Value Add Programs

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Value Add Programs (VAP) is a feature within Guide for Payers that surfaces relevant supplemental care programs alongside or above provider search results, based on a member's keyword search and plan eligibility.

The key distinction: this is not a static list of programs the member is eligible for. It dynamically surfaces the right program at the moment the member is searching for that type of care connecting members to benefits they may not know they have, at exactly the right point in their search journey.

Why it matters: Health plans invest heavily in preventive and alternative care programs disease management, care gap closure, virtual care that are often low cost to the plan but result in high savings. The problem is members don't always know these programs exist, or understand when they're relevant to them. VAP closes that gap.

Example: A member searching for a back surgeon will also see virtual physical therapy surfaced alongside results because the plan would prefer the member try preventive care first, with better outcomes and lower costs for both parties.

Capabilities

CapabilityDetails
Program types supportedProgram, Education, Condition Management, Virtual Care, Other
Data intakeProgram data provided via Benefits API integration or CSV file, including program name, description, enrollment links, and clinical keywords
Keyword-based matchingPrograms are matched to member search terms via configurable clinical keywords; exact matches take priority over partial matches
Eligibility targetingPrograms can be scoped to specific product codes and group IDs, or made available to all members
Member actionsEach program can support a Learn More link, an Enroll link, or both
Custom brandingEach program displays its own logo and description; a default logo is used if none is provided
Authenticated and public usersAvailable to both logged-in members and unauthenticated (public) users, based on eligibility configuration
Display logicOnly the top-matching program is displayed at a time; exact keyword matches take priority over partial matches
Managed content entriesProgram names, descriptions, and logos can be managed as reusable content entries for easier updates
Enablement scopeVAP can be turned on at the tenant level or for specific groups

How It Works

The health plan provides their supplemental benefits program information including program name, description, enrollment links, and clinical keywords via a Benefits API integration or CSV format (see example attached). Each program is tagged with clinically relevant terms. When a member searches for care matching those terms, the eligible program surfaces dynamically in the search results.

  1. Program Definitions — All available programs, including names, descriptions, logos, keywords, and enrollment links
  2. Eligibility Rules — Mapping of which programs are available to which product codes and group IDs
  3. Feature Enablement — Configuration flag that turns VAP on for your tenant or group

File Definitions Requirements

The program definitions file is a CSV you provide to configure which supplemental programs are available in the search experience. Each row defines one program. Below is a walkthrough of the fields using real examples. See attached for sample-eligible-benefits-setup.csv. Email to Kyruus when completed.

File #1: sample-eligible-benefits-setup.csv

FieldWhat It IsNotes
resourceIdA unique identifier for each program rowMust be unique across all rows. Use a UUID generator if the client does not provide one.
resourceNameThe display name of the program shown to the memberCan be a plain text value or a ref: content key (e.g. ref:my-program-name) for managed content.
resourceTypeThe category of the programMust be one of: Program, Education, Condition_Management, Virtual_Care, Other
keywordsComma-separated search terms that trigger this programMinimum 3 characters per keyword. These are matched against what the member types in the search bar.
resourceDescriptionThe description shown to the member when the program surfacesCan be plain text or a ref: content key. Using a content key makes future copy updates easier.
programLogoLinkURL or content key for the program logo imageOptional. A default logo is used if omitted. If using a content key, set Display to Image in Hub.
linkToAccessResourceThe Learn More destination URLRequired. This is the link members click to learn more about the program.
linkToEnrollmentResourceThe Enroll destination URLOptional. If provided, an Enroll button is shown alongside Learn More. Leave blank for programs without direct enrollment.

File #2: sample-benefit-definitions-for-ref.csv

FieldWhat It IsNotes
productcodeA unique identifier for each product code

String. We will allow an empty string or null or “all”. Given a groupId, row with empty productCode is used as a catch-all for all product codes - this enables benefits for any product code.

If a different set of benefits are needed for a productCode, add a new row to the eligibility file for your product code , and those benefitIds.

groupidThe display name of the program shown to the memberComma Separated Strings. We will allow an empty string or null or “all”. To support  an empty string or null or “all” , add a row of null,all, for the groupId.
benefitsidsThe category of the program

Comma Separated Strings. benefitIds value are to be copied from resourceId of the definition file.

  • To match all benefitIds - enter all in the column.

  • empty benefitIds value implies that no benefit is available for that productCode and groupId combination.

  • If there are multiple rows with same productCode and groupID combination and different benefitIds, a union of the specified benefitIds will be eligible for keyword match.

  • For above scenario, if one row has specific benefitIds , and other row has “all” for benefitIds - all the defined benefits from definition file will be eligible for keyword match.

How It Fits in Guide for Payers

Value Add Programs is one component of the Guide for Payers suite:

  1. Value Add Programs / Supplemental Benefits — ready to activate
  2. Ask (conversational search) — frequently bundled, available as a standalone product
  3. Future state: Clinical summaries, care gap dashboard, member-facing personalized experience, advanced ranking.

Frequently Asked Questions

How many programs can we configure?

There is no hard limit on the number of programs you can define. You can configure as many programs as your benefit catalog requires. Only one program will be surfaced per search at a time the one that best matches the member's search term and eligibility.

Can we show different programs to different member populations?

Yes. Eligibility rules let you map specific programs to product codes and group IDs. You can configure a broad default (available to all members) alongside targeted programs for specific groups. A union of all matching rules is applied, so members see everything they qualify for subject to the one-program-at-a-time display logic.

What happens if a member's search matches more than one program?

Only the first matching program is displayed. Exact keyword matches take priority over partial matches. When multiple programs share an exact match, the order they appear in your eligibility configuration determines which one is shown.

Can unauthenticated (public) users see Value Add Programs?

Yes, if configured to do so. Programs with eligibility rules that include empty or wildcard product code and group ID values will be visible to public users. You have full control over which programs appear for authenticated versus unauthenticated sessions.

Do we need to provide a logo for every program?

No. Logos are optional. If no logo is provided for a program, a default logo will be displayed. Logos can also be managed as reusable content entries, so the same image can be referenced across multiple programs.

How do we provide our program data?

Program data can be provided via a Benefits API integration or CSV file (attached). Each program record includes the program name, description, enrollment link, and clinical keywords. Your implementation team will guide you through the specific format and intake process.

How do we update a program's name, description, or logo after launch?

If content was set up using managed content entries (referenced via a content key), updates can be made directly without re-uploading the full program definitions file. If content was hardcoded in the definitions file, a file update is required. We recommend using content entries for anything you expect to change over time.

How long does it take for changes to appear in the UI?

Program definition and eligibility data is cached for up to 4 hours. After an update is made, changes may take up to 4 hours to fully propagate. Your implementation team can request a cache invalidation to surface changes immediately if needed.

Can VAP be enabled for only part of our membership?

Yes. VAP can be enabled at the tenant level (all members) or at a specific group level. This allows you to roll out to a subset of your population before a broader launch.

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