Simplyhealth will multiply service and sales capacity with Agentforce.

Routine questions and repetitive administrative tasks slowed Simplyhealth’s service and sales teams.

Simplyhealth is already a leader in rethinking healthcare. As the U.K.’s first Certified B Corp health insurer, the company is on a mission to remove complexity from healthcare and help more people get the care they need, faster. That’s especially urgent in the U.K., where 7.4 million people are currently waiting for treatment through the public provider, National Health Service. By offering customizable plans, intuitive tools, and clear starting points for private healthcare, Simplyhealth is creating an alternative and simpler way forward.

“The human side to healthcare for us is the single most important thing,” said Claudia Nicholls, Chief Customer Officer. “Putting yourself in the shoes of the member and what goes on in their life is what our human reps are trained to do.”

Although Simplyhealth is committed to personalizing every member interaction, 80%–90% of the 335,000 service cases that come in via email, phone, live chat, and WhatsApp each year are for routine inquiries. Responding to calls and emails from members checking the status of a claim or needing help resetting their password takes up valuable time that could be better spent on higher-touch needs.

High volume was a challenge on the sales side, too. Each rep manages around 700 members, which leaves little time for the research and prep required to personalize outreach, nurture leads, and upsell. As Simplyhealth works to grow its member base fourfold in the next few years, it was clear their service and sales teams needed to automate repetitive tasks and build a faster, more effective way to connect with current and future members.

Agentforce will help the sales team engage, nurture, and convert leads and tailor offers for new and existing members.

Agentforce will help Simplyhealth reach its goal of quadrupling the number of members it serves by transforming not just how their service teams work, but also by making their sales processes faster and smarter.

Simplyhealth is starting with Sales Coach, an Agentforce-powered assistant that delivers real-time coaching, surfaces contextual insights, and helps reps learn new products. It speeds onboarding, supports career growth, and helps service reps transition into sales roles while freeing time to strengthen member relationships.

In the future, Simplyhealth envisions Agentforce acting like an always-on sales team member — identifying upsell and cross-sell opportunities, booking calls, and generating personalized follow-up emails. This lead management agent could nurture prospects and existing members across WhatsApp, in-app chat, email, and web, while automating admin work like syncing each sales rep’s calendar to schedule meetings.

Looking ahead, Simplyhealth is already exploring what’s next — including new agents for case management, quote generation, and campaign creation. With Agentforce, they’ll be able to grow their membership fast while keeping care at the center of every interaction.

Simplyhealth’s Salesforce-powered “contact center of dreams” provides a single record for every service interaction.

Simplyhealth was able to launch Agentforce quickly because of their powerful foundation — a deeply unified platform that brings all member data together in one place. Built on Salesforce, Simplyhealth 360 unifies policy plans, service cases, and terms and conditions, and a history of interactions for every member.

That connected platform powers what Eddie calls a “contact center of dreams.” Using Service Cloud and Service Cloud Voice with Amazon Connect, service reps can see all relevant data — plus the full knowledge base with detailed policy terms — in one console, regardless of the channel a member prefers for customer service help.

Live chat has been the biggest shift, enabling service teams to handle two or three conversations at once compared to one at a time on the phone. Generative AI in
Service Cloud has also transformed email support. Instead of waiting 12 minutes for a reply, members now get a response in just 1.5 minutes — an 87.5% decrease in response time. The team now sends 1,300 emails per week with generative AI, saving reps more than 100 hours weekly.

When members do call, Service Cloud Voice with Amazon Connect brings the call into the console, displays real-time transcripts, and automatically updates the member record. This makes it easier to track context, spot patterns, and follow up.

This digital shift hasn’t replaced human connection — it’s strengthened it.

“We’re increasingly using technology to support our interactions with our members. It’s becoming more and more important over time,” said Nicholls. “In our industry, talking to members directly and in different forms doesn’t show any sign of disappearing. What’s changing is that repetitive tasks are being automated, making room for the human touch that matters to so many of our members.”

When Simplyhealth set out to explore agentic AI, they knew they needed a solution that met the strict requirements of the healthcare industry. With data privacy and regulatory compliance top of mind, the company wanted to move fast — but safely. Agentforce stood out from the competition thanks to its built-in guardrails, including the Trust Layer, data masking, and strict permissions controls. 

“We have a pretty sophisticated method of applying safeguards and keeping humans in the loop at the right points to make sure the accuracy of information is there,” said Nicholls. “You need to test, adjust, and deploy these things appropriately in circumstances when their use is able to derive the most benefit.”

Simplyhealth’s longstanding partnership with Salesforce gave them the confidence to go all in. “Simplyhealth and Salesforce have been partners for 10 years,” said Nicholls. “We work together across pretty much the whole business. The technology is business-critical and helps us grow by allowing us to remove the barriers to healthcare access and be available 24/7.” That reliability mattered as the company began transitioning from experimenting with Einstein features like summaries to beginning their
Agentforce implementation.

Agentforce offers capabilities more advanced than what the team could access with Einstein alone, particularly in areas like personalization. Because Agentforce can connect securely to specific data sources via APIs, Simplyhealth could begin tailoring every interaction to individual members — without compromising on security or compliance.

To guide overall AI strategy and implementation across the business, Simplyhealth created an internal AI forum to ensure they had a strong governance framework in place. The move builds on years of work with Salesforce, including the launch of their Simplyhealth 360 platform, which gave them the solid foundation they needed to implement AI thoughtfully and effectively. “Now we can respond faster, coach our sales teams faster and more consistently, and automate more of the work that doesn’t add value to our teams,” said Nicholls. “Our teams love it. Agentforce feels like part of the team.”