Predictika · Employer group benefits quotes

An AI sales agent's group disability and life quote, checked before it goes out

An AI sales agent prepares a monthly premium quote for an employer that wants Group Short Term Disability, Group Long Term Disability and Group Basic Life and AD&D for its employees. Before it goes out, the agent sends it to Predictika, which checks it against a declarative model of group plan design rules and illustrative rates and returns a verdict, every reason, a line-item quote and the figures it computed.

Scope: Employer group quotes for Short Term Disability, Long Term Disability and Basic Life and AD&D: participation by payment arrangement, benefit percentages and waiting periods, group-size maximums, guaranteed-issue limits and the monthly premium. See everything this validator covers

This validator models employer group quotes for three Unum product lines, not just the scenarios shown below. Unum's product names are public; the plan rules, limits and rates in this model are modeled from comparable group benefits products and are not published by Unum.

  • Group Short Term Disability — benefit of 50, 60 or 66 percent of pay, 11, 13 or 26 weeks of benefits, a 0, 7 or 14 day waiting period for sickness and a weekly maximum that depends on group size.
  • Group Long Term Disability — benefit of 50, 60 or 66 percent of pay, a 90, 180 or 365 day waiting period and a monthly maximum that depends on group size. Short Term Disability must not overlap the Long Term Disability waiting period, and a gap between them goes to a person.
  • Group Basic Life and AD&D — a multiple of 1 to 5 times annual pay, a maximum amount per employee and a guaranteed-issue amount that depends on group size; more than that needs evidence of good health and goes to a person.
  • Group rules — 10 to 1,000 eligible employees (more than 500 goes to underwriting), minimum participation of 100 percent when the employer pays, 75 percent when the cost is shared and 30 percent when employees pay, and a monthly premium compared with the total the agent states.

Any employer group quote for these three coverages is in scope — not only the scenarios pictured here. Not covered: Accident, Critical Illness, Hospital Indemnity, dental, vision, voluntary or whole life, individual disability, leave management, state-specific rules, age-banded life rates, taxes and any negotiated discount. The rates are illustrative.

The AI sales agentBuilds the group benefits 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.

7 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
Short Term Disability that must hand over to Long Term DisabilityOnly with workarounds
The two products are separate lines; a rule has to compare the end of one with the start of the other, and a gap or an overlap is easy to miss.		Benefit duration and waiting period are compared in one pass: an overlap blocks, a gap goes to a person.
Participation that depends on who paysOnly with care
A minimum for each payment arrangement; it works, but each arrangement is another rule to keep in step.		The minimum follows the payment arrangement and is checked with the rest.
Maximums and guaranteed-issue amounts that change with group sizeOnly with care
Size bands for weekly, monthly and life limits, each a separate table that has to be maintained.		The limits are computed from the group size on every call.
A premium built from covered payroll, benefit percentage and waiting periodOnly with care
A rate table per product keyed on several choices, with the total typed by a rep compared separately.		The three premiums are computed and compared with the total the agent states, to the cent.
Every problem returned in one answerOnly with workarounds
Rules tend to fire as the quote 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 quote; approval findings need a person to sign off; everything else is computed.

    
1The quote has 9 eligible employees; this quote covers groups of 10 to 1,000 employees.
2A group of 1,000 eligible employees is quoted by Unum underwriting case by case; a person should confirm it.
3The quote selects no Short Term Disability, Long Term Disability or Life and AD&D coverage.
4The quote has 74 percent participation; this payment arrangement needs at least 75 percent.
5Employee-paid Long Term Disability is offered up to 60 percent of pay; the quote has 66 percent.
6The quote has a Long Term Disability benefit of 55 percent of pay; 50, 60 or 66 percent is offered, where 66 means two thirds.
7The quote has a Long Term Disability waiting period of 120 days; 90, 180 or 365 days is offered.
8The quote has a Long Term Disability monthly maximum of $999; $1,000 up to $15,000 is offered for a group this size.
9A Long Term Disability monthly maximum of $10,001 is above 10,000 dollars and needs underwriting review.
10The quote has a Short Term Disability duration of 12 weeks; 11, 13 or 26 weeks is offered.
11Short Term Disability for 26 weeks overlaps the Long Term Disability waiting period of 90 days; the two benefits would be paid together.
12Short Term Disability for 11 weeks ends well before the Long Term Disability waiting period of 365 days starts, leaving employees with no benefit in between; a person should confirm it.
13The quote has a Short Term Disability waiting period of 10 days for sickness; 0, 7 or 14 days is offered.
14The quote has a Short Term Disability weekly maximum of $1,501; $500 up to $1,500 is offered for a group this size.
15The quote has a Short Term Disability benefit of 70 percent of pay; 50, 60 or 66 percent is offered, where 66 means two thirds.
16Basic Life and AD&D of $180,000 per employee is above the $150,000 guaranteed-issue amount for this group; employees would need evidence of good health, so a person should confirm it.
17The quote has Basic Life and AD&D of 6 times annual pay; 1 to 5 times is offered.
18The quote has Basic Life and AD&D of $1,600,000 per employee; the maximum is 1,500,000 dollars.
19The quote states a monthly premium of $6,695.00; the modeled rates give $6,696.00.

  

  

    
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. Large employer, full package: A 400-employee package with overlapping disability benefits, maximums above the limits and a total that leaves out the life line

    
The agent's request. Please quote Unum group benefits for an employer-paid plan covering 400 eligible employees with 100 percent participation and an average salary of $85,000, with Group Long Term Disability at 66 percent of pay with a 90-day waiting period and a monthly maximum of $16,000, Group Short Term Disability at 60 percent of pay for 26 weeks with a 7-day waiting period and a weekly maximum of $2,800 and Group Basic Life and AD&D of 3 times annual pay. The quote states a monthly premium of $32,012.90. It is ready to send.

    
Verdict: Blocked.

    
    
      
  • Long Term Disability monthly maximum not offered. The quote has a Long Term Disability monthly maximum of $16,000; $1,000 up to $15,000 is offered for a group this size.
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  • Short Term Disability weekly maximum not offered. The quote has a Short Term Disability weekly maximum of $2,800; $500 up to $2,500 is offered for a group this size.
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  • Short Term Disability runs past the Long Term Disability waiting period. Short Term Disability for 26 weeks overlaps the Long Term Disability waiting period of 90 days; the two benefits would be paid together.
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  • Stated monthly total does not match. The quote states a monthly premium of $32,012.90; the modeled rates give $46,292.90.
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2. Large employer, full package: The agent resubmits after fixing the errors

    
The agent's request. Please quote Unum group benefits for an employer-paid plan covering 400 eligible employees with 100 percent participation and an average salary of $85,000, with Group Long Term Disability at 66 percent of pay with a 180-day waiting period and a monthly maximum of $10,000, Group Short Term Disability at 60 percent of pay for 26 weeks with a 7-day waiting period and a weekly maximum of $2,400 and Group Basic Life and AD&D of 3 times annual pay. The quote states a monthly premium of $42,326.70. It is ready to send.

    
Verdict: Allowed.

    
    
      
  • Quote summary. 400 enrolled employees, covered monthly payroll of 2,833 thousand dollars, estimated monthly premium of $42,326.70: Long Term Disability $15,864.80, Short Term Disability $12,181.90, Life and AD&D $14,280.00.
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3. Employee-paid plan: An employee-paid plan with low participation, Long Term Disability above 60 percent and a large life amount

    
The agent's request. Please quote Unum group benefits for an employee-paid (voluntary) plan covering 150 eligible employees with 20 percent participation and an average salary of $90,000, with Group Long Term Disability at 66 percent of pay with a 90-day waiting period and a monthly maximum of $6,000, Group Short Term Disability at 60 percent of pay for 13 weeks with a 7-day waiting period and a weekly maximum of $1,500 and Group Basic Life and AD&D of 4 times annual pay. The quote states a monthly premium of $3,604.50. It is ready to send.

    
Verdict: Blocked.

    
    
      
  • Participation below the minimum. The quote has 20 percent participation; this payment arrangement needs at least 30 percent.
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  • Voluntary Long Term Disability above 60 percent. Employee-paid Long Term Disability is offered up to 60 percent of pay; the quote has 66 percent.
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  • Life amount above the guaranteed-issue limit. Basic Life and AD&D of $360,000 per employee is above the $250,000 guaranteed-issue amount for this group; employees would need evidence of good health, so a person should confirm it.
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4. Employee-paid plan: The agent resubmits after fixing the errors

    
The agent's request. Please quote Unum group benefits for an employee-paid (voluntary) plan covering 150 eligible employees with 35 percent participation and an average salary of $90,000, with Group Long Term Disability at 60 percent of pay with a 90-day waiting period and a monthly maximum of $6,000, Group Short Term Disability at 60 percent of pay for 13 weeks with a 7-day waiting period and a weekly maximum of $1,500 and Group Basic Life and AD&D of 4 times annual pay. The quote states a monthly premium of $5,662.80. It is ready to send.

    
Verdict: Needs approval.

    
    
      
  • Life amount above the guaranteed-issue limit. Basic Life and AD&D of $360,000 per employee is above the $250,000 guaranteed-issue amount for this group; employees would need evidence of good health, so a person should confirm it.
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  • Quote summary. 52 enrolled employees, covered monthly payroll of 390 thousand dollars, estimated monthly premium of $5,662.80: Long Term Disability $2,145.00, Short Term Disability $897.00, Life and AD&D $2,620.80.
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5. Employee-paid plan: The agent resubmits after fixing the errors

    
The agent's request. Please quote Unum group benefits for an employee-paid (voluntary) plan covering 150 eligible employees with 35 percent participation and an average salary of $90,000, with Group Long Term Disability at 60 percent of pay with a 90-day waiting period and a monthly maximum of $6,000, Group Short Term Disability at 60 percent of pay for 13 weeks with a 7-day waiting period and a weekly maximum of $1,500 and Group Basic Life and AD&D of 2 times annual pay. The quote states a monthly premium of $4,352.40. It is ready to send.

    
Verdict: Allowed.

    
    
      
  • Quote summary. 52 enrolled employees, covered monthly payroll of 390 thousand dollars, estimated monthly premium of $4,352.40: Long Term Disability $2,145.00, Short Term Disability $897.00, Life and AD&D $1,310.40.
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6. Shared-cost plan: A shared-cost plan with 26 weeks of Short Term Disability and a 90-day Long Term Disability waiting period

    
The agent's request. Please quote Unum group benefits for a shared-cost plan covering 60 eligible employees with 80 percent participation and an average salary of $68,000, with Group Long Term Disability at 60 percent of pay with a 90-day waiting period and a monthly maximum of $7,500, Group Short Term Disability at 50 percent of pay for 26 weeks with a 14-day waiting period and a weekly maximum of $1,800 and Group Basic Life and AD&D of 1 time annual pay. The quote states a monthly premium of $2,932.16. It is ready to send.

    
Verdict: Blocked.

    
    
      
  • Short Term Disability runs past the Long Term Disability waiting period. Short Term Disability for 26 weeks overlaps the Long Term Disability waiting period of 90 days; the two benefits would be paid together.
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7. Shared-cost plan: The agent resubmits after fixing the errors

    
The agent's request. Please quote Unum group benefits for a shared-cost plan covering 60 eligible employees with 80 percent participation and an average salary of $68,000, with Group Long Term Disability at 60 percent of pay with a 180-day waiting period and a monthly maximum of $7,500, Group Short Term Disability at 50 percent of pay for 26 weeks with a 14-day waiting period and a weekly maximum of $1,800 and Group Basic Life and AD&D of 1 time annual pay. The quote states a monthly premium of $2,632.96. It is ready to send.

    
Verdict: Allowed.

    
    
      
  • Quote summary. 48 enrolled employees, covered monthly payroll of 272 thousand dollars, estimated monthly premium of $2,632.96: Long Term Disability $1,196.80, Short Term Disability $979.20, Life and AD&D $456.96.
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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 monthly premium quote for an employer that wants Group Short Term Disability, Group Long Term Disability and Group Basic Life and AD&D for its employees. Before it goes out, the agent sends it to Predictika, which checks it against a declarative model of group plan design rules and illustrative rates and returns a verdict, every reason, a line-item quote and the figures it computed.
    2. 
      
  2. I will start with the first request by the agent.
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  3. The agent says. Please quote Unum group benefits for an employer-paid plan covering 400 eligible employees. The quote states a monthly premium of $32,012.90. 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. The quote has a Long Term Disability monthly maximum of $16,000; $1,000 up to $15,000 is offered for a group this size. The quote has a Short Term Disability weekly maximum of $2,800; $500 up to $2,500 is offered for a group this size. Short Term Disability for 26 weeks overlaps the Long Term Disability waiting period of 90 days; the two benefits would be paid together. 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 and against the stated total.
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  7. What this shows: for short Term Disability that must hand over to Long Term Disability, a rules-based CPQ can do this only with workarounds.
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  8. Now the agent resubmits.
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  9. The corrected request. It changes the Long Term Disability waiting period to 180 days, the Long Term Disability monthly maximum to $10,000, the Short Term Disability weekly maximum to $2,400 and the stated monthly premium to $42,326.70.
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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. The validator also returns the line-item quote. It starts with Group Long Term Disability and Group Short Term Disability; the other line is on screen.
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  13. All four earlier findings are cleared, and the validator's total, $42,326.70, matches the quote.
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  14. Four problems caught in one call, fixed in one pass, and a clean $42,326.70 quote. That is the value of Predictika's validator: catching mistakes before they reach the customer. Now you can try the other scenarios yourself.
    15.