Benefits Agent MCP Server

{ "members": { "MEM001": { "member_id": "MEM001", "name": "John Doe", "plan_type": "PPO Gold", "plan_year_start": "2024-01-01", "plan_year_end": "2024-12-31" }, "MEM002": { "member_id": "MEM002", "name": "Jane Smith", "plan_type": "HMO Silver", "plan_year_start": "2024-01-01", "plan_year_end": "2024-12-31" }, "MEM003": { "member_id": "MEM003", "name": "Robert Johnson", "plan_type": "EPO Platinum", "plan_year_start": "2024-01-01", "plan_year_end": "2024-12-31" }, "MEM004": { "member_id": "MEM004", "name": "Unnikrishnan", "plan_type": "PPO Premium", "plan_year_start": "2025-01-01", "plan_year_end": "2026-12-31" } }, "deductibles": { "MEM001": { "medical": { "individual_total": 1500, "individual_met": 850, "family_total": 3000, "family_met": 1200 }, "prescription": { "total": 200, "met": 150 } }, "MEM002": { "medical": { "individual_total": 2000, "individual_met": 500, "family_total": 4000, "family_met": 800 }, "prescription": { "total": 250, "met": 100 } }, "MEM003": { "medical": { "individual_total": 1000, "individual_met": 1000, "family_total": 2000, "family_met": 2000 }, "prescription": { "total": 150, "met": 150 } }, "MEM004": { "medical": { "individual_total": 2000, "individual_met": 2000, "family_total": 4000, "family_met": 4000 }, "prescription": { "total": 250, "met": 250 } } }, "out_of_pocket": { "MEM001": { "individual_maximum": 5000, "individual_current": 2100, "family_maximum": 10000, "family_current": 3500 }, "MEM002": { "individual_maximum": 6000, "individual_current": 1200, "family_maximum": 12000, "family_current": 2000 }, "MEM003": { "individual_maximum": 4000, "individual_current": 3800, "family_maximum": 8000, "family_current": 6500 }, "MEM004": { "individual_maximum": 8000, "individual_current": 4800, "family_maximum": 10000, "family_current": 7500 } }, "benefit_usage": { "MEM001": { "medical_visits": { "primary_care": {"used": 3, "limit": null}, "specialist": {"used": 5, "limit": null}, "emergency": {"used": 1, "limit": null} }, "dental": { "preventive": {"used": 2, "limit": 2}, "basic": {"used": 1, "limit": null}, "major": {"used": 0, "limit": null}, "annual_max_used": 450, "annual_max_total": 2000 }, "vision": { "eye_exams": {"used": 1, "limit": 1}, "frames": {"used": 1, "limit": 1, "allowance_used": 150, "allowance_total": 150}, "contacts": {"used": 0, "limit": 1, "allowance_used": 0, "allowance_total": 150} }, "pharmacy": { "tier1_generic": {"prescriptions": 12, "total_cost": 120}, "tier2_preferred": {"prescriptions": 3, "total_cost": 105}, "tier3_non_preferred": {"prescriptions": 1, "total_cost": 70}, "tier4_specialty": {"prescriptions": 0, "total_cost": 0} } }, "MEM002": { "medical_visits": { "primary_care": {"used": 2, "limit": null}, "specialist": {"used": 1, "limit": null}, "emergency": {"used": 0, "limit": null} }, "dental": { "preventive": {"used": 1, "limit": 2}, "basic": {"used": 0, "limit": null}, "major": {"used": 0, "limit": null}, "annual_max_used": 85, "annual_max_total": 1500 }, "vision": { "eye_exams": {"used": 0, "limit": 1}, "frames": {"used": 0, "limit": 1, "allowance_used": 0, "allowance_total": 0}, "contacts": {"used": 0, "limit": 1, "allowance_used": 0, "allowance_total": 0} }, "pharmacy": { "tier1_generic": {"prescriptions": 8, "total_cost": 120}, "tier2_preferred": {"prescriptions": 2, "total_cost": 80}, "tier3_non_preferred": {"prescriptions": 0, "total_cost": 0}, "tier4_specialty": {"prescriptions": 0, "total_cost": 0} } }, "MEM003": { "medical_visits": { "primary_care": {"used": 8, "limit": null}, "specialist": {"used": 12, "limit": null}, "emergency": {"used": 2, "limit": null} }, "dental": { "preventive": {"used": 2, "limit": 2}, "basic": {"used": 3, "limit": null}, "major": {"used": 1, "limit": null}, "annual_max_used": 1800, "annual_max_total": 2500 }, "vision": { "eye_exams": {"used": 1, "limit": 1}, "frames": {"used": 1, "limit": 1, "allowance_used": 200, "allowance_total": 200}, "contacts": {"used": 0, "limit": 1, "allowance_used": 0, "allowance_total": 200} }, "pharmacy": { "tier1_generic": {"prescriptions": 24, "total_cost": 120}, "tier2_preferred": {"prescriptions": 8, "total_cost": 200}, "tier3_non_preferred": {"prescriptions": 4, "total_cost": 200}, "tier4_specialty": {"prescriptions": 2, "total_cost": 800} } }, "MEM004": { "medical_visits": { "primary_care": {"used": 8, "limit": null}, "specialist": {"used": 12, "limit": null}, "emergency": {"used": 2, "limit": null} }, "dental": { "preventive": {"used": 2, "limit": 2}, "basic": {"used": 3, "limit": null}, "major": {"used": 1, "limit": null}, "annual_max_used": 2800, "annual_max_total": 3500 }, "vision": { "eye_exams": {"used": 1, "limit": 1}, "frames": {"used": 1, "limit": 1, "allowance_used": 160, "allowance_total": 200}, "contacts": {"used": 0, "limit": 1, "allowance_used": 0, "allowance_total": 200} }, "pharmacy": { "tier1_generic": {"prescriptions": 24, "total_cost": 220}, "tier2_preferred": {"prescriptions": 8, "total_cost": 200}, "tier3_non_preferred": {"prescriptions": 4, "total_cost": 200}, "tier4_specialty": {"prescriptions": 2, "total_cost": 1000} } } }, "spending_summary": { "MEM001": { "medical": 1850, "dental": 450, "vision": 150, "pharmacy": 295 }, "MEM002": { "medical": 650, "dental": 85, "vision": 0, "pharmacy": 200 }, "MEM003": { "medical": 3200, "dental": 1800, "vision": 200, "pharmacy": 1320 }, "MEM004": { "medical": 3100, "dental": 1600, "vision": 100, "pharmacy": 1120 } } }