How It Works

The AI transformation layer for insurance operations.

Relay Vault sits on top of the ben-admin, policy admin, claims, distribution, and finance systems you already run — and rebuilds the workflows around them. Employee benefits — medical, dental, vision, disability, hospital, worksite, and voluntary plans — and P&C. Carrier integrations and discrepancy management included. Layer-first by default. Migration-capable when you need it. SOC 2 Type II certified. HIPAA compliant.

What an audit produces

The Engagement

Audit. Architect. Deploy. Optimize.

Every engagement starts with a real workflow inside your business — not a generic demo. We ship transformation, not pilots.

01

AI Transformation Audit

Two-week embedded review of one workflow. We map where humans are the integration layer, where systems disagree, and what an AI-native version of the workflow would actually look like in your stack.

02

Workflow Architecture

We redesign the workflow with AI agents inside Guidewire, Duck Creek, Employee Navigator, Ease, Vertafore, AMS360, Applied Epic, Salesforce FSC, or ImageRight. Layer-first by default — platform migration or custom builds when that's the right call.

03

Production Deployment

Live in 6–12 weeks. Agents run inside your permissions, your audit logs, and your compliance controls. Human-in-the-loop by default for any decision your team wants to sign off on.

04

Continuous Optimization

Quarterly review that widens scope, tunes decision logic, and prepares the agent for the next state exam, SOC 2 audit cycle, or NAIC filing.

Workflow Library

Where we transform insurance workflows

Each workflow runs inside your existing controls — SOC 2 logs, HIPAA-compliant data handling, and exam-ready audit trails preserved end-to-end.

Employee Benefits

Medical, dental, vision, disability, hospital, worksite, and voluntary plans — open enrollment, census sync, eligibility verification, and carrier file reconciliation across ben-admin and HCM systems.

Claims Processing

FNOL intake, triage, document analysis, coverage validation, and adjudication support — rebuilt end to end with explainable AI agents and human-in-the-loop sign-off.

Discrepancy Management

Exception detection across enrollment, billing, and regulatory logic. Census-to-carrier mismatches, premium billing deltas, and exam exceptions — every flag traces back to its source.

Premium Reconciliation

Carrier statements, TPA billing, broker ledgers, and finance systems reconciled automatically. Catch payment errors before checks go out.

Property & Casualty

Policy, claims, and billing workflows coordinated across P&C carriers and programs. Layer-first on Guidewire and Duck Creek — or migrated when that's the right call.

Commission Management

Multi-tier distribution calculation, overrides, splits, and retroactive adjustments — automated, validated, and logged for every payee.

Built To Work With Your Stack

Layer-first on your stack — migrate when you need to

Agents operate inside your existing permissions, data, and audit logs — across P&C policy admin, ben-admin, HCM/HRIS/payroll, and carrier connectivity.

Guidewire
Duck Creek
Employee Navigator
Ease
Benefitfocus
Workday
Vertafore
AMS360
Applied Epic
ImageRight
Salesforce FSC
ADP / Paylocity / UKG
Microsoft Dynamics
Snowflake / Databricks
Legacy EDI / SFTP (834, 837)
Carrier APIs
Custom data feeds

Deployment

Two deployment paths

Most engagements start as a layer. When the platform is the problem, we migrate or build custom — same audit, same compliance trail.

Layer (default)

Your PAS, ben-admin, AMS, or TPA platform stays the system of record. Relay Vault rebuilds the workflows around it — carrier integrations, discrepancy detection, enrollment, claims, and reconciliation. Production in 6–12 weeks with no forced migration.

Migrate / build

When the platform itself is the bottleneck — or you need greenfield custom software — we lead platform migrations and custom builds with the same audit-first process. Not the 18-month strategy-deck-to-nowhere pattern.

What You Walk Away With

Transformation, not a pilot

6–12 wks

From audit to production deployment

Layer-first

Start on your stack; migrate or build custom when needed

100%

Audit-trail coverage for every agent decision

BAA

Signed for PHI handling and major model providers

Frequently Asked Questions

What exactly is the AI Transformation Audit?
A two-week embedded engagement focused on one workflow — claims intake, broker onboarding, eligibility, commission reconciliation. We sit with your team, trace the workflow end-to-end, identify where humans are the integration layer, and deliver an architecture proposal with scoped pricing.
Do we have to rip and replace our current systems?
No — and we're not asking you to. Relay Vault works best as a transformation layer on your existing ben-admin, PAS, AMS, or TPA platform. Your systems of record stay in place while we rebuild the workflows around them. If migration or custom software is the right long-term answer, we lead that too — without the 18-month strategy-deck-to-nowhere pattern.
Will I have to migrate off Guidewire, Duck Creek, or Vertafore?
Not unless that's the right call for your business. Relay Vault is built layer-first — your systems of record stay where they are while we integrate via APIs, EDI feeds (834, 837), SFTP, and direct database connections. When the platform itself is the bottleneck, we also lead platform migrations and custom builds.
How do carrier integrations work?
We standardize EDI, file-drop, and API integrations across medical, dental, vision, disability, hospital, worksite, voluntary, and P&C carriers. New carrier appointments and group setups onboard in days, not quarters — with discrepancy detection built in from day one so census, enrollment, and billing files stay reconciled.
How do you handle PII and PHI?
We encrypt data in transit (TLS 1.3) and at rest (AES-256). PII is redacted when applicable. PHI is handled under a Business Associate Agreement, with BAAs in place with major model providers.
Are you SOC 2 Type II?
Yes. SOC 2 Type II controls cover access, change management, monitoring, and incident response. Reports are available under NDA during the audit engagement.
How is this different from RPA?
RPA replays clicks. Relay Vault rebuilds the workflow. RPA bots break when a carrier changes a form field; AI agents read the field, understand the change, and keep going. And unlike RPA, every Relay Vault decision is explainable, logged, and traceable.
Who owns the agent after deployment?
You do. The agents run in your environment, on your data, under your permissions. We maintain the underlying platform and extend scope quarterly — but your team can pause, override, or modify any agent action.

Book a transformation audit

Two weeks. One workflow. A scoped architecture and pricing for what an AI transformation looks like inside your stack.