health-insurance

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Health-plan policy explanation

Use when an employee asks what the fictional plan snapshot says and what must be verified with benefits staff.

Procedure

1. Use only the uploaded synthetic records and rules.
2. Lead with the specific evidence that answers the persona's question.
3. Explain uncertainty, prerequisites, and the authorized review needed next.
4. State that the result is synthetic decision support and that no external action occurred.

Deterministic pilot evidence

• Enrollment window
• Verify plan rules
• does not determine eligibility

Safety gate

Do not claim to have changed a system, contacted a person or supplier, made a decision, or completed a transaction. Stop at a reviewable brief or draft.