontia, Early Smiles and a waiting-period waiver, with a 4-year rate guarantee. The quote states an annual premium of $11,880. It is ready to send.

    
Verdict: Blocked.

    
    
      
  • Rate guarantee not allowed for this group. A 4 year rate guarantee is not available for a group with 15 enrolled employees.
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  • Waiting-period waiver on a small group. Waiving waiting periods for a group with 15 enrolled employees needs underwriting approval.
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  • Plus plan for a small group. The Plus plan for a group with 20 eligible employees needs underwriting approval.
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6. Small-group approvals: The agent resubmits after fixing the errors

    
The agent's request. Please quote DentalGuard group dental on the Plus plan for a contributory group in California with 20 eligible employees and 15 enrolled, with an annual maximum of 3,000 dollars, and orthodontia, Early Smiles and a waiting-period waiver, with a 1-year rate guarantee. The quote states an annual premium of $11,880. It is ready to send.

    
Verdict: Needs approval.

    
    
      
  • Waiting-period waiver on a small group. Waiving waiting periods for a group with 15 enrolled employees needs underwriting approval.
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  • Plus plan for a small group. The Plus plan for a group with 20 eligible employees needs underwriting approval.
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  • Quote summary. 15 enrolled of 20 eligible, monthly rate 66 dollars per employee, annual premium 11,880 dollars.
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Narration transcript
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The text of the narrated walkthrough, step by step.

    
    
      
  1. Welcome to a demo of Predictika's Validator. An AI sales agent prepares a group dental quote for DentalGuard, with a plan, a funding type, a state, orthodontia and Early Smiles options. Before it goes out, the agent sends it to Predictika, which checks it against a declarative model of the product and returns a verdict and every reason.
    2. 
      
  2. I will start with the first request by the agent.
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  3. The agent says. Please quote DentalGuard group dental on the Core plan for a contributory group in New Mexico. The quote states an annual premium of $18,240. The rest of the request is on screen.
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  4. Before it goes out, the agent calls the validator.
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  5. Blocked, with four findings, all in one answer. Group dental is not offered in the state of New Mexico. The customer asks for a 2,000 dollar annual maximum; this plan offers 1,750 dollars. Orthodontia coverage is not available on this plan. The other one is on screen.
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  6. The validator returned four blocking findings in one answer. A check that reads one field at a time would pass most of this; it shows only when the choices in the quote are checked against each other.
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  7. What this shows: for plan features by plan, a rules-based CPQ is error-prone for this.
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  8. Now the agent resubmits.
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  9. The corrected request. It changes the plan to Buy Up, the state to California, the annual maximum to $2,500 and the stated annual premium to $24,960.
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  10. It calls the validator again.
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  11. This time the validator clears it.
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  12. All four earlier findings are cleared.
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  13. Four problems caught in one call, fixed in one pass, and a clean $24,960 quote. That is the value of Predictika's validator: catching mistakes before they reach the customer. Now you can try the other scenarios yourself.
    14.