Post-Claims Support
ICHRA administrators handle reimbursements. Nobody handles what happens when a claim gets denied, a provider is out-of-network, or an employee gets a $4,000 surprise bill. We're building that layer.
The Gap No One Is Filling
When an employer moves from a group plan to an ICHRA, employees gain plan choice — but lose the employer's HR team as a backstop for coverage disputes. ICHRA administrators are reimbursement platforms. They are not insurance advisors.
That leaves employees on their own when:
- →A claim is denied and the appeal window is 30 days
- →A provider bills out-of-network despite being listed as in-network
- →An EOB doesn't match what the employee was told at point of service
- →A balance bill arrives months after treatment
- →An employee's plan choice created a coverage gap for a condition they didn't disclose during enrollment
These aren't edge cases. They're the normal friction of individual market coverage, and employees experiencing them for the first time after an ICHRA transition are not equipped to navigate them alone.
What We're Building
Claim Dispute Navigator
Step-by-step guidance for denied claims, surprise bills, and out-of-network disputes — specific to the employee's carrier and state.
Appeal Templates
Pre-written, carrier-specific appeal letter templates for the most common denial reason codes. Editable, downloadable, ready to file.
Coverage Gap Checker
Retrospective review tool that flags whether an employee's selected plan covers their known conditions and care patterns.
Employer Reporting
Aggregate post-claims data for HR teams — denial rates, appeal outcomes, common gaps — so employers can improve their allowance and plan guidance over time.
Join the Waitlist
We'll notify you when post-claims support tools are available. Early access is free.