AI Coverage Guide

Coverage Guide is the AI-assisted intake and organization layer for CoveredNYC. It helps users prepare for licensed broker review without pretending to make official eligibility decisions.

What it can do

  • Ask plain-language follow-up questions
  • Summarize coverage situations and notices
  • Create starter document checklists
  • Flag deadlines and complex issues
  • Route to individual, family, self-employed, small-business, mixed-household, NYC Care, or Medicare-referral paths

Human review guardrails

  • Licensed broker review before plan advice or enrollment support
  • Human escalation for urgent notices, Medicare, complex employer coverage, immigration-sensitive fears, or privacy concerns
  • No official eligibility decisions or guarantees
  • No hidden plan steering

Competitor lessons adapted

Inspired by AI benefit advisers, broker platforms, and health navigation tools, CoveredNYC should combine AI intake with local New York broker review, clear disclosures, and privacy-first design.

Try the screener foundation
AI safety rule: The AI guide should explain options and organize next steps. It should not say “you qualify,” “this plan is best,” “you are approved,” or “this will not affect immigration.”

Coverage Guide analysis preview

This AI-ready endpoint is rules-based in the ZIP until real API keys and production review are configured. It prepares a summary for broker review, not an official eligibility decision.

Internal AI reviewers

Coverage Guide is one simple front-end assistant supported by internal roles: eligibility path reviewer, plan comparison analyst, notice/deadline explainer, broker compliance guard, and licensed broker review queue.

Broker review required

AI may organize facts and checklist items, but final plan advice, quoting, and enrollment support require licensed/certified broker review where permitted.

Safety guard

The system flags unsafe wording like “you qualify,” “approved,” “guaranteed,” “best plan,” or “we represent every carrier.”