Breckpoint Enhances Underwriting and Risk Management with Gradient AI

Self-funded Insurance Provider Improves Accuracy, Efficiency, and Risk Projection for Employee Benefits Programs
BusinessWireSeptember 24, 20245 min

Gradient AI, a leading enterprise software provider of artificial intelligence (AI) solutions in the insurance industry, announced at the SIIA National Conference that BreckpointĀ®Ā has successfully adopted Gradient AIā€™sĀ SAILTMĀ SolutionĀ to enhance underwriting for its self-funded employee benefits programs. SAIL has helped Breckpoint improve risk assessment, leading to more accurate pricing and better financial outcomes.

Breckpoint, a self-funded insurance provider recognized for its advanced risk financing strategies and customized self-funding arrangements for employers and groups of all sizes, chose Gradient AI to refine its existing rating tools. Gradient AIā€™s SAIL Solution has created a stronger, more precise data driven process in underwriting and pricing. Powered by advanced machine learning algorithms and an extensive dataset composed of medical, prescription, and lab data, SAIL has provided Breckpoint with comprehensive insights into group health risks, significantly enhancing its medical loss ratio (MLR) performance.

Breckpoint implemented SAIL to better understand specific group risks and achieve several critical goals. These included filling data gaps for new business by accessing more detailed medical and pharmacy utilization reports, improving match rates for more accurate risk projections, and streamlining processes to accelerate quote turnaround times.

ā€œWe needed a tool that could significantly enhance our risk assessment capabilities, particularly in areas where detailed group-specific data was lacking,ā€ said Chief Revenue Officer Derek Atkinson, at Breckpoint. ā€œSAIL has helped us to better define risk, which is critical when underwriting populations that donā€™t have sufficient data. These insights have been invaluable in refining our risk assessment and pricing strategies.ā€

By providing more accurate risk assessments, SAIL has enabled Breckpoint to price its plans more precisely, leading to better overall financial outcomes. The insurer is able to price more aggressively and win more business when the risk is low, and price commensurately with higher risk to maintain its MLR goals. Atkinson noted that recent cases involving high-cost drug utilization and pivotal treatment status were impacted by Gradient AIā€™s technology. ā€œGradient AIā€™s tool provided the insight we needed. Combined with our thorough analysis with brokers and customers, the information allowed us to properly assess the risk involved and price accordingly.ā€

ā€œBreckpointā€™s successful adoption of SAIL is a testament to the value of advanced AI in underwriting and risk management,ā€ said Stan Smith, CEO of Gradient AI. ā€œWe support Breckpoint in its efforts to deliver more accurate and efficient insurance solutions that enhance the companyā€™s operational performance and client outcomes.ā€

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