For Benefits Administrators ·
What you'll accomplish
By the end of this guide, you'll have a reliable workflow for turning carrier SPD language, insurance policy text, and legal plan document sections into clear, readable employee communications — using Claude Pro with the actual documents uploaded. What used to take a day of editing work takes 30 minutes, and the output is consistently more readable than what most HR teams produce manually.
What you'll need
You are a benefits communication editor helping rewrite insurance plan documents into plain English.
Rules:
- Preserve ALL specific coverage details: dollar amounts, visit limits, exclusions, prior authorization requirements
- Do not change the meaning of any coverage provision — if coverage is excluded, that must remain clear
- Write at 8th-grade reading level — short sentences, active voice, no jargon
- Replace industry terms: "Covered Charges" → "covered costs", "Medically Necessary" → "medically necessary (meaning your doctor has documented why you need it)", "In-Network Provider" → "an in-network doctor or facility"
- After each rewritten section, add a note: "[LEGAL REVIEW: Confirm meaning preserved]"
What you should see: A project workspace ready to receive sections to rewrite.
Start with the sections that generate the most employee questions. Common high-value targets:
Paste the section into Claude with a specific instruction:
Rewrite the following section of our SPD in plain English. Preserve all coverage limits, exclusions, and dollar amounts exactly. Target: 8th-grade reading level. Add [LEGAL REVIEW] flag after each paragraph where the meaning could be misread:
[PASTE ORIGINAL SPD SECTION HERE]
What you should see: A rewritten section with shorter sentences, clearer language, and [LEGAL REVIEW] flags where interpretation could vary.
Read both versions side-by-side. Verify:
If anything seems to have shifted in meaning, type: "In your rewrite, I want to confirm that [specific provision] still means [your interpretation]. If not, please revise."
As you complete sections, compile them into a single document. Structure it as:
Rewrite this health plan exclusions list in plain English. Preserve all specific exclusions exactly. Group related exclusions together under clear headings. Target: 8th-grade reading level.
[PASTE EXCLUSIONS LIST]
Rewrite this prior authorization section. Make it clear which services require pre-approval, how to get pre-approval, and what happens if they don't get it before receiving care.
[PASTE PRIOR AUTH SECTION]
Rewrite this mental health benefits section. Be clear about in-network vs. out-of-network coverage, session limits, and the mental health parity rules employees are entitled to. Plain English.
[PASTE MENTAL HEALTH SECTION]
Create a one-page glossary explaining these terms from our SPD in plain English: deductible, copay, coinsurance, out-of-pocket maximum, in-network, prior authorization, explanation of benefits. Use examples with dollar amounts.
Rewrite this prescription drug formulary section. Make it clear how the tier system works, what each tier costs, and when prior authorization is required.
[PASTE FORMULARY SECTION]