How Agentic AI Is Redefining the Employee Benefits Experience 

Sofia, Businessolver’s AI-powered benefits assistant, is redefining how employees and HR teams interact with their benefits.

AI in benefits isn’t new—in fact, we’re pretty sure you’ve read at least one article in the past month about how AI is changing benefits administration. While this topic might feel like the latest media trend, it’s an important one HR should be thinking about as part of their overall benefits strategy.  

At Businessolver, AI is embedded into everyday moments, interactions, and decisions. Powered by a ‘constellation’ of purpose-built agents, our Sofia Adaptive Intelligence engine is transforming the benefits experience across every stakeholder. Built on an agentic AI framework, Sofia delivers personalized, intelligent, and proactive support across the entire benefits journey. 

What exactly is agentic AI?  

Agentic AI refers to intelligent systems made up of multiple specialized agents—each built to carry out a particular function, often in coordination with one another. Agentic AI enables dynamic, personalized, and multi-step engagement.  

You might be picturing a chatbot answering questions. But agentic AI transforms the chatbot experience into a holistic and intelligent information gathering and delivery experience. Not only will the AI answer your question, virtual assistants powered by agents will pull in the right data, surfaces related topics or programs you hadn’t considered, and packages everything you need into one seamless, proactive interaction.

In the world of benefits, this means: 

• Faster and more accurate answers to employees’ benefits questions 

• End-to-end issue resolution 

• Improved year-round engagement and enhance utilization of meaningful benefits 

• Work reduction and strategic insights and real-time data for HR teams 

Sofia is built on this agentic model. It’s not one AI, but a constellation of intelligent agents working together across voice, web, chat, mobile and more. Each agent is purpose-built to support a different part of the benefits journey.  

Here are a few examples of how Sofia’s agentic AI capabilities support the entire benefits delivery experience. 

Personalizing benefits guidance at critical moments 

When members log in to their Benefitsolver platform and chat with Sofia, they’re being supported by several agents to get the help and guidance they need with their benefits. 

• The Intake Agent assesses each question in real time, identifying urgency, clarifying ambiguities, and applying contextual safeguards. The intake agent doesn’t just interpret questions, it helps ensure they’re handled appropriately. The intake agent can determine, in real-time, whether to clarify, escalate, deflect, or proceed. By applying built-in safeguards, it identifies questions that fall outside the scope of benefits support, recognizes critical situations requiring human intervention, and enhances inputs with contextual signals for more accurate downstream handling. 

• The Answer Agent draws on member data, plan documents, eligibility rules, and timing to deliver precise, personalized responses. With more than 1.7 million unique questions resolved annually using Sofia’s chat function, the answer agent drives 90% same-day resolution and 83% sustained resolution after 7 days, enabling members to take informed action with clarity and trust. The Answer Agent is powered by a hybrid retrieval system built to scale with Sofia’s growing intelligence. 

For both of these agents, Sofia leverages RAG, retrieval augmented generation, to enhance our ability to extract information from documents and personalize responses for members. RAG is just a fancy way to say, Sofia is able to take content from existing client documents (e.g., plan documents, FAQs) and use it as data to improve both accuracy and relevance of her responses. Another way you may have heard this referred to is context engineering. Simply put, Sofia is doing a lot behind the scenes to piece together the context the user needs to support their question.  

Delivering a better service experience 

Sofia supports the full end-to-end caller experience. Whether she is providing self-service on the phones through an automated voice experience or supporting our advocates, Sofia is driving a personalized and thoughtful experience through our call center.

Here’s how Sofia’s agents support our advocates when a member calls in: 

• Personalized Voice Experience and Routing: Sofia’s conversational instruction is the first thing that greets the member upon calling. By serving as a more intelligent front door to the call center, Sofia helps members get the answers they need faster, without waiting in queues or navigating frustrating menu trees. For those with quick or common questions, Sofia delivers immediate support. And for more sensitive, high-touch situations, she ensures members are seamlessly connected to a live advocate who’s better equipped to focus help the member find an answer or resolution. 

• Real-time Call Center Support: Sofia’s AI works alongside advocates during live interactions, triaging inquiries, retrieving relevant data instantly, and offering real-time guidance to support first-call resolution and reduce repeat contacts.  

As organizations continue to look for ways to streamline operations and support a more empowered workforce, agentic AI represents a meaningful step forward — not just in technology, but in how we serve people.