Who We Serve: Health Plans

Connected journeys. Clear costs. Smarter member decisions.

Members want clarity. Employers want value. Regulators want transparency. Opyn helps health plans meet all three with unified data, automated support, and seamless navigation across every touchpoint.

Why Health Plans Choose Opyn

Cut costs. Reduce friction. Protect retention.

Opyn helps health plans modernize high-volume interactions without adding head countor complexity. By simplifying service-heavy workflows and improving clarity across benefits, costs, and care navigation, plans can lower operating expenses and deliver a measurable lift in member and employer satisfaction.

Lower cost to serve
Fewer prior-auth andservice delays
Clear, predictable cost and coverage answers
Stronger employer and member retention
Better operational consistency and compliance

Featured Insight

Change Is Imminent, Are Health Plans Prepared for the Future?

Health plans are facing a major shift. With the rise of ICHRAs and self-insured models, are you equipped to adapt? Discover how innovation and AI can help you stay ahead.

Automate the Front Line of Your Provider Relations

Don’t let routine inquiries slow down your plan’s operations. Our AI Agent provides your network with 24/7 self-service for their most frequent questions. By delivering instant, accurate answers without a phone call, you remove administrative hurdles and allow your team to focus on high-value clinical outcomes.

Own the Experience, AI the Navigation

Provide a unified, white-label platform that connects members, employers, and brokers under your brand. Our AI assistant helps members self-navigate their health plans in real-time, reducing your administrative load by turning complex back-office workflows into seamless, automated experiences.

Compliance as a Competitive Edge

Turn transparency mandates into a member magnet. Our Transparency Solution powers intelligent provider search and care navigation—guiding members toward high-value, in-network options while reducing unnecessary spend.

Fully Integrated Virtual Care

Offer a seamless, connected ecosystem. Members can review benefits, check costs, and access 24/7 virtual primary + behavioral care—all within the same interface.

Supercharge operations and CSR efficiency
‍Streamline service with a human–AI hybrid model. AI handles routine inquiries and escalates only what your team needs to review.

Lower costs for members and plans
‍Intercept high-cost events early with AI-driven navigation. Guide members to the right, in-network care or instant $0 virtual visits.

Grow your client base with best-in-class tools
‍Give clients shared access to member data and insights. Our Opyn platform enables seamless collaboration across brokers and stakeholders.

Your brand, your team, your preferred benefit solutions
‍Make the platform your own with flexible branding and group-level configuration.

Go live in weeks, not months
‍Skip long implementations. We set up your book of business and train your team—delivering fast onboarding and faster ROI.