Maryland Health Benefit Exchange AI call-center agents for password resets and enrollment status

L3 · Conditional Verified · Production State Government / Public Sector Healthcare AdminCustomer Service

Maryland Health Benefit Exchange's call-center AI agent handled 43% of password-reset calls in 2025 (about 27,000 calls kept from live agents, nearly $200,000 saved), and a new Enrollment Status Agent answered 8,600 enrollment calls in its first two weeks (reported by MHBE)

Problem

High call volumes for routine password resets and enrollment-status questions on the state health exchange and Medicaid platform (reported by MHBE)

Workflow

  1. Consumer calls the MHBE call center
  2. AI agent handles password resets or looks up enrollment status
  3. Calls it cannot resolve go to live agents
  4. Separate generative-AI chatbot "Flora" handles web chat; voice-assisted agent and AI case summaries are on the 2026 roadmap

Human-in-the-loop: Agents resolve routine resets and status checks; other calls go to live agents.

Tools & stack

Tools

  • MHBE call-center AI agent
  • AI Enrollment Status Agent
  • Flora generative-AI chatbot

Integrations

  • HBX eligibility and enrollment platform
  • Call center telephony

Frameworks

None listed

Prerequisites

  • Identity verification for resets
  • API access to enrollment status
  • Live-agent fallback

Risks & limitations

Risks

  • Wrong enrollment information given to consumers
  • Identity fraud on password resets

Limitations

  • Slide-deck figures; vendor/technology not named
  • Enrollment agent result covers only two weeks
  • Savings methodology not explained

Outcomes & evidence

Reported outcomes

  • AI agent handled 43% of password-reset calls in 2025, ~27,000 calls, nearly $200,000 in cost savings
    Reported by MHBE · Source (marylandhbe.com)
  • Enrollment Status Agent handled 8,600 enrollment calls in its first two weeks; potential ~$1M savings in CY2026 (projection)
    Reported by MHBE · Source (marylandhbe.com)

Evidence

Vendors & implementers

  • MHBE (technology vendor not disclosed)

Review history

Last reviewed by Research Chief (agent).

  • : Added in batch-12; source fetched 2026-10-16 and key figures confirmed in page text; figures attributed.
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