Leading benefits administrator automates open enrollment with Voice AI and saves over $800K per year

The old model worked, but only by throwing people at the problem. When call volume spiked, the company hired and trained a large variable workforce, absorbed the cost, and released them when the season ended. That approach created several compounding problems.

• Seasonal staffing was a seven-figure annual line item. Onboarding hundreds of temporary agents through staffing agencies cost millions in a single season. The spend recurred every year and grew with the business.
• Most of that expensive labor answered the same handful of questions. The seasonal team was overwhelmed by repetitive, transactional inquiries: “What is my deductible?” “What’s the difference between my HMO and PPO premium?” “What do I need to do to change my benefits after a qualifying life event?” These were high in volume and low in complexity, exactly the questions that did not need a trained human.
• Agents lost minutes per call to a swivel-chair workflow. There was no single place to find an answer. To respond to a basic plan question, an agent had to move between Microsoft SharePoint for plan documents, a proprietary Azure SQL enrollment platform for member data, and Zendesk for ticketing. Toggling across three systems drove average handle time to eight to twelve minutes per call.
• Escalations started from zero every time. When a caller was handed to a senior benefits specialist, no context came with them. The caller had to repeat the entire story from scratch, which frustrated members and burned specialist time on information the caller had already given once.

The math did not hold up as the business grew. Each new corporate client meant more plans, more employees, and a bigger seasonal hiring bill. The company needed to break the link between service capacity and seasonal headcount.

Quiq became the autonomous “digital front door” for the benefits service center, deployed as a Voice AI layer over the company’s existing Five9 telephony and Zendesk ticketing. There was no rip-and-replace of the core systems the team already relied on.

The deployment was built around a few capabilities specific to how this benefits administrator operates.

• Real-time caller authentication against live enrollment data. The Voice AI verifies each caller using date of birth and employee ID pulled directly from the HRally enrollment platform, so the caller is identified before any plan-specific answer is given. This is what lets routine questions resolve instantly instead of waiting on hold for a human to look up the record.
• Plan documents ingested as-is, with no manual reformatting. Quiq ingested the company’s unstructured plan data and carrier documentation straight from SharePoint, turning raw PDFs into AI-ready knowledge without the team rebuilding a knowledge base by hand. Competing approaches required that content to be manually restructured first.
• Strict data boundaries between corporate clients. Because the service center supports many employers on one platform, a member from one company can never receive another company’s plan data. Company-specific guardrails and segmented data structures enforce that separation, so multiple corporate clients run on a single AI system without cross-contamination.
• Business-approved process guides govern multi-step inquiries. Rather than following a rigid phone tree, the Voice AI works through benefits inquiries using approved workflows that encode how each type of question should be handled and where the data boundaries sit.
• Warm handoff with full context, into the existing ticketing system. When an inquiry exceeds the Voice AI’s authority, for example a denied pre-authorization dispute, the system generates a pre-populated Zendesk ticket containing the full interaction text, metadata, and a conversation summary, then routes the caller to a specialist through Five9. The caller never repeats themselves, which directly removed the escalation problem the team had before.

• A routine plan question, answered without a queue. A member calls asking, “What’s the difference between my HMO and PPO premium?” The Voice AI authenticates the caller against their enrollment record, then answers for that member’s specific plan rather than reading a generic definition. Before Quiq, this same question would have gone to a seasonal agent toggling between three systems.
• A qualifying life event, handled end to end. A member calls to change their benefits after a qualifying life event. The Voice AI works through the approved process guide for that scenario, collects what’s needed, and keeps the interaction within the member’s own employer’s data boundary.
• An escalation that arrives complete. A caller disputes a denied pre-authorization, which is beyond what the Voice AI is authorized to resolve. Instead of dropping the caller into a cold transfer, the system opens a Zendesk ticket already populated with the full conversation and summary, and routes them to a specialist through Five9. The specialist opens the ticket already knowing the story.

For the benefits service center, the change is about which calls reach a person. Routine, transactional questions, the deductible checks, the HMO-versus-PPO comparisons, the qualifying-life-event basics, no longer require a trained seasonal hire. The Voice AI authenticates the caller and resolves those directly.

That shifts what the human team does. Specialists spend their time on genuinely complex cases like coverage disputes, where judgment matters, rather than on the repetitive questions that used to fill the queue. And because escalations arrive as complete Zendesk tickets rather than blank transfers, specialists start each hard case with the full context already in front of them instead of asking the caller to start over.

The strategic payoff is capacity that no longer scales one-for-one with enrollment season. The company can absorb a busy season without hiring and training hundreds of temporary agents to match it.

By putting an authenticated, autonomous Voice AI layer in front of a seasonal contact center, this benefits administrator broke the link between service capacity and seasonal human capital cost, and did it without replacing its telephony or ticketing systems.

• 40% reduction in seasonal headcount,  by containing routine inbound volume.
• $700+ in avoided seasonal staffing spend in year one, cutting agency staffing cost 
• $100k+ in hard telephony savings, reducing Five9 and other seat licenses
• Approximately $800k in total identified year-one savings 
• 24/7 authenticated self-service, so routine plan questions resolve instantly at any hour instead of waiting on a live agent.
• Lower average handle time on the calls that do reach a person, since instant authentication and knowledge retrieval remove the swivel-chair lookups that pushed handle time to eight to twelve minutes.