The Problem

Emme tells members exactly what their healthcare will cost under their specific plan. Every calculation depends on a precise set of inputs—but we currently have no clean way to collect them. The core challenge isn't the data model; it's the front door. Healthcare is a subject most people approach with anxiety and learned helplessness. A form that feels like a standard medical form kills trust before we earn it. We need an intake experience that feels like a smart, reassuring first conversation—progressive, low-friction, with every question earning its place.

More context: https://www.uhc.com/understanding-health-insurance/how-does-health-insurance-work/explanation-of-benefits

Sample data: https://www.kentcountymi.gov/DocumentCenter/View/1459/BCBS-Understanding-Your-Explanation-of-Benefits-EOB-Statement-PDF

The Build

Core Flow Rule: Both paths must be available simultaneously. Start with upload, fall back gracefully to manual entry for any unextracted fields, and allow members to edit/correct pre-populated data. Members must also be able to skip document upload entirely.

Required Data to Collect

Category Fields to Capture
Identity Name, Email, Zip Code
Household Household Size, Income Range, Filing Status
Plan Details Carrier, Plan Name, Metal Tier, Plan Type (HMO/PPO/EPO/HDHP)
Cost-Sharing Deductible (Individual + Family), YTD Deductible Met, OOP Max, OOP Met YTD, Copays, Coinsurance, Monthly Premium
Documents SBC Upload, Most Recent EOB Upload (Optional/Skippable)
HSA HSA Eligible (Y/N), Current Balance, YTD Contributions, Employer Contribution
Prescriptions Drug Name, Dosage, Frequency, Payment Method (Cash vs. Insurance), Preferred Pharmacy
Upcoming Care Planned Procedures, Chronic Conditions, Pregnancy, Behavioral Health Needs

Acceptance Criteria & Requirements