Copy the previous year's template and manually update every plan, tier, benefit and rule.
For Third-Party Administrators
Your plan docs are costing you
Your plan docs are costing you
more than you realize.
A 200-plan TPA wastes 1,600+ hours every year rekeying data, chasing employer approvals, and fixing claim errors caused by outdated documents. That’s $56K/year you could stop spending—starting now.
SOC 2 Type II · ERISA-aligned · Trusted by TPAs and self-insured plans
Word document
Unstructured prose
Structured plan
Editable, versionable, reusable
PlanPPO Gold 2026
TierIn-Network
BenefitMRI / MRA Outpatient
Cost Share20% after deductible
ExclusionsCosmetic, item 11
EligibilityActive, 30-day wait
Prior AuthorizationRequired over $1,000
Limits20 visits per year
A Word document becomes data your team can actually work with.
Compliance and certification
SOC 2 Type II certified
HIPAA-minded by design
Built for ERISA recordkeeping
The Old Way
A new plan year shouldn't mean starting over.
Copy, paste, email, repeat.
Every year, plan updates get trapped in Word templates and lost in comment threads. The final headache? Manually converting that document so your claims system can actually read it.
It works.
It just takes far too much work.
Where the manual process costs time
Email documents to employers, consultants, legal and other approvers. Wait. Follow up. Repeat.
Compare versions by opening documents side by side and hunting through pages and tables.
Once everyone finally agrees, the approved plan still has to be translated into the systems that run the plan.
Save time. Save complaints. Use SmartPlanDoc.
Where the Money Goes
A 200-plan TPA loses $56,000 every year to manual plan document work.
These aren’t estimates. They’re the six recurring cost categories that TPAs report when they benchmark their own operations — before SmartPlanDoc.
Annual Plan Renewal Rekeying
Staff manually re-enter benefit data, cost-share rules, and coverage limits every renewal cycle — often across 200 separate documents from prior-year Word templates.
26.4% of total waste
Eliminated with SmartPlanDoc
Employer Review & Approval Cycles
Each round of employer feedback requires exporting a new document version, emailing it, waiting for replies, reconciling comments, and re-exporting. Average 3–4 rounds per plan.
23.6% of total waste
Replaced by in-app workflow
Claim Rework from Document Errors
Adjusters running claims against stale or mismatched plan docs trigger denials, appeals, and manual overrides. Each rework incident averages 45–90 minutes of staff time.
20% of total waste
Prevented at source
ERISA Compliance & Audit Preparation
DOL audits require current SPD versions, SMM tracking, and participant distribution proof. Without a structured audit trail, TPAs spend days reconstructing records under deadline pressure.
11.4% of total waste
Automated audit trail
Mid-Year Amendment Processing
Carrier updates, regulatory changes, and employer requests trigger mid-year edits. Each amendment must be manually propagated across all affected document versions and re-distributed.
10% of total waste
Single-edit propagation
Document Version & Distribution Control
Tracking which employer has which version, ensuring the right SPD reaches participants, and maintaining proof of delivery is a constant coordination burden across email and shared drives.
8.6% of total waste
Centralized & tracked
Total Avoidable Cost · 200-Plan TPA · Per Year
$56,000 / yr
Across 1,600+ hours of staff time per renewal cycle
Typical Recovery with SmartPlanDoc
$34K – $42K / yr
How SmartPlanDoc addresses ERISA compliance
ERISA requires plan sponsors and TPAs to maintain current Summary Plan Descriptions, track Summary of Material Modifications, and prove timely participant distribution. SmartPlanDoc creates a versioned, timestamped audit trail of every document approval — who reviewed it, when they approved it, and what version participants received. During a DOL audit, that record is one export, not a multi-day reconstruction from email archives.
A Better Way
One plan. One workspace. One version of the truth. SmartPlanDoc.
SmartPlanDoc replaces the scattered tools and handoffs around plan documents with one connected workspace.
Your plan starts as a document. It becomes structured data.
Your team works on the plan itself, not another Word file.
Edit benefits, tiers, cost share, eligibility, exclusions, limits and prior authorization without rebuilding a document.
Send an employer or approver into the exact plan version that needs review. Comments stay attached to the benefit or service they refer to.
Create the next plan year from the previous version instead of starting with a blank Word document.
The SmartPlanDoc Lifecycle
From last year's document to next year's live plan.
SmartPlanDoc connects the work that used to happen across Word, email, spreadsheets and downstream systems.
The six lifecycle stages
- Ingest
- Build
- Review
- Approve
- Generate
- Deploy
01 - Ingest
Upload the plan document you already have.
SmartPlanDoc reads the .docx and structures plans, tiers, benefits, services, exclusions, eligibility, limits and prior authorization requirements.
02 - Build
Start from the existing plan and make the changes for the new year.
Clone a version, change cost share, add or remove benefits, update tiers and modify plan rules.
03 - Review
Send the plan to the people who need to review it.
Comments stay attached to the exact benefit, service or rule they refer to.
04 - Approve
Once everyone agrees, the plan can be approved and electronically signed.
The approval history, comments and version stay together.
05 - Generate
Generate the documents your group needs.
Use your templates to produce SPD, SOB, SBC and other plan documents using approved plan data.
06 - Deploy
Map, validate and move the approved plan into the claims environment.
Benefit and service codes are mapped, the plan is validated, and the approved plan is built into the TPA's claims adjudication environment.
Changes requested, back to Review
TPA Plan Build
Map every benefit to its codes. Build a plan claims can actually adjudicate.
The Plan Build module connects your structured plan data directly to the claims environment — mapping each benefit to CPT, HCPCS, ICD-10 and CDT code ranges, validating coverage rules, and deploying a plan that adjudicates correctly from day one.
Every benefit mapped. Every code validated. No guesswork.
SmartPlanDoc displays all plan benefits — Medical, Dental, Vision — and flags each one until its code ranges are mapped and confirmed. A live progress counter shows exactly how far through the build your team is, and the "Show unmapped only" filter keeps focus on what remains.
- ✓ Supports CPT, HCPCS, CDT, ICD-10-CM, MODIFIER and ESRDCB code types in one mapping panel
- ✓ Code ranges (From / To) cover broad procedure families with a single mapping row
- ✓ In-Network and Out-of-Network coverage rules set per benefit at the code level
- ✓ Linked document rules — Exclusions, Eligibility, Limits, Prior Auth — attach directly to each mapped code
- ✓ Status moves automatically from CodeMappingPending to Complete when all benefits are mapped
One panel. Every code type. From ICD-10 to CDT.
Click any benefit to open the code mapping panel inline. Select the code type, enter the code range, set cost share by tier, and attach the plan document rules that govern this benefit — all without leaving the page.
Code Types
CPT · HCPCS · CDT
ICD-10-CM · MODIFIER
ESRDCB · HPCSSIG
ICD-10-CM · MODIFIER
ESRDCB · HPCSSIG
Document Rules
Exclusions · Eligibility
Limits · Prior Auth
attached per code
Limits · Prior Auth
attached per code
Coverage Tiers
In-Network and
Out-of-Network COVERED
set per code row
Out-of-Network COVERED
set per code row
Exclusions
Per-code exclusion
checkbox keeps specific
codes out of coverage
checkbox keeps specific
codes out of coverage
Plan Build Status
77 benefits mapped
Status: Complete — ready to deploy
100%
Benefits Mapped
7
Code Types Used
0
Errors / Warnings
Day 1
Clean Adjudication
The Platform
Everything around the plan document, in one place.
The AI reads the document before your team touches it.
Upload last year's .docx. SmartPlanDoc extracts your plan data in minutes — and flags errors that would have caused claim denials before a single staff member opens the file.
- 178-page documents processed in under 10 minutes — plans, tiers, benefits, exclusions, limits, and prior auth rules extracted automatically.
- AI catches document errors automatically — malformed EINs, corrupted benefit text, wrong page numbers in the table of contents, invalid phone numbers.
- Errors surface before adjudication, not after a member gets wrongly denied and appeals.
Your staff reviews what matters. The AI handles the rest.
AI Ingest Summary · ABC Staffing, 2026 SPD.docx
178 pages43 tables · 4 plans extracted
8 min 13 sec
AI flagged before your team opened the file
Malformed EIN'45-556756' has 8 digits, not 9 — IRS requires 9
Error
Corrupted benefit titleCover page reads 'enrollmentHealth' — merged text
Error
TOC pagination mismatchTable of contents page numbers broadly incorrect
Warning
Invalid phone numberCustomer service number has too many digits
Warning
All flagged before a claim is ever submitted against this plan.
Make changes to the plan, not the Word document.
Change cost share. Add a tier. Modify an exclusion. Update eligibility. Change a prior authorization rule. Save it as a new version while the original remains intact.
- Clone any version to launch a new plan year from your last approved baseline.
- The root version stays untouched, preserving a permanent source of truth for compliance and auditing.
- Edit granular details at any level—from entire plan structures down to a single copay or rule.
Keep the source. Build the next version. Know exactly what changed.
Version history · Acme Manufacturing
v1 · Source documentIngested from 2025 SPD.docx
Root
v2 · 2026 plan yearCloned from v1, approved
Approved
v3 · Mid-year amendmentBehavioral health benefit added
Approved
v4 · 2027 plan yearCloned from v3, in progress
Draft
Primary Care Office Visit
$25 copay$30 copay
Review the plan without the email chain.
Share a secure review link with employers, consultants, legal counsel, or other stakeholders. Approvers read the plan and leave inline comments directly on the exact benefit rules they want changed.
- Comments, change requests, and approvals stay centralized inside SmartPlanDoc.
- Real-time status tracking lets you see exactly who has responded and who's holding up approval.
- Reviewers don't need an account in your system to review the plan.
"Change page 14" becomes "Change this benefit."
Reviewer comment, as it lands internally
"Out-of-network coinsurance should be 50% after the out-of-network deductible."
J. Whitfield · attached to MRI / MRA Outpatient · Aug 2, 11:47
Internal complianceApproved
Outside counselApproved
Benefits consultantChanges asked
Plan sponsor e‑signatureWaiting
See exactly, instantly, what changed between plan years.
No more opening two Word documents and hunting. SmartPlanDoc highlights changed, added, removed, and renamed items at the exact benefit level.
- Compare at the plan, benefit, and rule level, never page by page.
- Pinpoint cost shares and rule updates with clear, automated visual callouts.
- Track renamed items accurately, avoiding false "delete and add" noise to reconcile manually.
$25 → $30 isn't buried on page 47. It's right in front of you.
Comparing v3 with v4
Primary Care Office VisitIn-network cost share
$25$30
Annual Deductible, In-NetworkAmount
$1,500$1,750
Virtual Behavioral HealthNew benefit
Added
MRI Outpatientnow "MRI / MRA Outpatient"
Changed
Routine Foot CareExclusion
Removed
Get answers from the plan — instantly, with citations.
Ask any compliance or coverage question in plain English. SmartPlanDoc searches the actual plan document and returns an answer with the exact section and page that backs it up.
- Compliance staff and claim reviewers stop hunting through 200-page PDFs — the Advisor finds the relevant section in seconds.
- Every answer is cited to the exact plan section, so you can verify it yourself before acting on it.
- Works across multiple plan docs — ask about the 2025 plan and the 2026 plan in the same conversation.
The right answer in 10 seconds. Not the right document in 20 minutes.
Plan Doc Advisor · ABC Staffing, 2026 SPD
Is chiropractic covered for a PPO member with an unmet deductible?
Yes — chiropractic is a covered benefit under the PPO plan, subject to the in-network deductible and a 20% coinsurance after the deductible is met. Prior authorization is required for visits exceeding 20 per plan year.
Source: Section 4.3, p. 47 — "Chiropractic & Spinal Manipulation" · Prior Auth Schedules, Appendix B
Full conversation history is retained and searchable for each plan document.
Build the data structure once. Generate every document in seconds.
Store your custom templates for SPDs, SOBs, and SBCs. Once a plan is approved, SmartPlanDoc automatically populates your templates using live plan data to generate polished, finished .docx files.
- Manage custom templates for Summary Plan Descriptions, Schedules of Benefits, and Summary of Benefits and Coverage in one place.
- Generate from approved plan data, eliminating manual copy-pasting and formatting work.
- Consistent output every time, because the same plan data drives every document.
Faster to produce, more accurate every time. The template controls the presentation, the plan controls the data.
Generating from an approved plan
Approved Plan
PPO Gold 2026 · v3
SPD Template
SOB Template
SBC Template
2026 SPD.docx
2026 SOB.docx
2026 SBC.docx
The plan doesn't stop at the document.
Map benefits and services to the codes your claims system needs. Validate the plan against example claim scenarios before it goes live. Then move the approved plan into the claims adjudication environment.
- Benefit and service code mapping against current code sets and code sources.
- Validation against example claims, so problems surface before the plan is live.
- Build into the claims environment without re-keying the plan a second time.
The exact plan your team reviewed is the exact plan your claims system receives.
From approved plan to live plan
- Plan
- Code Mapping
- Validation
- Claims System
- Live Plan
Validation runs against example claim scenarios while the plan is still being built.
Try It Yourself
What your reviewer sees.
No training. No login portal. No email attachments. Open the plan, comment and approve, all in one place.
Reviewer View, Acme Manufacturing 2026 Plan
- Open your link
- Review the coverage
- Sign off
Open your link
To jordan@smartplandoc.com
From SmartPlanDoc
From SmartPlanDoc
Acme Manufacturing has routed a plan document to you for review
Jordan, the 2026 plan document is in your approval queue. This link is personal to you, protected by a one-time code, and expires in 14 days. No account needed.
Protected by one-time verification so forwarded links can't be misused. Send to legal, plan sponsors, and actuaries simultaneously, each receives a unique link and independent audit trail.
Review the coverage
Document information
- Employer
- Acme Manufacturing
- Document
- 2026 SPD
- Version
- Version 3
- Effective
- Jan 1, 2026
Summary of benefits, PPO Gold 2026
Comment on any row. Notes collect on the right and submit as one batch.
| Service / Benefit | In-Network | Out-of-Network | Comment |
|---|
No comments yet, you can approve as-is, or leave notes first.
Sign off
Back in SmartPlanDoc, every comment automatically syncs to its exact benefit, timestamped and fully attributed to the reviewer who left it.
See It Live
Working in SmartPlanDoc.
No abstract diagrams. No stock illustrations. Just the tools your team uses to build and manage a plan.
Plan Editor
Edit cost share, tiers, benefits and rules directly. This is the plan itself, not a Word document.
Every benefit, side by side across versions. The one real change, Non-Emergency Air Ambulance from Not Covered to a $250 copay, is flagged for you.
Reviewers comment on the exact benefit, and every approval is timestamped and e-signed. Nothing advances silently.
Pick the document type and template, then generate. The template controls the presentation. The plan controls the data.
Every benefit shows whether it has codes yet. Unmapped benefits are flagged before the plan is built, not after it goes live.
Plan Doc Advisor
Ask the plan. Get the answer — with the exact page.
Instead of hunting through a 200-page PDF, ask Plan Doc Advisor in plain English. It reads the live, approved document and returns a precise answer citing the section and page that backs it up — in seconds, not minutes.
Plan Doc Advisor · ABC Staffing, 2026 SPD
Ready
Choose a coverage question
Each answer draws from the live, approved 2026 SPD — the same document adjudicators use, not a shared-drive PDF from last year.
Answer with citations
Choose a question on the left
The answer — with section and page citations — appears here.
Every answer cites the exact section and page. Your team goes straight to the source — no manual searching.
CSR Coverage Lookup
A member calls. Your CSR has the answer in seconds — not after 20 minutes on hold.
When a member calls to ask "is this covered?", your customer service rep selects the group, asks the question in plain English, and gets an answer sourced directly from that group's approved, current plan document — with the exact section and page that backs it up.
CSR Coverage Lookup
Ready
1 · Select a group
2 · Ask a coverage question
Coverage answer
Select a group, then ask a question
The answer — drawn from that group's approved plan — appears here with the page and section citation.
No more "let me check and call you back." The right answer for the right group's plan — in seconds, not minutes.
Claim Advisor
Real-time adjudication guidance — from the current, approved plan.
Because the plan is structured data, you can test it against claim scenarios during build and use it as a live reference during adjudication. Pick a claim and a plan version to see exactly how it resolves — and why.
Claim Advisor
Ready
1 · Select an example claim
2 · Validate against
Two approved 2026 plans for Acme Manufacturing. The same claim can land differently on each, which is exactly what you want to catch before the plan is live.
Plan rules checked
Validation trace
Decision
Nothing run yet
Choose an example claim on the left. The outcome, the plan rule that produced it and the AI second opinion appear here.
Your plan rules decide. The model advises. It can agree or raise its hand, never override.
AI, Where It Helps
AI does the heavy reading.
AI does the heavy reading.
Your team stays in control.
SmartPlanDoc uses AI to read existing plan documents, catch errors before they reach claims, answer coverage questions instantly, and surface things your team needs to see — without replacing the human decisions that matter.
- Processes a 178-page plan document in under 10 minutes — extracting 43 tables and 4 plans, structured and ready for review.
- Catches document errors before adjudication — malformed EINs, corrupted text, wrong page numbers, invalid phone numbers — flagged automatically on ingest.
- Answers plan questions in plain English, cited to the exact section — so a compliance question takes seconds, not a manual search through 200 pages.
- Provides a second opinion on adjudication, so your claim reviewers have a check against the current plan language — not a cached version from last quarter.
AI helps approve the plan, faster and more accurately.
It helps manage benefits, so your team isn't buried in manual updates.
The final decision stays with the people who own the plan.
Security & Auditability
Every change has a history
Every version, comment, approval, signature and publication is recorded against the plan. When someone asks what changed, who changed it and when it was approved, you have the answer.
Versions, edits, comments, approvals, signatures and publications each carry a timestamp and an owner.
Reviewers hold no standing account. One link, one person, one plan version, verified per session by a one-time code.
A separate workspace and a separate database per client organization. Nothing co-mingles.
Every request is signed and tied to the browser that issued it (DPoP, RFC 9449). A stolen token alone is useless.
Certifications and regulatory alignment
Decision Tree Consulting, which builds and hosts SmartPlanDoc, holds an independently audited SOC 2 Type II report covering Security, Availability and Confidentiality.
Encrypted at rest and in transit, role-based minimum-necessary access, and every action written to an audit log.
Every prompt is scrubbed of HIPAA-protected health information before it goes to AI for analysis. Member names, IDs, dates of birth and other identifiers never reach the model.
Version history, timestamped sponsor sign-off and plan-to-document traceability support the recordkeeping and disclosure practices ERISA and ACA plan administration require.
Free Savings Estimate
See exactly how much your TPA is leaving on the table.
Tell us your plan count and we’ll model your specific ROI—average hours recovered, admin cost reduction, and payback timeline. No obligation, no sales pitch.
- Personalized to your plan count & team size
- Response within one business day
- Trusted by TPAs and self-insured plans and self-insured plans
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