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Streamline open enrollment and new hire benefits processing. Extract medical, dental, vision, and life insurance selections along with dependent information and coverage tiers. Validate elections against plan rules and flag incomplete enrollments.
benefits-enrollment.pdf
Viewer
JSON
employee_name
Jennifer Adams
employee_id
EMP-00789
enrollment_reason
New Hire
effective_date
2024-03-01
medical_plan
plan_name: PPO Gold, coverage_level: Employee + Family, monthly_premium: 650
dental_plan
plan_name: Delta Dental PPO, coverage_level: Employee + Family, monthly_premium: 85
vision_plan
plan_name: VSP Choice, coverage_level: Employee + Family, monthly_premium: 25
life_insurance
basic_coverage: 1x Salary, supplemental_coverage: 2x Salary, monthly_premium: 45
Dependents
2 items
name
relationship
date_of_birth
ssn_last_four
Michael Adams
Spouse
1988-07-22
4567
Emma Adams
Child
2015-03-10
8901
fsa_election
2500
employee_signature
[Signed]
signature_date
2024-02-15
benefits-enrollment.pdf
Viewer
JSON
employee_name
Jennifer Adams
employee_id
EMP-00789
enrollment_reason
New Hire
effective_date
2024-03-01
medical_plan
plan_name: PPO Gold, coverage_level: Employee + Family, monthly_premium: 650
dental_plan
plan_name: Delta Dental PPO, coverage_level: Employee + Family, monthly_premium: 85
vision_plan
plan_name: VSP Choice, coverage_level: Employee + Family, monthly_premium: 25
life_insurance
basic_coverage: 1x Salary, supplemental_coverage: 2x Salary, monthly_premium: 45
Dependents
2 items
name
relationship
date_of_birth
ssn_last_four
Michael Adams
Spouse
1988-07-22
4567
Emma Adams
Child
2015-03-10
8901
fsa_election
2500
employee_signature
[Signed]
signature_date
2024-02-15
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