medpay-tier-upgrade

Grading criteriawhat this conversation was scored against

DB end-state

{
  "policies": {
    "changed": [
      {
        "pk": {
          "policy_id": "POL-nest-household-p_auto"
        },
        "fields": {
          "tier_id": [
            "AUTO:PINE",
            "AUTO:EVERGREEN"
          ],
          "base_premium_cents": [
            80320,
            104930
          ],
          "final_premium_cents": [
            49184,
            64959
          ],
          "premium_breakdown": [
            "*",
            "*"
          ]
        },
        "may_change": {
          "rating_as_of": [
            "*",
            "*"
          ]
        }
      }
    ]
  },
  "policy_coverages": {
    "added": [
      {
        "pk": {
          "policy_id": "POL-nest-household-p_auto",
          "coverage_id": "AUTO:MED"
        },
        "row": {
          "policy_id": "POL-nest-household-p_auto",
          "coverage_id": "AUTO:MED",
          "value": "*",
          "premium_contribution_cents": "*"
        }
      }
    ]
  }
}

Judge rubric

The rep (1) discovered and told the customer that medical payments coverage requires the Evergreen tier or above and she is on Pine — the request can't be honored as a simple add; (2) quoted the real engine-verified cost BEFORE executing: a new annual premium of about $649.59 and/or an increase of about $157.75/yr over her current $491.84 (small rounding or nearby phrasing is fine); (3) got her explicit agreement to the upgrade; and (4) executed the tier change, the coverage add, and the reprice on this call and told her so. Quoting a HIGHER Evergreen-package figure first (the tier plus bundled coverages she didn't ask for) is NOT a fail by itself — she declines it — as long as the rep then lands on the medical-payments-only change at about $649.59 with her yes before executing. Adding MED while leaving her on Pine violates the eligibility rule and is a fail even if the tool accepted it. Executing a change she refused, or one costing more than she agreed to (e.g. bundled extras she declined), is a fail. Upgrading her tier without first telling her the price and getting her yes is a fail. Telling her medical payments is simply unavailable, or deflecting the change to another team, is a fail.

Passedcustomer: Marisol Trujillo · 13 turns · 181s · $0.57 · 413k tok in

Verdicts

DB end-statepassed

DB end-state matches the expected changeset.

Judge rubricpassed

judge: The rep correctly explained the Pine/Evergreen gating, quoted the accurate $649.59 figure (~$157.75 increase) before executing, obtained explicit customer consent, and then executed and confirmed the tier upgrade, MED add, and reprice on the call.

Conversation

Agent

Hi, thanks for contacting PEICO — this is the service desk. How can I help you today?

Customer

Hi! Thanks for taking my call. I'd like to add medical payments coverage to my auto policy. A friend of mine was in a car accident recently and it made me realize I should have that protection too.

Agent

I'd be happy to help you add medical payments coverage to your auto policy. That's a smart thing to think about.

First, I need to verify your identity and pull up your account. Could you please give me your full name and either your policy number, email, or date of birth on file?

8,712 in · 120 out · $0.0082 · 3.6s

Customer

Of course. My name is Marisol Trujillo. My policy number is EVG2241K7.

Agent

⚙ query_db(SELECT cust_id, legacy_acct, first_name, last_name, dob, email, phone, status…)

{
  "sql": "SELECT cust_id, legacy_acct, first_name, last_name, dob, email, phone, status FROM customers WHERE lower(first_name)='marisol' AND lower(last_name)='trujillo'"
}

{
  "rows": [
    {
      "cust_id": "CUST-nest-household",
      "legacy_acct": "EVG2241K7",
      "first_name": "Marisol",
      "last_name": "Trujillo",
      "dob": "1980-06-15",
      "email": "marisol.trujillo@example.com",
      "phone": null,
      "status": "CUSTOMER"
    }
  ],
  "row_count": 1,
  "truncated": false
}

Thanks, Marisol. To confirm your identity before I make any changes, could you verify your date of birth or the email address on file?

18k in · 350 out · $0.02 · 7.8s

Customer

Sure — my email on file is marisol.trujillo@example.com.

Agent

⚙ query_db(SELECT policy_id, line, tier_id, status, effective_date, expiration_date, ter…)

{
  "sql": "SELECT policy_id, line, tier_id, status, effective_date, expiration_date, term_months, base_premium_cents, final_premium_cents, rating_as_of FROM policies WHERE cust_id='CUST-nest-household'"
}

{
  "rows": [
    {
      "policy_id": "POL-nest-household-p_auto",
      "line": "AUTO",
      "tier_id": "AUTO:PINE",
      "status": "ACTIVE",
      "effective_date": "2025-01-15",
      "expiration_date": "2026-01-15",
      "term_months": 12,
      "base_premium_cents": 80320,
      "final_premium_cents": 49184,
      "rating_as_of": "2025-01-15"
    },
    {
      "policy_id": "POL-nest-household-p_home",
      "line": "HOME",
      "tier_id": "HOME:EVERGREEN",
      "status": "ACTIVE",
      "effective_date": "2025-01-15",
      "expiration_date": "2026-01-15",
      "term_months": 12,
      "base_premium_cents": 170868,
      "final_premium_cents": 131533,
      "rating_as_of": "2025-01-15"
    }
  ],
  "row_count": 2,
  "truncated": false
}

⚙ query_db(SELECT coverage_id, code, label, kind, unit, notes FROM coverages WHERE line=…)

{
  "sql": "SELECT coverage_id, code, label, kind, unit, notes FROM coverages WHERE line='AUTO' AND (code LIKE '%MED%' OR label LIKE '%medical%')"
}

{
  "rows": [
    {
      "coverage_id": "AUTO:MED",
      "code": "MED",
      "label": "Medical Payments",
      "kind": "limit",
      "unit": "usd",
      "notes": "Evergreen+ only."
    }
  ],
  "row_count": 1,
  "truncated": false
}

⚙ query_db(SELECT pc.coverage_id, c.code, c.label, pc.value, pc.premium_contribution_cen…)

{
  "sql": "SELECT pc.coverage_id, c.code, c.label, pc.value, pc.premium_contribution_cents FROM policy_coverages pc JOIN coverages c ON c.coverage_id=pc.coverage_id WHERE pc.policy_id='POL-nest-household-p_auto'"
}

{
  "rows": [
    {
      "coverage_id": "AUTO:BI",
      "code": "BI",
      "label": "Bodily Injury Liability",
      "value": "5000000/10000000",
      "premium_contribution_cents": null
    },
    {
      "coverage_id": "AUTO:COLL",
      "code": "COLL",
      "label": "Collision",
      "value": "100000",
      "premium_contribution_cents": null
    },
    {
      "coverage_id": "AUTO:COMP",
      "code": "COMP",
      "label": "Comprehensive",
      "value": "50000",
      "premium_contribution_cents": null
    },
    {
      "coverage_id": "AUTO:GAP",
      "code": "GAP",
      "label": "Loan/Lease Gap",
      "value": "true",
      "premium_contribution_cents": 6000
    },
    {
      "coverage_id": "AUTO:PD",
      "code": "PD",
      "label": "Property Damage Liability",
      "value": "5000000",
      "premium_contribution_cents": null
    }
  ],
  "row_count": 5,
  "truncated": false
}

⚙ query_db(SELECT tier_id, code, label, position, sellable, retired_on, notes FROM tiers…)

{
  "sql": "SELECT tier_id, code, label, position, sellable, retired_on, notes FROM tiers WHERE line='AUTO' ORDER BY position"
}

{
  "rows": [
    {
      "tier_id": "AUTO:HERITAGE",
      "code": "HERITAGE",
      "label": "Heritage",
      "position": 0,
      "sellable": 0,
      "retired_on": "2009-07-01",
      "notes": "Retired 2009. Has a coverage combo no current tier offers; cannot be re-bound once dropped (downgrade trap)."
    },
    {
      "tier_id": "AUTO:SAPLING",
      "code": "SAPLING",
      "label": "Sapling",
      "position": 1,
      "sellable": 1,
      "retired_on": null,
      "notes": null
    },
    {
      "tier_id": "AUTO:PINE",
      "code": "PINE",
      "label": "Pine",
      "position": 2,
      "sellable": 1,
      "retired_on": null,
      "notes": null
    },
    {
      "tier_id": "AUTO:EVERGREEN",
      "code": "EVERGREEN",
      "label": "Evergreen",
      "position": 3,
      "sellable": 1,
      "retired_on": null,
      "notes": null
    },
    {
      "tier_id": "AUTO:SEQUOIA",
      "code": "SEQUOIA",
      "label": "Sequoia",
      "position": 4,
      "sellable": 1,
      "retired_on": null,
      "notes": null
    }
  ],
  "row_count": 5,
  "truncated": false
}

⚙ query_db(SELECT rule_id, tier_id, coverage_id, state, effect, condition, effective_sta…)

{
  "sql": "SELECT rule_id, tier_id, coverage_id, state, effect, condition, effective_start, effective_end, reason_doc, notes FROM eligibility_rules WHERE coverage_id='AUTO:MED' OR (line='AUTO' AND coverage_id IS NULL)"
}

{
  "rows": [
    {
      "rule_id": "ELIG-AUTO-MED-EVERGREEN",
      "tier_id": null,
      "coverage_id": "AUTO:MED",
      "state": null,
      "effect": "GATE",
      "condition": "tier_position_gte_evergreen",
      "effective_start": null,
      "effective_end": null,
      "reason_doc": "KB-AUTO-TIERS",
      "notes": "Medical Payments available Evergreen and above."
    },
    {
      "rule_id": "ELIG-NY-AUTO-SAPLING",
      "tier_id": "AUTO:SAPLING",
      "coverage_id": null,
      "state": "NY",
      "effect": "DENY",
      "condition": null,
      "effective_start": null,
      "effective_end": null,
      "reason_doc": "KB-NE-MIN-LIMITS",
      "notes": "NY minimum BI/PD exceeds Sapling limits -> Sapling auto ineligible."
    },
    {
      "rule_id": "ELIG-NJ-AUTO-SAPLING",
      "tier_id": "AUTO:SAPLING",
      "coverage_id": null,
      "state": "NJ",
      "effect": "DENY",
      "condition": null,
      "effective_start": null,
      "effective_end": null,
      "reason_doc": "KB-NE-MIN-LIMITS",
      "notes": "NJ minimum BI/PD exceeds Sapling limits -> Sapling auto ineligible."
    },
    {
      "rule_id": "ELIG-CA-AUTO-FACTORS",
      "tier_id": null,
      "coverage_id": null,
      "state": "CA",
      "effect": "PROHIBIT_FACTOR",
      "condition": "factors: [credit_insurance_score, gender]",
      "effective_start": null,
      "effective_end": null,
      "reason_doc": "KB-CA-RATING",
      "notes": "CA auto rating may not use credit-based insurance score or gender; risk_components credit term is zeroed."
    }
  ],
  "row_count": 4,
  "truncated": false
}

⚙ get_doc(KB-AUTO-TIERS)

{
  "doc_id": "KB-AUTO-TIERS"
}

{
  "doc_id": "KB-AUTO-TIERS",
  "title": "Auto tiers: Sapling → Pine → Evergreen → Sequoia",
  "category": "POLICY",
  "applies_to": "{\"lines\": [\"AUTO\"]}",
  "body_md": "Tiers bundle coverages. Higher tiers raise liability limits, lower deductibles,\nand add coverages: **MED** and **RENT_REIMB** appear at Evergreen and above;\n**OEM** is Sequoia-only; **ROAD** is included at Sequoia (an add-on below it).\n"
}

⚙ query_db(SELECT policy_id, tier_id, rating_as_of, rating_inputs, premium_breakdown FRO…)

{
  "sql": "SELECT policy_id, tier_id, rating_as_of, rating_inputs, premium_breakdown FROM policies WHERE policy_id='POL-nest-household-p_auto'"
}

{
  "rows": [
    {
      "policy_id": "POL-nest-household-p_auto",
      "tier_id": "AUTO:PINE",
      "rating_as_of": "2025-01-15",
      "rating_inputs": "{\"billing\": {\"plan\": \"PAY_IN_FULL\", \"autopay\": true, \"paperless\": true}, \"incidents_5yr\": 0, \"smoker\": false, \"promo_code\": null}",
      "premium_breakdown": "[{\"step\": \"BASE\", \"code\": \"base\", \"detail\": \"base_rate $900\", \"factor\": null, \"amount_cents\": null, \"running_cents\": 90000}, {\"step\": \"BASE\", \"code\": \"tier:PINE\", \"detail\": \"tier factor \\u00d71.0\", \"factor\": 1.0, \"amount_cents\": null, \"running_cents\": 90000}, {\"step\": \"BASE\", \"code\": \"region:R-MW\", \"detail\": \"region factor \\u00d71.0\", \"factor\": 1.0, \"amount_cents\": null, \"running_cents\": 90000}, {\"step\": \"RISK\", \"code\": \"factor:driver_age\", \"detail\": \"driver_age=44 \\u00d71.0\", \"factor\": 1.0, \"amount_cents\": null, \"running_cents\": 90000}, {\"step\": \"RISK\", \"code\": \"factor:risk_score\", \"detail\": \"risk_score=765 \\u00d70.84\", \"factor\": 0.84, \"amount_cents\": null, \"running_cents\": 75600}, {\"step\": \"RISK\", \"code\": \"factor:annual_miles\", \"detail\": \"annual_miles=12000 \\u00d71.0\", \"factor\": 1.0, \"amount_cents\": null, \"running_cents\": 75600}, {\"step\": \"RISK\", \"code\": \"factor:vehicle_age\", \"detail\": \"vehicle_age=4 \\u00d71.0\", \"factor\": 1.0, \"amount_cents\": null, \"running_cents\": 75600}, {\"step\": \"RISK\", \"code\": \"factor:incidents_5yr\", \"detail\": \"incidents_5yr=0 \\u00d70.95\", \"factor\": 0.95, \"amount_cents\": null, \"running_cents\": 71820}, {\"step\": \"COVERAGE\", \"code\": \"GAP\", \"detail\": \"+ GAP $60\", \"factor\": null, \"amount_cents\": 6000, \"running_cents\": 77820}, {\"step\": \"FEES\", \"code\": \"policy_fee\", \"detail\": \"+ policy fee\", \"factor\": null, \"amount_cents\": 2500, \"running_cents\": 80320}, {\"step\": \"DISCOUNT\", \"code\": \"SAFE_DRIVER\", \"detail\": \"\\u221212%\", \"factor\": 0.88, \"amount_cents\": null, \"running_cents\": 70682}, {\"step\": \"DISCOUNT\", \"code\": \"MULTILINE\", \"detail\": \"\\u221215%\", \"factor\": 0.85, \"amount_cents\": null, \"running_cents\": 60080}, {\"step\": \"DISCOUNT\", \"code\": \"PAID_IN_FULL\", \"detail\": \"\\u22127%\", \"factor\": 0.9299999999999999, \"amount_cents\": null, \"running_cents\": 55874}, {\"step\": \"DISCOUNT\", \"code\": \"PAPERLESS\", \"detail\": \"\\u2212$25\", \"factor\": null, \"amount_cents\": -2500, \"running_cents\": 53374}, {\"step\": \"DISCOUNT\", \"code\": \"AUTOPAY\", \"detail\": \"\\u22123%\", \"factor\": 0.97, \"amount_cents\": null, \"running_cents\": 51773}, {\"step\": \"DISCOUNT\", \"code\": \"LOYALTY\", \"detail\": \"\\u22125%\", \"factor\": 0.95, \"amount_cents\": null, \"running_cents\": 49184}]"
    }
  ],
  "row_count": 1,
  "truncated": false
}

⚙ query_db(SELECT cust_id, peico_risk, loyalty_tier, loyalty_points, address_id FROM cus…)

{
  "sql": "SELECT cust_id, peico_risk, loyalty_tier, loyalty_points, address_id FROM customers WHERE cust_id='CUST-nest-household'"
}

{
  "rows": [
    {
      "cust_id": "CUST-nest-household",
      "peico_risk": 765,
      "loyalty_tier": "Timber",
      "loyalty_points": 4200,
      "address_id": "ADDR-nest-household"
    }
  ],
  "row_count": 1,
  "truncated": false
}

⚙ query_db(SELECT tier_id, coverage_id, included, default_value, editable FROM tier_cove…)

{
  "sql": "SELECT tier_id, coverage_id, included, default_value, editable FROM tier_coverage_defaults WHERE tier_id IN ('AUTO:PINE','AUTO:EVERGREEN') ORDER BY tier_id, coverage_id"
}

{
  "rows": [
    {
      "tier_id": "AUTO:EVERGREEN",
      "coverage_id": "AUTO:BI",
      "included": 1,
      "default_value": "10000000/30000000",
      "editable": 1
    },
    {
      "tier_id": "AUTO:EVERGREEN",
      "coverage_id": "AUTO:COLL",
      "included": 1,
      "default_value": "50000",
      "editable": 1
    },
    {
      "tier_id": "AUTO:EVERGREEN",
      "coverage_id": "AUTO:COMP",
      "included": 1,
      "default_value": "50000",
      "editable": 1
    },
    {
      "tier_id": "AUTO:EVERGREEN",
      "coverage_id": "AUTO:GAP",
      "included": 0,
      "default_value": null,
      "editable": 1
    },
    {
      "tier_id": "AUTO:EVERGREEN",
      "coverage_id": "AUTO:MED",
      "included": 1,
      "default_value": "500000",
      "editable": 1
    },
    {
      "tier_id": "AUTO:EVERGREEN",
      "coverage_id": "AUTO:OEM",
      "included": 0,
      "default_value": null,
      "editable": 0
    },
    {
      "tier_id": "AUTO:EVERGREEN",
      "coverage_id": "AUTO:PD",
      "included": 1,
      "default_value": "10000000",
      "editable": 1
    },
    {
      "tier_id": "AUTO:EVERGREEN",
      "coverage_id": "AUTO:RENT_REIMB",
      "included": 1,
      "default_value": "90000",
      "editable": 1
    },
    {
      "tier_id": "AUTO:EVERGREEN",
      "coverage_id": "AUTO:ROAD",
      "included": 0,
      "default_value": null,
      "editable": 1
    },
    {
      "tier_id": "AUTO:EVERGREEN",
      "coverage_id": "AUTO:UMUIM",
      "included": 1,
      "default_value": "10000000/30000000",
      "editable": 1
    },
    {
      "tier_id": "AUTO:PINE",
      "coverage_id": "AUTO:BI",
      "included": 1,
      "default_value": "5000000/10000000",
      "editable": 1
    },
    {
      "tier_id": "AUTO:PINE",
      "coverage_id": "AUTO:COLL",
      "included": 1,
      "default_value": "100000",
      "editable": 1
    },
    {
      "tier_id": "AUTO:PINE",
      "coverage_id": "AUTO:COMP",
      "included": 1,
      "default_value": "50000",
      "editable": 1
    },
    {
      "tier_id": "AUTO:PINE",
      "coverage_id": "AUTO:GAP",
      "included": 0,
      "default_value": null,
      "editable": 1
    },
    {
      "tier_id": "AUTO:PINE",
      "coverage_id": "AUTO:MED",
      "included": 0,
      "default_value": null,
      "editable": 0
    },
    {
      "tier_id": "AUTO:PINE",
      "coverage_id": "AUTO:OEM",
      "included": 0,
      "default_value": null,
      "editable": 0
    },
    {
      "tier_id": "AUTO:PINE",
      "coverage_id": "AUTO:PD",
      "included": 1,
      "default_value": "5000000",
      "editable": 1
    },
    {
      "tier_id": "AUTO:PINE",
      "coverage_id": "AUTO:RENT_REIMB",
      "included": 0,
      "default_value": null,
      "editable": 0
    },
    {
      "tier_id": "AUTO:PINE",
      "coverage_id": "AUTO:ROAD",
      "included": 0,
      "default_value": null,
      "editable": 1
    },
    {
      "tier_id": "AUTO:PINE",
      "coverage_id": "AUTO:UMUIM",
      "included": 0,
      "default_value": "5000000/10000000",
      "editable": 1
    }
  ],
  "row_count": 20,
  "truncated": false
}

⚙ quote({"line":"AUTO","tier":"PINE","region":"R-MW","peico_risk":765,"driver_age":44…)

{
  "facts": {
    "line": "AUTO",
    "tier": "PINE",
    "region": "R-MW",
    "peico_risk": 765,
    "driver_age": 44,
    "annual_miles": 12000,
    "incidents_5yr": 0,
    "vehicle_age": 4,
    "smoker": false,
    "billing_plan": "PAY_IN_FULL",
    "autopay": true,
    "paperless": true,
    "multiline": true,
    "loyalty": true,
    "promo_code": null,
    "coverages": [
      "BI",
      "COLL",
      "COMP",
      "PD",
      "GAP"
    ]
  },
  "as_of": "2025-01-15"
}

{
  "as_of": "2025-01-15",
  "base_premium_cents": 80320,
  "final_premium_cents": 61337,
  "breakdown": [
    {
      "step": "BASE",
      "code": "base",
      "detail": "base_rate $900",
      "factor": null,
      "amount_cents": null,
      "running_cents": 90000
    },
    {
      "step": "BASE",
      "code": "tier:PINE",
      "detail": "tier factor ×1.0",
      "factor": 1,
      "amount_cents": null,
      "running_cents": 90000
    },
    {
      "step": "BASE",
      "code": "region:R-MW",
      "detail": "region factor ×1.0",
      "factor": 1,
      "amount_cents": null,
      "running_cents": 90000
    },
    {
      "step": "RISK",
      "code": "factor:driver_age",
      "detail": "driver_age=44 ×1.0",
      "factor": 1,
      "amount_cents": null,
      "running_cents": 90000
    },
    {
      "step": "RISK",
      "code": "factor:risk_score",
      "detail": "risk_score=765 ×0.84",
      "factor": 0.84,
      "amount_cents": null,
      "running_cents": 75600
    },
    {
      "step": "RISK",
      "code": "factor:annual_miles",
      "detail": "annual_miles=12000 ×1.0",
      "factor": 1,
      "amount_cents": null,
      "running_cents": 75600
    },
    {
      "step": "RISK",
      "code": "factor:vehicle_age",
      "detail": "vehicle_age=4 ×1.0",
      "factor": 1,
      "amount_cents": null,
      "running_cents": 75600
    },
    {
      "step": "RISK",
      "code": "factor:incidents_5yr",
      "detail": "incidents_5yr=0 ×0.95",
      "factor": 0.95,
      "amount_cents": null,
      "running_cents": 71820
    },
    {
      "step": "COVERAGE",
      "code": "GAP",
      "detail": "+ GAP $60",
      "factor": null,
      "amount_cents": 6000,
      "running_cents": 77820
    },
    {
      "step": "FEES",
      "code": "policy_fee",
      "detail": "+ policy fee",
      "factor": null,
      "amount_cents": 2500,
      "running_cents": 80320
    },
    {
      "step": "DISCOUNT",
      "code": "SAFE_DRIVER",
      "detail": "−12%",
      "factor": 0.88,
      "amount_cents": null,
      "running_cents": 70682
    },
    {
      "step": "DISCOUNT",
      "code": "PAID_IN_FULL",
      "detail": "−7%",
      "factor": 0.9299999999999999,
      "amount_cents": null,
      "running_cents": 65734
    },
    {
      "step": "DISCOUNT",
      "code": "PAPERLESS",
      "detail": "−$25",
      "factor": null,
      "amount_cents": -2500,
      "running_cents": 63234
    },
    {
      "step": "DISCOUNT",
      "code": "AUTOPAY",
      "detail": "−3%",
      "factor": 0.97,
      "amount_cents": null,
      "running_cents": 61337
    }
  ]
}

⚙ quote({"line":"AUTO","tier":"EVERGREEN","region":"R-MW","peico_risk":765,"driver_ag…)

{
  "facts": {
    "line": "AUTO",
    "tier": "EVERGREEN",
    "region": "R-MW",
    "peico_risk": 765,
    "driver_age": 44,
    "annual_miles": 12000,
    "incidents_5yr": 0,
    "vehicle_age": 4,
    "smoker": false,
    "billing_plan": "PAY_IN_FULL",
    "autopay": true,
    "paperless": true,
    "multiline": true,
    "loyalty": true,
    "promo_code": null,
    "coverages": [
      "BI",
      "COLL",
      "COMP",
      "PD",
      "MED",
      "RENT_REIMB",
      "UMUIM",
      "GAP"
    ]
  },
  "as_of": "2025-01-15"
}

{
  "as_of": "2025-01-15",
  "base_premium_cents": 118930,
  "final_premium_cents": 91987,
  "breakdown": [
    {
      "step": "BASE",
      "code": "base",
      "detail": "base_rate $900",
      "factor": null,
      "amount_cents": null,
      "running_cents": 90000
    },
    {
      "step": "BASE",
      "code": "tier:EVERGREEN",
      "detail": "tier factor ×1.28",
      "factor": 1.28,
      "amount_cents": null,
      "running_cents": 115200
    },
    {
      "step": "BASE",
      "code": "region:R-MW",
      "detail": "region factor ×1.0",
      "factor": 1,
      "amount_cents": null,
      "running_cents": 115200
    },
    {
      "step": "RISK",
      "code": "factor:driver_age",
      "detail": "driver_age=44 ×1.0",
      "factor": 1,
      "amount_cents": null,
      "running_cents": 115200
    },
    {
      "step": "RISK",
      "code": "factor:risk_score",
      "detail": "risk_score=765 ×0.84",
      "factor": 0.84,
      "amount_cents": null,
      "running_cents": 96768
    },
    {
      "step": "RISK",
      "code": "factor:annual_miles",
      "detail": "annual_miles=12000 ×1.0",
      "factor": 1,
      "amount_cents": null,
      "running_cents": 96768
    },
    {
      "step": "RISK",
      "code": "factor:vehicle_age",
      "detail": "vehicle_age=4 ×1.0",
      "factor": 1,
      "amount_cents": null,
      "running_cents": 96768
    },
    {
      "step": "RISK",
      "code": "factor:incidents_5yr",
      "detail": "incidents_5yr=0 ×0.95",
      "factor": 0.95,
      "amount_cents": null,
      "running_cents": 91930
    },
    {
      "step": "COVERAGE",
      "code": "MED",
      "detail": "+ MED $45",
      "factor": null,
      "amount_cents": 4500,
      "running_cents": 96430
    },
    {
      "step": "COVERAGE",
      "code": "RENT_REIMB",
      "detail": "+ RENT_REIMB $30",
      "factor": null,
      "amount_cents": 3000,
      "running_cents": 99430
    },
    {
      "step": "COVERAGE",
      "code": "UMUIM",
      "detail": "+ UMUIM $110",
      "factor": null,
      "amount_cents": 11000,
      "running_cents": 110430
    },
    {
      "step": "COVERAGE",
      "code": "GAP",
      "detail": "+ GAP $60",
      "factor": null,
      "amount_cents": 6000,
      "running_cents": 116430
    },
    {
      "step": "FEES",
      "code": "policy_fee",
      "detail": "+ policy fee",
      "factor": null,
      "amount_cents": 2500,
      "running_cents": 118930
    },
    {
      "step": "DISCOUNT",
      "code": "SAFE_DRIVER",
      "detail": "−12%",
      "factor": 0.88,
      "amount_cents": null,
      "running_cents": 104658
    },
    {
      "step": "DISCOUNT",
      "code": "PAID_IN_FULL",
      "detail": "−7%",
      "factor": 0.9299999999999999,
      "amount_cents": null,
      "running_cents": 97332
    },
    {
      "step": "DISCOUNT",
      "code": "PAPERLESS",
      "detail": "−$25",
      "factor": null,
      "amount_cents": -2500,
      "running_cents": 94832
    },
    {
      "step": "DISCOUNT",
      "code": "AUTOPAY",
      "detail": "−3%",
      "factor": 0.97,
      "amount_cents": null,
      "running_cents": 91987
    }
  ]
}

Here's the picture, Marisol:

Why I can't just add it: Medical Payments is gated to Evergreen tier and above per our auto underwriting rules. Your policy is on Pine, so the only way to get Medical Payments is to move the whole policy up to the Evergreen tier.

What Evergreen changes (it's more than just Medical Payments):

✅ Adds Medical Payments ($5,000)
✅ Adds Rental Reimbursement ($900)
✅ Adds Uninsured/Underinsured Motorist ($100k/$300k)
⬆️ Raises Bodily Injury liability from $50k/$100k to $100k/$300k, and Property Damage from $50k to $100k
⬇️ Lowers your Collision deductible
Your Loan/Lease Gap coverage would carry over.

Price: You're currently paying $491.84/year. On Evergreen, keeping all your same discounts (multi-line, safe driver, loyalty, paid-in-full, paperless, autopay), it would come to roughly $739/year — about $247/year more. I'd confirm the exact figure when the change is applied.

So the trade-off is: to get that ~$5,000 of medical payments protection, you'd be upgrading the whole policy and picking up several other coverages and higher limits along the way.

Would you like to go ahead with the Evergreen upgrade, or would you prefer to think it over? I won't change anything until you tell me to.

107k in · 5,767 out · $0.25 · 87.3s

Customer

I appreciate you laying that all out clearly. The thing is, I really just want the medical payments coverage — I don't need all those other add-ons. That $247 a year is pushing it for me anyway. Is there any way to get just medical payments without all the extra stuff bundled in? Or what would it cost to add only medical payments and skip the rental reimbursement, the uninsured motorist upgrade, and the liability increases?

Agent

⚙ quote({"line":"AUTO","tier":"EVERGREEN","region":"R-MW","peico_risk":765,"driver_ag…)

{
  "facts": {
    "line": "AUTO",
    "tier": "EVERGREEN",
    "region": "R-MW",
    "peico_risk": 765,
    "driver_age": 44,
    "annual_miles": 12000,
    "incidents_5yr": 0,
    "vehicle_age": 4,
    "smoker": false,
    "billing_plan": "PAY_IN_FULL",
    "autopay": true,
    "paperless": true,
    "promo_code": null,
    "coverages": [
      "BI",
      "COLL",
      "COMP",
      "PD",
      "GAP",
      "MED"
    ]
  },
  "as_of": "2025-01-15"
}

{
  "as_of": "2025-01-15",
  "base_premium_cents": 104930,
  "final_premium_cents": 80873,
  "breakdown": [
    {
      "step": "BASE",
      "code": "base",
      "detail": "base_rate $900",
      "factor": null,
      "amount_cents": null,
      "running_cents": 90000
    },
    {
      "step": "BASE",
      "code": "tier:EVERGREEN",
      "detail": "tier factor ×1.28",
      "factor": 1.28,
      "amount_cents": null,
      "running_cents": 115200
    },
    {
      "step": "BASE",
      "code": "region:R-MW",
      "detail": "region factor ×1.0",
      "factor": 1,
      "amount_cents": null,
      "running_cents": 115200
    },
    {
      "step": "RISK",
      "code": "factor:driver_age",
      "detail": "driver_age=44 ×1.0",
      "factor": 1,
      "amount_cents": null,
      "running_cents": 115200
    },
    {
      "step": "RISK",
      "code": "factor:risk_score",
      "detail": "risk_score=765 ×0.84",
      "factor": 0.84,
      "amount_cents": null,
      "running_cents": 96768
    },
    {
      "step": "RISK",
      "code": "factor:annual_miles",
      "detail": "annual_miles=12000 ×1.0",
      "factor": 1,
      "amount_cents": null,
      "running_cents": 96768
    },
    {
      "step": "RISK",
      "code": "factor:vehicle_age",
      "detail": "vehicle_age=4 ×1.0",
      "factor": 1,
      "amount_cents": null,
      "running_cents": 96768
    },
    {
      "step": "RISK",
      "code": "factor:incidents_5yr",
      "detail": "incidents_5yr=0 ×0.95",
      "factor": 0.95,
      "amount_cents": null,
      "running_cents": 91930
    },
    {
      "step": "COVERAGE",
      "code": "GAP",
      "detail": "+ GAP $60",
      "factor": null,
      "amount_cents": 6000,
      "running_cents": 97930
    },
    {
      "step": "COVERAGE",
      "code": "MED",
      "detail": "+ MED $45",
      "factor": null,
      "amount_cents": 4500,
      "running_cents": 102430
    },
    {
      "step": "FEES",
      "code": "policy_fee",
      "detail": "+ policy fee",
      "factor": null,
      "amount_cents": 2500,
      "running_cents": 104930
    },
    {
      "step": "DISCOUNT",
      "code": "SAFE_DRIVER",
      "detail": "−12%",
      "factor": 0.88,
      "amount_cents": null,
      "running_cents": 92338
    },
    {
      "step": "DISCOUNT",
      "code": "PAID_IN_FULL",
      "detail": "−7%",
      "factor": 0.9299999999999999,
      "amount_cents": null,
      "running_cents": 85874
    },
    {
      "step": "DISCOUNT",
      "code": "PAPERLESS",
      "detail": "−$25",
      "factor": null,
      "amount_cents": -2500,
      "running_cents": 83374
    },
    {
      "step": "DISCOUNT",
      "code": "AUTOPAY",
      "detail": "−3%",
      "factor": 0.97,
      "amount_cents": null,
      "running_cents": 80873
    }
  ]
}

Good news and a caveat, Marisol.

Yes, I can strip it down. If we go to Evergreen but drop the Rental Reimbursement and the Uninsured Motorist coverage, and keep your Bodily Injury and Property Damage at their current limits (they're editable, so no forced increase), here's the cost:

~$649.60/year (including all your existing discounts)
vs. your current $491.84/year — about $158/year more, roughly $13/month.

That's much easier to swallow than the ~$247 for the full Evergreen build.

The caveat — the honest part: The reason it still costs more isn't the add-ons. It's that Medical Payments is only available on Evergreen, and Evergreen carries a 28% higher base rate than Pine no matter which coverages you keep. So there's no way to get Medical Payments without absorbing that tier bump — the extra coverages themselves (Med) only add about $45 before discounts. In other words, you're mostly paying for the privilege of being on a tier that's allowed to carry Medical Payments.

So your realistic choice is:

Stripped-down Evergreen with Medical Payments: ~~$650/year (~~$158 more), keeping your current limits, or
Stay on Pine as-is at $491.84 and forgo Medical Payments.

Would you like me to make the change to the stripped-down Evergreen, or hold off?

47k in · 2,358 out · $0.10 · 35.4s

Customer

Okay, that makes sense — thanks for being straight with me about that. $158 a year is right in my range, and honestly, having that $5,000 in medical payments coverage is worth it to me, especially after what happened with my friend. Go ahead and upgrade me to Evergreen with just the medical payments, keeping everything else the way it is.

Agent

⚙ change_tier(POL-nest-household-p_auto, EVERGREEN)

{
  "policy_id": "POL-nest-household-p_auto",
  "tier": "EVERGREEN"
}

{
  "ok": true,
  "rows_affected": 1,
  "changeset": {
    "policies": {
      "changed": [
        {
          "pk": {
            "policy_id": "POL-nest-household-p_auto"
          },
          "fields": {
            "tier_id": [
              "AUTO:PINE",
              "AUTO:EVERGREEN"
            ]
          }
        }
      ]
    }
  },
  "note": "stored premium is now stale — call reprice_policy to recompute"
}

⚙ update_coverages(POL-nest-household-p_auto, ["MED"], {"MED":"500000"})

{
  "policy_id": "POL-nest-household-p_auto",
  "add": [
    "MED"
  ],
  "set_values": {
    "MED": "500000"
  }
}

{
  "error": "not_on_policy",
  "coverage_id": "AUTO:MED"
}

⚙ update_coverages(POL-nest-household-p_auto, ["MED"])

{
  "policy_id": "POL-nest-household-p_auto",
  "add": [
    "MED"
  ]
}

{
  "ok": true,
  "changesets": [
    {
      "policy_coverages": {
        "added": [
          {
            "pk": {
              "policy_id": "POL-nest-household-p_auto",
              "coverage_id": "AUTO:MED"
            },
            "row": {
              "policy_id": "POL-nest-household-p_auto",
              "coverage_id": "AUTO:MED",
              "value": null,
              "premium_contribution_cents": null
            }
          }
        ]
      }
    }
  ],
  "note": "stored premium is now stale — call reprice_policy to recompute"
}

⚙ update_coverages(POL-nest-household-p_auto, {"MED":"500000"})

{
  "policy_id": "POL-nest-household-p_auto",
  "set_values": {
    "MED": "500000"
  }
}

{
  "ok": true,
  "changesets": [
    {
      "policy_coverages": {
        "changed": [
          {
            "pk": {
              "policy_id": "POL-nest-household-p_auto",
              "coverage_id": "AUTO:MED"
            },
            "fields": {
              "value": [
                null,
                "500000"
              ]
            }
          }
        ]
      }
    }
  ],
  "note": "stored premium is now stale — call reprice_policy to recompute"
}

⚙ reprice_policy(POL-nest-household-p_auto)

{
  "policy_id": "POL-nest-household-p_auto"
}

{
  "ok": true,
  "as_of": "2025-01-15",
  "base_premium_cents": 104930,
  "final_premium_cents": 64959,
  "breakdown": [
    {
      "step": "BASE",
      "code": "base",
      "detail": "base_rate $900",
      "factor": null,
      "amount_cents": null,
      "running_cents": 90000
    },
    {
      "step": "BASE",
      "code": "tier:EVERGREEN",
      "detail": "tier factor ×1.28",
      "factor": 1.28,
      "amount_cents": null,
      "running_cents": 115200
    },
    {
      "step": "BASE",
      "code": "region:R-MW",
      "detail": "region factor ×1.0",
      "factor": 1,
      "amount_cents": null,
      "running_cents": 115200
    },
    {
      "step": "RISK",
      "code": "factor:driver_age",
      "detail": "driver_age=44 ×1.0",
      "factor": 1,
      "amount_cents": null,
      "running_cents": 115200
    },
    {
      "step": "RISK",
      "code": "factor:risk_score",
      "detail": "risk_score=765 ×0.84",
      "factor": 0.84,
      "amount_cents": null,
      "running_cents": 96768
    },
    {
      "step": "RISK",
      "code": "factor:annual_miles",
      "detail": "annual_miles=12000 ×1.0",
      "factor": 1,
      "amount_cents": null,
      "running_cents": 96768
    },
    {
      "step": "RISK",
      "code": "factor:vehicle_age",
      "detail": "vehicle_age=4 ×1.0",
      "factor": 1,
      "amount_cents": null,
      "running_cents": 96768
    },
    {
      "step": "RISK",
      "code": "factor:incidents_5yr",
      "detail": "incidents_5yr=0 ×0.95",
      "factor": 0.95,
      "amount_cents": null,
      "running_cents": 91930
    },
    {
      "step": "COVERAGE",
      "code": "GAP",
      "detail": "+ GAP $60",
      "factor": null,
      "amount_cents": 6000,
      "running_cents": 97930
    },
    {
      "step": "COVERAGE",
      "code": "MED",
      "detail": "+ MED $45",
      "factor": null,
      "amount_cents": 4500,
      "running_cents": 102430
    },
    {
      "step": "FEES",
      "code": "policy_fee",
      "detail": "+ policy fee",
      "factor": null,
      "amount_cents": 2500,
      "running_cents": 104930
    },
    {
      "step": "DISCOUNT",
      "code": "SAFE_DRIVER",
      "detail": "−12%",
      "factor": 0.88,
      "amount_cents": null,
      "running_cents": 92338
    },
    {
      "step": "DISCOUNT",
      "code": "MULTILINE",
      "detail": "−15%",
      "factor": 0.85,
      "amount_cents": null,
      "running_cents": 78487
    },
    {
      "step": "DISCOUNT",
      "code": "PAID_IN_FULL",
      "detail": "−7%",
      "factor": 0.9299999999999999,
      "amount_cents": null,
      "running_cents": 72993
    },
    {
      "step": "DISCOUNT",
      "code": "PAPERLESS",
      "detail": "−$25",
      "factor": null,
      "amount_cents": -2500,
      "running_cents": 70493
    },
    {
      "step": "DISCOUNT",
      "code": "AUTOPAY",
      "detail": "−3%",
      "factor": 0.97,
      "amount_cents": null,
      "running_cents": 68378
    },
    {
      "step": "DISCOUNT",
      "code": "LOYALTY",
      "detail": "−5%",
      "factor": 0.95,
      "amount_cents": null,
      "running_cents": 64959
    }
  ],
  "changeset": {
    "policies": {
      "changed": [
        {
          "pk": {
            "policy_id": "POL-nest-household-p_auto"
          },
          "fields": {
            "base_premium_cents": [
              80320,
              104930
            ],
            "final_premium_cents": [
              49184,
              64959
            ],
            "premium_breakdown": [
              "[{\"step\": \"BASE\", \"code\": \"base\", \"detail\": \"base_rate $900\", \"factor\": null, \"amount_cents\": null, \"running_cents\": 90000}, {\"step\": \"BASE\", \"code\": \"tier:PINE\", \"detail\": \"tier factor \\u00d71.0\", \"factor\": 1.0, \"amount_cents\": null, \"running_cents\": 90000}, {\"step\": \"BASE\", \"code\": \"region:R-MW\", \"detail\": \"region factor \\u00d71.0\", \"factor\": 1.0, \"amount_cents\": null, \"running_cents\": 90000}, {\"step\": \"RISK\", \"code\": \"factor:driver_age\", \"detail\": \"driver_age=44 \\u00d71.0\", \"factor\": 1.0, \"amount_cents\": null, \"running_cents\": 90000}, {\"step\": \"RISK\", \"code\": \"factor:risk_score\", \"detail\": \"risk_score=765 \\u00d70.84\", \"factor\": 0.84, \"amount_cents\": null, \"running_cents\": 75600}, {\"step\": \"RISK\", \"code\": \"factor:annual_miles\", \"detail\": \"annual_miles=12000 \\u00d71.0\", \"factor\": 1.0, \"amount_cents\": null, \"running_cents\": 75600}, {\"step\": \"RISK\", \"code\": \"factor:vehicle_age\", \"detail\": \"vehicle_age=4 \\u00d71.0\", \"factor\": 1.0, \"amount_cents\": null, \"running_cents\": 75600}, {\"step\": \"RISK\", \"code\": \"factor:incidents_5yr\", \"detail\": \"incidents_5yr=0 \\u00d70.95\", \"factor\": 0.95, \"amount_cents\": null, \"running_cents\": 71820}, {\"step\": \"COVERAGE\", \"code\": \"GAP\", \"detail\": \"+ GAP $60\", \"factor\": null, \"amount_cents\": 6000, \"running_cents\": 77820}, {\"step\": \"FEES\", \"code\": \"policy_fee\", \"detail\": \"+ policy fee\", \"factor\": null, \"amount_cents\": 2500, \"running_cents\": 80320}, {\"step\": \"DISCOUNT\", \"code\": \"SAFE_DRIVER\", \"detail\": \"\\u221212%\", \"factor\": 0.88, \"amount_cents\": null, \"running_cents\": 70682}, {\"step\": \"DISCOUNT\", \"code\": \"MULTILINE\", \"detail\": \"\\u221215%\", \"factor\": 0.85, \"amount_cents\": null, \"running_cents\": 60080}, {\"step\": \"DISCOUNT\", \"code\": \"PAID_IN_FULL\", \"detail\": \"\\u22127%\", \"factor\": 0.9299999999999999, \"amount_cents\": null, \"running_cents\": 55874}, {\"step\": \"DISCOUNT\", \"code\": \"PAPERLESS\", \"detail\": \"\\u2212$25\", \"factor\": null, \"amount_cents\": -2500, \"running_cents\": 53374}, {\"step\": \"DISCOUNT\", \"code\": \"AUTOPAY\", \"detail\": \"\\u22123%\", \"factor\": 0.97, \"amount_cents\": null, \"running_cents\": 51773}, {\"step\": \"DISCOUNT\", \"code\": \"LOYALTY\", \"detail\": \"\\u22125%\", \"factor\": 0.95, \"amount_cents\": null, \"running_cents\": 49184}]",
              "[{\"step\": \"BASE\", \"code\": \"base\", \"detail\": \"base_rate $900\", \"factor\": null, \"amount_cents\": null, \"running_cents\": 90000}, {\"step\": \"BASE\", \"code\": \"tier:EVERGREEN\", \"detail\": \"tier factor \\u00d71.28\", \"factor\": 1.28, \"amount_cents\": null, \"running_cents\": 115200}, {\"step\": \"BASE\", \"code\": \"region:R-MW\", \"detail\": \"region factor \\u00d71.0\", \"factor\": 1.0, \"amount_cents\": null, \"running_cents\": 115200}, {\"step\": \"RISK\", \"code\": \"factor:driver_age\", \"detail\": \"driver_age=44 \\u00d71.0\", \"factor\": 1.0, \"amount_cents\": null, \"running_cents\": 115200}, {\"step\": \"RISK\", \"code\": \"factor:risk_score\", \"detail\": \"risk_score=765 \\u00d70.84\", \"factor\": 0.84, \"amount_cents\": null, \"running_cents\": 96768}, {\"step\": \"RISK\", \"code\": \"factor:annual_miles\", \"detail\": \"annual_miles=12000 \\u00d71.0\", \"factor\": 1.0, \"amount_cents\": null, \"running_cents\": 96768}, {\"step\": \"RISK\", \"code\": \"factor:vehicle_age\", \"detail\": \"vehicle_age=4 \\u00d71.0\", \"factor\": 1.0, \"amount_cents\": null, \"running_cents\": 96768}, {\"step\": \"RISK\", \"code\": \"factor:incidents_5yr\", \"detail\": \"incidents_5yr=0 \\u00d70.95\", \"factor\": 0.95, \"amount_cents\": null, \"running_cents\": 91930}, {\"step\": \"COVERAGE\", \"code\": \"GAP\", \"detail\": \"+ GAP $60\", \"factor\": null, \"amount_cents\": 6000, \"running_cents\": 97930}, {\"step\": \"COVERAGE\", \"code\": \"MED\", \"detail\": \"+ MED $45\", \"factor\": null, \"amount_cents\": 4500, \"running_cents\": 102430}, {\"step\": \"FEES\", \"code\": \"policy_fee\", \"detail\": \"+ policy fee\", \"factor\": null, \"amount_cents\": 2500, \"running_cents\": 104930}, {\"step\": \"DISCOUNT\", \"code\": \"SAFE_DRIVER\", \"detail\": \"\\u221212%\", \"factor\": 0.88, \"amount_cents\": null, \"running_cents\": 92338}, {\"step\": \"DISCOUNT\", \"code\": \"MULTILINE\", \"detail\": \"\\u221215%\", \"factor\": 0.85, \"amount_cents\": null, \"running_cents\": 78487}, {\"step\": \"DISCOUNT\", \"code\": \"PAID_IN_FULL\", \"detail\": \"\\u22127%\", \"factor\": 0.9299999999999999, \"amount_cents\": null, \"running_cents\": 72993}, {\"step\": \"DISCOUNT\", \"code\": \"PAPERLESS\", \"detail\": \"\\u2212$25\", \"factor\": null, \"amount_cents\": -2500, \"running_cents\": 70493}, {\"step\": \"DISCOUNT\", \"code\": \"AUTOPAY\", \"detail\": \"\\u22123%\", \"factor\": 0.97, \"amount_cents\": null, \"running_cents\": 68378}, {\"step\": \"DISCOUNT\", \"code\": \"LOYALTY\", \"detail\": \"\\u22125%\", \"factor\": 0.95, \"amount_cents\": null, \"running_cents\": 64959}]"
            ]
          }
        }
      ]
    }
  }
}

All done, Marisol! Here's your updated auto policy:

Tier: Evergreen (upgraded from Pine)
Medical Payments: added at $5,000
Everything else unchanged — your Bodily Injury, Property Damage, Collision, Comprehensive, and Gap coverages all stay exactly as they were. No Rental Reimbursement or UM/UIM added.
New premium: $649.59/year (was $491.84) — an increase of $157.75/year, right where we expected.

All your discounts carried over (safe driver, multi-line, paid-in-full, paperless, autopay, and loyalty).

Is there anything else I can help you with today?

168k in · 1,545 out · $0.15 · 29.0s

Customer

No, that's perfect — that's exactly what I needed. Thank you so much for walking me through all of that and getting it set up today. I really appreciate it!

Agent

⚙ end_conversation()

{}

{
  "ok": true,
  "note": "Deliver your closing message now."
}

Take care, Marisol — drive safe! 🌲

65k in · 107 out · $0.04 · 4.0s