Helping Brokers and Consultants Compete: Why Brokers and Consultants Are Turning to AI for Smarter Insurance Decisions

Group health underwriting is a high-stakes business. Speed, accuracy, and pricing are critical, but traditional tools often fall short, especially when data gaps or complex client profiles are involved.

Gradient AI understands that brokers and consultants in this market are facing multiple interrelated challenges, stemming from rising healthcare costs, increased client expectations, regulatory complexity, and the growing demand for data-driven solutions.

5 Top Challenges Facing Brokers and Consultants in Group Health Underwriting Today

Here's a breakdown of five of the top challenges:

1. Limited risk visibility: Brokers and consultants often lack access to complete or timely data, especially for smaller groups, making it difficult to accurately assess risk.
   
   
2. Rising and unpredictable costs: Healthcare expenses continue to climb, with volatility driven by high-cost claimants and specialty drugs.
   
   
3. Pressure to deliver savings: Clients expect strategic cost-containment guidance, but limited underwriting insight makes this hard to achieve.
   
   
4. Tight quoting timelines: Brokers and consultants must respond quickly to RFPs, often with limited data and time for thorough analysis.
   
   
5. The need to differentiate: Many brokers offer similar quoting approaches, making it difficult to stand out without deeper insights.

“Gradient AI provides insights into high-cost drugs and conditions for groups where this data is currently unavailable. This enables our broker and consultant clients to strategically identify cost-containment solutions, alternative funding options, or care management programs — all aimed at maintaining or reducing costs for their customers.”

– Chase Pettus. VP, Group Health, Gradient AI

How AI-Powered Underwriting Helps Brokers and Consultants Succeed

Here’s where AI comes in. AI models for underwriting can help address these top challenges, allowing brokers and consultants to:

• See risk more clearly. AI models deliver accurate risk scores even when claims data is limited. By analyzing alternative data like Rx or census files, brokers can confidently assess small and mid-sized groups.
  
  
• Stay ahead of rising costs. AI can identify likely high-cost claimants and key cost drivers early, helping brokers anticipate costs and recommend strategies to manage volatility.
  
  
• Respond faster. AI dramatically shortens quote turnaround times. Brokers and consultants can meet tight deadlines and improve responsiveness during RFP season.
  
  
• Help stand out from the crowd. Using advanced underwriting tools positions brokers and consultants as data-driven advisors - giving them a clear edge over firms still relying on manual methods.
  
  
• Operate more efficiently. AI automates and scales underwriting processes - freeing up time, reducing errors, and allowing time to serve more clients more effectively
  
  
• Offer more strategic value, moving beyond quotes. With AI-driven insights, brokers can guide clients toward smarter plan designs, cost-saving programs, and better risk management.

Why Brokers and Consultants Choose Gradient AI for Group Health Underwriting

Gradient AI’s SAIL™ solution gives brokers and consultants the insight they need to guide their clients more effectively and negotiate with greater confidence.

Gradient AI partners with brokers and consultants who need to:

• Improve visibility into group health risks
  
  
• Strengthen carrier negotiations with data-backed insights
  
  
• Deliver tailored recommendations for each client group

SAIL™ offers predictive analytics that helps fill in the gaps, especially when there’s limited claims history or the group includes a complex mix of covered individuals.

With Gradient AI’s SAIL™ solution, brokers and consultants can:

• Identify cost-saving opportunities: Share high-cost pharmacy data to explore PBM alternatives and manage spending more effectively.
  
  
• Improve stop loss strategies: Use predictive analytics to support smarter stop loss decision-making.
  
  
• Navigate business changes: Understand the impact of mergers and acquisitions on group risk.
  
  
• Project future claims: Use Gradient AI’s models to forecast risk and claims more accurately.
  
  
• Negotiate pricing with confidence: Bring deeper insights to your discussions with carriers.

“We use SAIL™ to give our clients better insight and a better prognosis into claims. Prior to using SAIL™, we could only look through the rear-view mirror at past claims data. Now we can look through the windshield to better predict what costs our clients can expect to incur. With the speed, quick turnaround, and insights we've gained, SAIL™ has more than paid for itself.”

– Chief Strategy Officer (and Gradient AI client), Employee Benefits Agency



A Clearer Picture of Group Risk

SAIL™ provides greater transparency into a group’s health profile. It helps brokers and consultants work with their clients to create solutions that are specifically aligned to their population’s needs. Gradient AI uses a combination of medical claims data, prescription and lab data, and machine learning-powered modeling

Together, these inputs deliver fast, reliable risk projections, even with minimal historical data.

Ready to Learn More?

Gradient AI can help you support better outcomes for your clients while staying competitive in a fast-moving market. To find out how SAIL™ can support your business, download our capabilities brochure, and get in touch with us today!

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