Practical and Responsible Uses for Generative AI for Group Health Insurance Advisors
Maintaining a self-funded health insurance plan is one of the most powerful ways to control healthcare costs over time. To be successful, self-funding requires careful modeling, good data, and a clear strategy.
Unfortunately, many plans are still priced using inaccurate carrier plan design decrements, poor quality data, or renewal formulas that don’t reflect the true risk of the clients’ population. In the complex healthcare environment we’re in, our pricing models need precision.
Advanced actuarial modeling and underwriting strategies are available, and they are more accessible than most plan sponsors and brokers realize.
You don’t need me to tell you that generative AI is everywhere right now. What’s less obvious is how it’s actually useful in our world of group health insurance.
For brokers and consultants, AI shouldn’t be about replacing judgment or expertise. It’s about helping you work faster, communicate better, and spend more time on the parts of the job that truly need a human touch.
This guide lays out where we think AI is genuinely helpful, where it can cause problems, and how to use it in a way that strengthens your role as a trusted advisor.
Why This Matters
Employers are under pressure. Renewal seasons are getting messier. Expectations keep going up. You’re being asked to quote more plans, benchmark more frequently, and explain more complexity, all without magically getting more hours in the day.
Used the right way, AI can take a bit of that load off your plate. It won’t replace your team or close your renewals for you, but it can help you spend less time formatting spreadsheets and more time building strategy.
That’s the real opportunity here: using AI to remove friction.
Core Belief: AI Should Make Advisors Stronger, Not Replace Them
We believe generative AI should:
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Help advisors move faster without sacrificing quality
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Simplify complex information for clients
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Make data more actionable
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Never replace professional judgment or client relationships
Used well, AI is a force multiplier. But it requires a responsible approach that respects privacy, prioritizes accuracy, and serves the unique needs of your clients.
Four Responsible and Practical Ways Brokers Can Use Generative AI
1. Drafting Clear, Client-Ready Summaries
You’ve probably spent hours turning a claims report or pharmacy trend slide into something an HR team can actually understand. It’s time-consuming, and it usually starts with a blank page.
That’s where AI can help. You can feed it a report and ask for a simple summary in plain language. Then you tweak it and add your own insights.
Example:
“Summarize this Q2 pharmacy spend report in 4 bullet points for an HR team with no clinical background.”
It’s not perfect out of the gate, but it gets you started. You stay in control of the message, but you’re not starting from scratch every time.
2. Turning Technical Insights into Strategic Talking Points
A good renewal or pricing model might take hours to build, but clients won’t see the value unless you can explain it clearly.
AI can help turn your analysis into something that’s easy to follow, without watering it down. It’s a way to bridge the gap between technical work and strategic advice.
Example:
“Explain how pooling works in a way that a school board member would understand.”
You still own the message. AI just helps you sharpen it for the audience.
3. Speed Up Internal Workflows and Proposal Drafts
AI isn’t going to win the RFP for you, but it can knock out the first draft of a few sections. Think of it like a rough outline or a jump-start.
You can also use it to build internal tools, checklists, or talking points. It’s not doing the thinking for you, but it can keep the busy work from eating your day.
Try it for:
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Proposal outlines
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Plan comparison summaries
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Client-ready call notes
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Internal SOP drafts
It won’t replace your strategy. It just helps you get there faster.
4. Personalize Plan Communications and Member Education
Even after renewal decisions are made, member education is often rushed or overlooked. You can use AI to help fill that gap.
Need to prep an open enrollment FAQ, a plan comparison grid, or an email about 2026 changes? AI can give you a starting point.
It saves HR time and helps you show up as more than just the person who found a good stop-loss rate. You’re helping them think ahead, and they’ll remember that.
What AI Should Not Replace
It’s tempting to overuse AI. But there are a few lines it shouldn’t cross.
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Don’t let it generate rates, projections, or quotes without solid data behind them. That’s risky and usually inaccurate.
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Don’t use it to interpret contracts or compliance rules. These need real oversight and legal review.
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Don’t pass off AI summaries as your own expertise. Add your voice. Add your perspective. That’s what your clients are paying for.
At Blue Raven, we use AI where it makes sense. But everything we deliver is reviewed by credentialed professionals. That’s the standard our clients expect.
How Blue Raven Actuarial Helps You Harness AI the Right Way
We don’t think AI should replace your work. We think it should make your work stronger.
That’s what our tools are designed to do. They help you move faster, be more consistent, and focus on strategy. You’re still the expert. We just make it easier for that expertise to show up in every client interaction.
Generative AI is a real advantage, but only if you use it with purpose. The winners won’t be the firms that try to automate everything. They’ll be the ones who know how to use AI to communicate better, work faster, and keep trust at the center.
If you’re curious how to bring AI into your own workflows or client conversations, we’re happy to walk through it with you.
Curious how AI could enhance your client experience?
Let’s explore it together with strategy, safeguards, and real actuarial support.