Sun Life U.S. Partners with Claritev to Improve Supplemental Health Benefits

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<span class="ht-pill-solid">EMPLOYEE BENEFITS</span>

<span class="ht-pill-out">HEALTH TECH</span>

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<h1 class="ht-title">Sun Life U.S. and Claritev Boost Efficiency of Supplemental Health Benefits</h1>

<span class="ht-meta-item"><span class="ht-dot"></span> HR Tech · Benefits Administration</span>

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<span class="ht-strong-o">Sun Life U.S.</span>, a provider of employee and government benefits, and <span class="ht-strong-o">Claritev</span>, a healthcare technology, data and insights company, have joined forces to bring greater efficiency to the supplemental health coverage offered by <span class="ht-strong-b">self-funded employers</span>. The announcement was made on <span class="ht-strong-b">July 16, 2026</span> from Wellesley, Massachusetts and McLean, Virginia.

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At the centre of the collaboration is Claritev's <span class="ht-strong-b">machine-learning technology</span>, which surfaces diagnosis connections between an employee's medical claims and the supplemental health coverages they hold — <span class="ht-strong-o">critical illness, accident and hospital indemnity</span> — so that covered employees can actually access the benefits they are already eligible for.

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<p>"With Claritev, we can take a more proactive approach."</p>

<span class="ht-attr">— Joi Tillman, President, Group Benefits, Sun Life U.S.</span>

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<h2 class="ht-h2"><span class="ht-h2-bar"></span>Connecting the Dots Between Health Plans and Supplemental Coverage</h2>

Tillman explained that bringing Claritev's services to self-funded clients should help link health plans and supplemental health coverage together, producing greater cohesion across the wider employee benefits package. The intent, she noted, is a more proactive model of getting payments to employees who are facing a serious illness or injury, rather than waiting for them to come forward.

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The practical problem the pairing addresses is a familiar one in benefits administration: while employees are focused on managing their health needs after a medical event, remembering to claim every benefit available to them is rarely top of mind. Claims that could have been paid simply never get filed.

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<p>"Claritev's innovative approach gives self-funded employers a strong tool."</p>

<span class="ht-attr">— Jen Collier, President, Health and Risk Solutions, Sun Life U.S.</span>

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<h2 class="ht-h2"><span class="ht-h2-bar-t"></span>How the Process Works</h2>

Once employees are enrolled in their supplemental health benefits, their medical claim data is reviewed on an <span class="ht-strong-b">ongoing basis</span>. Claritev's solution scans that claim data and flags employees who appear eligible for supplemental health benefits. <span class="ht-strong-o">Sun Life</span> then notifies the client's employees so they can file the appropriate claims.

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Every step of the process is designed to be secure and <span class="ht-strong-b">HIPAA compliant</span>, with employee privacy and data protection treated as a first-order requirement rather than an afterthought.

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<h2 class="ht-h2"><span class="ht-h2-bar"></span>Availability and Eligibility</h2>

Claritev's capabilities are open to <span class="ht-strong-o">any self-funded employer</span> offering Sun Life supplemental health coverage — the employer does not need to be a Sun Life stop-loss client. The solution is available for quoting now, for policies effective on or after <span class="ht-strong-b">January 1, 2027</span>.

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Collier framed the move as part of a broader push to give self-funded clients more capabilities and solutions that make their health plans work better for employees, ensuring supplemental health benefits meet people where they actually are. Group insurance policies are issued by Sun Life Assurance Company of Canada (Wellesley Hills, Mass.), except in New York, where they are issued by Sun Life and Health Insurance Company (U.S.) (Lansing, Mich.). <span class="ht-strong-o">Claritev</span> trades publicly under the ticker <span class="ht-strong-b">CTEV</span>.

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<span class="ht-tk-title">Key Takeaways</span>

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<p class="ht-tk-text"><strong style="color:#F26522;">Machine learning meets benefits.</strong> Claritev's ML technology identifies diagnosis connections between medical claims and supplemental coverage, so eligible employees are found rather than missed.</p>

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<p class="ht-tk-text"><strong style="color:#2E6DB4;">Three coverage types in scope.</strong> Critical illness, accident and hospital indemnity benefits are all covered by the connected-claims approach.</p>

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<p class="ht-tk-text"><strong style="color:#00B4C8;">Proactive, not reactive.</strong> Claim data is reviewed continuously and Sun Life notifies employees to file, instead of waiting for employees to initiate.</p>

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<p class="ht-tk-text"><strong style="color:#F26522;">Privacy built in.</strong> All processes are secure and HIPAA compliant, with employee data protection prioritised throughout the workflow.</p>

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<p class="ht-tk-text"><strong style="color:#1B2A4A;">Broad availability from 2027.</strong> Open to any self-funded employer with Sun Life supplemental coverage — no stop-loss relationship required — for policies effective on or after January 1, 2027.</p>

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<span class="ht-tag ht-tag-b">Claritev</span>

<span class="ht-tag ht-tag-t">Supplemental Health Benefits</span>

<span class="ht-tag ht-tag-n">Self-Funded Employers</span>

<span class="ht-tag ht-tag-o">Machine Learning</span>

<span class="ht-tag ht-tag-b">Employee Benefits</span>

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