Case Study: Smart Employee Benefits achieves flexible, agile health plan adjudication with FICO Decision Management Suite

SEB Brings Flexibility and Agility to Health Plan Adjudication with FICO® Solution

SEB (Smart Employee Benefits), a health-plan technology specialist, faced a common industry challenge: claims-adjudication logic was hard-coded into software, making plan customization slow and dependent on IT. This limited SEB’s ability to offer individualized plans and to respond quickly to market or customer changes.

By embedding the FICO Decision Management Suite into its adjudication platform, SEB empowered business users to edit decision rules directly without new IT development cycles. The result is a more flexible, agile solution that supports individualized customer offerings, faster market responsiveness, and a stronger competitive position for expansion and new services.

Smart Employee Benefits

Rohan D'Souza

Smart Employee Benefits