Nexgile-AgentiCare Hub
Nexgile-AgentiCare Hub is a cloud-based platform designed specifically for Taft-Hartley multi-employer trust funds, serving union members, employers, healthcare providers, and fund trustees. The portal integrates two core systems: BenefitDriven for benefits administration and SpyGlass for health claims processing.
Platform Overview
Comprehensive enterprise solution
Provider Directory - Healthcare Provider Search Interface
ID Cards Portal Interface
Nexgile-AgentiCare Hub documents page displaying member resources, guides, and healthcare benefit documentation
Hours Banking - Work hours tracking interface for union members
Digital Workers
Autonomous AI systems orchestrating multi-agent workflows
AI-Powered Healthcare Claims Adjudication System
Manual claims processing is slow, error-prone, and costly. Human reviewers struggle to consistently apply 750K+ CCI edits, detect sophisticated fraud patterns, and maintain compliance across HIPAA, ERISA, and ACA requirements while processing high claim volumes.
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Proactive Healthcare Coverage Risk Analysis System
Union members with variable work hours across multiple employers risk losing healthcare coverage without warning. Manual monitoring cannot predict coverage gaps or coordinate proactive interventions before termination occurs.
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Intelligent Retirement Application Processing System
Pension application processing requires complex service credit calculations across decades of employment, actuarial benefit computations, regulatory compliance verification, and document validation—traditionally taking weeks of manual review.
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Platform at a Glance
Comprehensive overview of capabilities, audience, and value delivered
Enterprise Capabilities
19 core functions
Member self-service through unified dashboard with real-time eligibility status and coverage details
Hours tracking across multiple employers with Hours Banking module
View claims history and download digital ID cards
Manage dependents and submit documents online
Secure messaging with fund administrators
Employer contribution reporting with bulk uploads and real-time validation
Payment scheduling and delinquency tracking with automated collection workflows
Reciprocity hour transfers between trust funds for cross-state work
Retirement benefit estimation with integrated calculator
Online retirement application submission and pension payment tracking
Real-time provider eligibility verification and electronic claims submission
Claims status checking and remittance information access
Executive dashboards with financial health metrics and enrollment trends
Claims utilization analysis and employer compliance status reporting
Regulatory reporting and population health insights
HIPAA, ERISA, and ACA compliance management with automated reporting
Trust fund financial management with bank reconciliation and audit support
Preventive care and chronic disease management programs through Wellness module
Automated notifications for eligibility changes, claims updates, and coverage terminations
Target Audience
7 stakeholder groups
Union members
Contributing employers
Healthcare providers
Fund trustees
Retirees
Fund administrators
Construction and trade union workers
Competitive Edge
8 key differentiators
Cloud-based platform designed specifically for Taft-Hartley multi-employer trust funds
Integrated dual-system architecture combining BenefitDriven and SpyGlass
Unified member self-service dashboard for comprehensive benefits access
Hours Banking module uniquely designed for variable-hour union workers
Reciprocity features enabling seamless hour transfers across state lines
SpyGlass claims engine with high auto-adjudication rates
Single integrated system supporting multiple user roles with role-based access
Purpose-built for the unique complexities of multi-employer union benefit plans
Value Proposition
10 key benefits
Real-time visibility into eligibility status and coverage details
Seamless multi-employer hour aggregation and tracking
Automated delinquency tracking and collection workflow initiation
High auto-adjudication rates reduce manual claims processing
Comprehensive regulatory compliance across HIPAA, ERISA, and ACA
Population health insights enable proactive cost containment
Secure communication channels between all stakeholders
Role-based access ensures appropriate data visibility for each user type
Late fee calculation and payment scheduling reduce administrative burden
Tax document access simplifies retiree financial planning