For Benefits Administrators ·
What you'll accomplish
By the end of this guide, you'll have Claude set up with your actual employer plan documents uploaded — so when an employee asks "Is my physical therapy covered?" or "What's the out-of-pocket max for family coverage?", you can get an accurate, document-grounded answer in seconds instead of hunting through PDFs for 5 minutes. You'll also have a tool you can use to quickly train new HR staff on plan details.
What you'll need
What you should see: The main Claude chat interface with a Projects option visible in the left sidebar.
Troubleshooting: If you don't see Projects, try refreshing the page or clearing your browser cache. Projects is a Pro feature — make sure billing went through.
What you should see: A project workspace with a chat area and a sidebar showing Project Instructions and Knowledge sections.
What you should see: Each document listed in the Knowledge section. Claude can now reference these documents when answering questions.
Troubleshooting: If a PDF upload fails, try saving the PDF to a different format or re-downloading it from the carrier portal. Very large PDFs (100+ pages) may take longer to process.
You are a benefits Q&A assistant for [Company Name]'s HR team. You have access to our 2026 benefit plan documents including the SPD, SBCs, and carrier plan summaries.
When answering questions:
- Always cite the specific plan document and section where the information comes from
- Be specific about cost-sharing amounts (deductibles, copays, coinsurance, out-of-pocket maximums)
- If a question is about a specific employee's situation or requires interpretation, say so and recommend they contact HR or the carrier directly
- Do not speculate about coverage for situations not explicitly addressed in the plan documents
- When coverage depends on medical necessity or prior authorization, say that clearly
You are helping HR staff find accurate plan information quickly. You are NOT providing legal or medical advice.
Type a few test questions to verify the setup is working:
What you should see: Responses that cite specific plan document sections and give accurate dollar amounts matching your documents. If a response gives the wrong amount or doesn't cite a source, check that the relevant document uploaded correctly.
What you should see: Team members can now access the same project and get consistent, document-grounded answers.
What is the out-of-pocket maximum for [Plan Name] for an employee with family coverage?
Is [specific procedure or service] covered under our [Plan Name]? Does it require prior authorization?
How does our FSA work? What are the eligible expenses, the contribution limit, and the deadline to use funds?
An employee had a baby last month. What benefits changes can they make and what is the deadline?
What is the difference between our HDHP and PPO plans for an employee who takes a monthly specialty medication?