Benewise is a navigation layer for the members you already cover — one place that reads all four layers of their coverage and answers, with receipts, the questions the fund office fields every day. Free to the member, forever.
So members guess — and every wrong guess is paid for twice.
Context trustees already know: the NYC Comptroller reports the Health Insurance Stabilization Fund's disposable balance was essentially depleted in FY 2024 — the cushion that used to absorb overruns is gone, and the MLC healthcare-savings mandate asks funds to find savings, not just administer benefits.
These are screens from the working demo — the same build your members would install — with what each answer does for the fund underneath.
Plan papers are read and answered on the member's phone. No PHI leaves the device — there is no Benewise server holding member health data to breach, subpoena, or sell.
Every dollar figure comes from a verified calculation engine reading published plan documents — never from a language model's guess. Each answer cites its source on screen.
Benewise books nothing, enrolls nothing, and takes no payment from any pharmacy, provider, or vendor it surfaces. The member track is free, forever.
A welfare fund's own book is its drug, dental, and optical benefit. Site-of-care savings land on the City program's ledger — the one the MLC mandate holds funds answerable to — and in the member's pocket. This model keeps the ledgers separate, and every input is yours to change.
Member copay deltas cite published NYCE PPO plan documents (Benewise extraction, 2026). Allowed-amount and ingredient-cost deltas are illustrative and editable — plan documents don't publish them; your fund's PBM and the City's data verify them at reconciliation, which is the point. Utilization rates are labeled assumptions.
| Who members have today | What it sees |
|---|---|
| Carrier portalThe plan's view of the plan | One layer — its own claims and network. Nothing about the fund, PICA, or agency benefits. |
| Fund officeTrusted, and stretched | The fund's benefits, in office hours — answering the same four-layer questions by phone. |
| PBM toolsThe drug layer only | A price, not the move — no plan context, no fund-vs-PICA routing. |
| Employer-gated navigatorsSold to employers, not funds | The employer is the customer. Nothing is built for a welfare fund's structure — or sold to one. |
| BenewiseBuilt for this structure | The only tool designed to cross all four layers — with a member track that is free, forever. |
Category characterizations; the named, feature-by-feature grid is at the comparison page.
Senior payer-side executive who designs pharmacy, quality, and risk programs for a living — building, on the member's side, the navigator the industry never shipped.
Nursing background; leads the clinical navigation verticals — surgical and ambulatory-surgery episodes, and maternity — so the app's guidance matches how care actually unfolds.
Healthcare-data compliance and HIPAA-grade infrastructure background, building the on-device architecture that keeps member data on the member's phone.
Benewise goes to your members free — no fund contract, no fund data, no fund cost. The fund sees a quarterly engagement report: activations, questions answered, documents covered.
When engagement is real, the fund can fund it for members — at a founding rate locked for founding funds. No share of savings, ever: savings verification is the deliverable, not our revenue.
The same engine, offered where the savings mandate lives — with founding funds as the proof. Founding funds keep the founding rate.
One flat founding rate — $2 per member per month, locked for founding funds, in writing. No tiers that creep, no per-feature upsells mid-contract. Early funds keep the founding rate as we scale.
No share of savings, ever. Calculating "attributable savings" is tedious and adversarial — it puts vendor math against fund math every quarter and taxes your staff to referee it. We charge a flat fee; the savings ledger is your deliverable, not our revenue. The only number at risk is 10% of our own fee.
We will not guess your book from the outside. Under a BAA and a data-sharing agreement, we model your population's actual claims and return a signed, assumption-by-assumption projection on your letterhead-ready terms. Without your data, we show the method — not made-up numbers.
Member-authorized claims connectivity (Flexpa) is a per-connection vendor cost, quoted separately at contract — never buried in the PMPM. And we say where it works today: Anthem and Cigna populations connect; original-Medicare retirees ride the CMS Blue Button; EmblemHealth and MetroPlus employer lines don't expose the data yet, and we tell you that up front.
The first transfer period after the NYCE PPO transition is exactly when members get lost. Benewise turns the choice into plain English — what changes, what it costs, which fund benefits ride along — before the window closes, not after the regret letter arrives.
Your fund's documents, your riders, your excess-spend concerns — drug-book pressure, out-of-network leakage, ER-instead-of-urgent-care — drive what the engine watches and what the member sees. This is configured per fund from your own papers, not a one-size template.
A non-binding LOI — so we build your fund's documents in first — and one fund-office contact to verify we read them right. That's the whole ask. The member launch is free either way.
For emergencies, members are always told: call 911 — on every care screen, every time.