Members may not think they are talking to AI when they call their health plan, but the person assisting them might be.
Some insurers have been leaning into member-facing AI capabilities. One of UnitedHealth Group’s 1,000 AI use cases has been using chatbots to handle customer calls, with an AI chatbot initially responding to more than 65 million calls in 2024.
However, there has been a growing trend of AI quietly working behind the scenes on customer service calls, too. These tools aim to boost the member experience by increasing efficiency and accuracy.
Stellarus is a healthcare technology company that spawned from a Blue Shield of California restructuring. Along with its tie to Blue Shield of California, Hawaii Medical Service Association and Blue Cross and Blue Shield of Kansas signed on as Stellarus co-founders, signaling Stellarus’ deep footprint with BCBS plans.
The company just launched its AI-powered Customer Service Representative Chat for health plan staff. CSR Chat is the company’s first product in its Compass suite, an AI-driven engagement platform for health plans.
“CSR Chat helps put the right information in front of representatives at the right moment, enabling more consistent service, faster resolutions and better experiences for the people they support,” Vanessa Colella, PhD, president and CEO of Stellarus, said in a July 30 news release.
But health insurers themselves have been rolling out these functions for even longer. SCAN Health Plan was one early adopter.
SCAN first identified call center operations as an area that could benefit from AI integration in 2023. The insurer incorporated AI in its call centers through a partnership with AI company Cresta. The tool worked with call center employees on real-time transcription, automated notes and guided workflows. The tool also gave recommendations for handling member inquiries, including questions about supplemental benefits or switching primary care providers.
“I’ve been able to peek in on the calls and when the hints pop up, sometimes the member might say something like, ‘Wow, how did you know that?’ They seem delighted by some of the experiences,” Corinne Stroum, SCAN’s senior director of emerging technologies, told Becker’s in 2024.
SCAN’s tool also sought to address employee burnout.
“It’s a big workforce change, and we need to manage this as a process and a personnel change as well,” Ms. Stroum said.
Independence Blue Cross kicked off a similar pilot in February 2025 with more than 40 customer service representatives. The company’s AI tool lowered the number of steps representatives had to take to retrieve essential information and increased the share of customers who got solutions on their first inquiry. IBX documented a 90% success rate among its representatives and planned to scale the tool for at least another year.
Humana has entrenched itself more deeply with Google Cloud through its rollout of Agent Assist in 2025 and 2026. While operating in the background with Humana’s 20,000 member advocates, Agent Assist is designed to output real-time conversation summaries, predict member needs and surface relevant information. Google Cloud’s Vertex AI, Gemini and Gemini Enterprise for Customer Experience power Agent Assist.
In the Agent Assist announcement, Humana confirmed ongoing monitoring to ensure the tool’s compliance. The tool is an extension of Humana’s existing partnership with Google Cloud, building upon a collaboration for cloud infrastructure and AI resources in 2024.
A 2024 survey from advisory firm Gartner found 64% of customers would prefer companies not use AI in customer service, with their top concern being difficulty accessing a person. However, given the spike in health plans deploying AI behind the scenes rather than as customer-facing bots, insurers are betting AI use itself is not members’ main issue. Instead, it is about keeping a human on the line.
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