Predictika · Employer group benefits proposals

An AI sales agent's Principal group benefits proposal, checked before it goes out

An AI sales agent prepares a group benefits proposal for an employer: group dental, vision, group or voluntary term life with spouse and child cover and AD&D, short- and long-term disability, and voluntary critical illness and accident cover. It states how many employees are eligible and enrolled, who pays, the coverage amounts and a monthly premium. Before it goes out, the agent sends it to Predictika, which checks it against a declarative model of these products and returns a verdict and every reason.

Scope: Principal group benefits proposals: group size and participation, who pays, voluntary products, state rules, benefit limits, underwriting approvals and the stated premium (illustrative rates). See everything this validator covers

This validator models employer group benefits proposals, not just the scenarios shown below.

  • Group size and participation — the eligible and enrolled counts, the participation minimum for employer-paid and voluntary groups, and when a participation waiver is available.
  • Products and combinations — critical illness and accident cover offered voluntary only and sold with another product, group term life paired with employer-paid funding and voluntary term life with employee-paid funding, dependent life, AD&D, and the Vermont size rule for critical illness.
  • Limits, approvals and price — the dental annual maximum and coinsurance, the life, spouse, child and critical illness amounts, underwriting approvals for large life amounts, waivers and large cases, and the stated monthly premium against the quoted coverages.

Any group benefits proposal that touches these rules is in scope — not only the scenarios pictured here. Not covered: retirement and 401(k), medical, paid family leave, hospital indemnity and the other Principal lines. The product lines and several limits follow Principal's public pages and a broker-hosted product guide; the participation arithmetic, the waiver window, the major dental coinsurance cap, the underwriting thresholds, the life product pairing and all premium rates are modeled from comparable group products, are illustrative and are not published by Principal (see the note at the foot of the page).

The AI sales agentBuilds the group benefits proposal 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
Participation depends on who paysOnly with care
The minimum share of employees who must enroll differs for employer-paid, contributory and voluntary groups, so the same headcount passes in one and fails in another.		Funding, contribution, eligible and enrolled counts are checked together on every call.
Products that depend on each otherOnly with workarounds
Critical illness and accident cover are voluntary only and need another product, group term life goes with employer-paid funding, and dependent life needs voluntary term life.		Funding, products and amounts are compared on every call, whatever order they were entered in.
State, limits and underwritingOnly with workarounds
A Vermont size rule, dollar maximums that differ by life product, and amounts that need underwriting approval read several fields at once.		State, group size, benefit amounts and approval thresholds are evaluated together.
Every problem returned in one answerOnly with workarounds
Rules tend to fire as the proposal is saved or 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 proposal; approval findings need a person to sign off; everything else is computed.

    
1Participation of 24 enrolled out of 50 eligible is below the minimum for this funding and contribution choice.
2The group size is outside the range this model supports (employer-paid 3 to 5,000 enrolled; voluntary 5 to 5,000 eligible).
3Participation of 2 enrolled out of 4 eligible is below the minimum for this funding and contribution choice.
4Participation of 49 enrolled out of 50 eligible is below the minimum for this funding and contribution choice.
525 employees are enrolled but only 20 are eligible.
6Participation of 19 enrolled out of 100 eligible is below the minimum for this funding and contribution choice.
7Participation of 4 enrolled out of 4 eligible is below the minimum for this funding and contribution choice.
8Groups over 500 eligible employees go to a case manager for review.
9Critical illness and accident cover are offered voluntary only, not employer-paid.
10Critical illness and accident cover must be sold with another group product (dental, vision, life or disability).
114 employees enrolled in critical illness or accident cover is below the voluntary minimum for 100 eligible employees.
12Critical illness in Vermont needs at least 50 eligible employees; the group has 40.
13The critical illness benefit of USD 101 thousand is above the USD 100 thousand maximum.
14The dental annual maximum of USD 3,500 is above the USD 3,000 maximum.
15Major dental coinsurance of 90 percent is above the 80 percent maximum.
16The employee life amount of USD 1,001 thousand is above the USD 1,000 thousand limit for this life product.
17Group term life above USD 500 thousand needs underwriting approval.
18The employee life amount of USD 501 thousand is above the USD 500 thousand limit for this life product.
19Spouse life of USD 251 thousand is above the USD 250 thousand maximum.
20Child life of USD 26 thousand is above the USD 25 thousand maximum.
21Spouse and child life are offered only with voluntary term life.
22Group term life is employer-paid and voluntary term life is employee-paid; the funding choice does not match the life product.
23AD&D can only be added to group or voluntary term life.
24A participation waiver needs underwriting approval.
25A participation waiver needs 5 to 499 eligible employees and at least 3 enrolled.
26The proposal states a monthly premium of 1 cents; the quoted coverages give 328,000 cents.
27Participation of 10 enrolled out of 40 eligible is below the minimum for this funding and contribution choice.
281 employees enrolled in critical illness or accident cover is below the voluntary minimum for 40 eligible employees.
29The critical illness benefit of USD 150 thousand is above the USD 100 thousand maximum.
30The dental annual maximum of USD 4,000 is above the USD 3,000 maximum.
31The employee life amount of USD 1,200 thousand is above the USD 1,000 thousand limit for this life product.
32The proposal states a monthly premium of 5 cents; the quoted coverages give 433,000 cents.
33Participation of 40 enrolled out of 100 eligible is below the minimum for this funding and contribution choice.
34The employee life amount of USD 750 thousand is above the USD 500 thousand limit for this life product.
35The proposal states a monthly premium of 300,000 cents; the quoted coverages give 450,000 cents.

  

  

    
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. Vermont voluntary group: A Vermont voluntary group of 40 eligible with critical illness, high life amounts, low enrollment and a wrong premium

    
The agent's request. Please prepare a group benefits proposal for an employer in Vermont with 40 eligible employees and 6 enrolled. The plan is voluntary (employee-paid) and includes dental PPO, voluntary term life of USD 750 thousand with spouse life of USD 300 thousand, and critical illness of USD 150 thousand for 2 employees. The proposal states a monthly premium of 40,000 cents. It is ready to send.

    
Verdict: Blocked.

    
    
      
  • Participation too low. Participation of 6 enrolled out of 40 eligible is below the minimum for this funding and contribution choice.
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  • Voluntary participation too low. 2 employees enrolled in critical illness or accident cover is below the voluntary minimum for 40 eligible employees.
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  • Critical illness in Vermont needs 50 employees. Critical illness in Vermont needs at least 50 eligible employees; the group has 40.
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  • Critical illness benefit too high. The critical illness benefit of USD 150 thousand is above the USD 100 thousand maximum.
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  • Life amount over the limit. The employee life amount of USD 750 thousand is above the USD 500 thousand limit for this life product.
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  • Spouse life over USD 250 thousand. Spouse life of USD 300 thousand is above the USD 250 thousand maximum.
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  • Stated premium does not match. The proposal states a monthly premium of 40,000 cents; the quoted coverages give 286,800 cents.
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2. Vermont voluntary group: The agent resubmits after fixing the errors

    
The agent's request. Please prepare a group benefits proposal for an employer in Vermont with 55 eligible employees and 15 enrolled. The plan is voluntary (employee-paid) and includes dental PPO, voluntary term life of USD 500 thousand with spouse life of USD 250 thousand, and critical illness of USD 100 thousand for 6 employees. The proposal states a monthly premium of 531,000 cents. It is ready to send.

    
Verdict: Allowed.

    
    
      
  • Proposal summary (illustrative rates). 15 enrolled of 55 eligible; estimated monthly premium 531,000 cents (illustrative rates).
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3. Employer-paid group: An employer-paid, non-contributory group of 80 with 76 enrolled, a high life amount, a high dental maximum and a wrong premium

    
The agent's request. Please prepare a group benefits proposal for an employer with 80 eligible employees and 76 enrolled. The plan is employer-paid and non-contributory and includes dental PPO with a USD 3,500 annual maximum, vision, group term life of USD 1,200 thousand, and short- and long-term disability. The proposal states a monthly premium of 500,000 cents. It is ready to send.

    
Verdict: Blocked.

    
    
      
  • Participation too low. Participation of 76 enrolled out of 80 eligible is below the minimum for this funding and contribution choice.
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  • Dental annual maximum too high. The dental annual maximum of USD 3,500 is above the USD 3,000 maximum.
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  • Life amount over the limit. The employee life amount of USD 1,200 thousand is above the USD 1,000 thousand limit for this life product.
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  • Stated premium does not match. The proposal states a monthly premium of 500,000 cents; the quoted coverages give 3,336,400 cents.
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  • Large group term life amount. Group term life above USD 500 thousand needs underwriting approval.
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4. Employer-paid group: The agent resubmits after fixing the errors

    
The agent's request. Please prepare a group benefits proposal for an employer with 80 eligible employees and 80 enrolled. The plan is employer-paid and non-contributory and includes dental PPO with a USD 3,000 annual maximum, vision, group term life of USD 500 thousand, and short- and long-term disability. The proposal states a monthly premium of 1,832,000 cents. It is ready to send.

    
Verdict: Allowed.

    
    
      
  • Proposal summary (illustrative rates). 80 enrolled of 80 eligible; estimated monthly premium 1,832,000 cents (illustrative rates).
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5. Accident cover: Accident cover sold on its own with only four employees enrolled

    
The agent's request. Please prepare a group benefits proposal for an employer with 100 eligible employees and 30 enrolled. The plan is voluntary (employee-paid) and includes 24-hour accident cover for 4 employees. It is ready to send.

    
Verdict: Blocked.

    
    
      
  • Critical illness or accident sold alone. Critical illness and accident cover must be sold with another group product (dental, vision, life or disability).
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  • Voluntary participation too low. 4 employees enrolled in critical illness or accident cover is below the voluntary minimum for 100 eligible employees.
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6. Accident cover: The agent revises the proposal: accident cover sold with dental and more employees enrolled

    
The agent's request. Please prepare a group benefits proposal for an employer with 100 eligible employees and 30 enrolled. The plan is voluntary (employee-paid) and includes dental PPO, voluntary term life of USD 100 thousand, and 24-hour accident cover for 12 employees. The proposal states a monthly premium of 252,000 cents. It is ready to send.

    
Verdict: Allowed.

    
    
      
  • Proposal summary (illustrative rates). 30 enrolled of 100 eligible; estimated monthly premium 252,000 cents (illustrative rates).
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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 benefits proposal for an employer: group dental, vision, group or voluntary term life with spouse and child cover and AD&D, and more. It states how many employees are eligible and enrolled, who pays, the coverage amounts and a monthly premium. Before it goes out, the agent sends it to Predictika, which checks it against a declarative model of these products 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 prepare a group benefits proposal for an employer in Vermont with 40 eligible employees and 6 enrolled. The plan is voluntary (employee-paid) and includes dental PPO, voluntary term life of USD 750 thousand with spouse life of USD 300 thousand. The rest of the request is on screen. The proposal states a monthly premium of 40,000 cents.
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  4. Before it goes out, the agent calls the validator.
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  5. Blocked, with seven findings, all in one answer. Participation of 6 enrolled out of 40 eligible is below the minimum for this funding and contribution choice. 2 employees enrolled in critical illness or accident cover is below the voluntary minimum for 40 eligible employees. Critical illness in Vermont needs at least 50 eligible employees; the group has 40. The other four are on screen.
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  6. The validator returned seven 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 proposal are checked against each other.
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  7. What this shows: for participation depends on who pays, 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 eligible employees to 55, the enrolled employees to 15, the life amount to 500 thousand dollars, the spouse life to 250 thousand dollars and the stated monthly premium to 531,000 cents. Two more changes are on screen.
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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 seven earlier findings are cleared.
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  13. Seven problems caught in one call, fixed in one pass, and a clean proposal. That is the value of Predictika's validator: catching mistakes before they reach the merchant. Now you can try the other scenarios yourself.
    14.