Healthcare Multi-Employer Trust Fund Administration & Benefits Management

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.

Explore Digital Workers View Capabilities

System Status

Operational

3 Digital Workers

26 AI Agents

19 + Capabilities

AI Powered

Portal ID: Nexgile-AgentiCare Hub

Platform Overview

Comprehensive enterprise solution

The Hours Banking module tracks accumulated work hours that determine benefit eligibility—a unique requirement for construction and trade union workers whose hours fluctuate seasonally. Contributing employers report hours and submit contributions through a dedicated portal, with the Contribution Reporting module supporting bulk uploads, real-time v... The Hours Banking module tracks accumulated work hours that determine benefit eligibility—a unique requirement for construction and trade union workers whose hours fluctuate seasonally. Contributing employers report hours and submit contributions through a dedicated portal, with the Contribution Reporting module supporting bulk uploads, real-time validation, and payment scheduling. The system automatically tracks delinquencies, calculates late fees, and initiates collection workflows. The Pension module handles defined benefit and defined contribution plans with complex calculation engines. The SpyGlass claims engine processes medical, dental, vision, and disability claims with configurable rules achieving high auto-adjudication rates. The Compliance module manages HIPAA, ERISA, and ACA requirements with automated reporting, while the Accounting module handles trust fund financials, bank reconciliation, and audit support. A Wellness module promotes preventive care and chronic disease management programs. Integrated Messaging enables secure communication between all stakeholders, and the Notifications system alerts members about eligibility changes, claims updates, coverage terminations, and required actions. The platform supports multiple user roles with role-based access, ensuring members see their personal benefits, employers manage their contribution obligations, providers handle patient interactions, and trustees oversee fund operations—all through a single integrated system built for the unique complexities of multi-employer union benefit plans.

Platform Screenshots 4 images

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

AI-Powered Automation

Digital Workers

Autonomous AI systems orchestrating multi-agent workflows

3 Workers

26 Agents

24/7 Uptime

Digital Worker

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.

AI Agents

Orchestrator Agent ACTIVE

Eligibility Verification Agent ACTIVE

+ 6 more

8 Agents View Details

Digital Worker

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.

AI Agents

Multi-Employer Intelligence Agent ACTIVE

Risk Assessment Agent ACTIVE

+ 7 more

9 Agents View Details

Digital Worker

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.

AI Agents

Orchestrator Agent ACTIVE

Service Credit Auditor ACTIVE

+ 7 more

9 Agents View Details

Business Overview

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