Job Description:
• Creates, maintains, and updates PHIA-regulated Summary Plan Descriptions (SPDs) and Plan Documents for ERISA and non-ERISA health plans
• Produces Summaries of Benefits and Coverage (SBCs) in accordance with federal and state compliance requirements and ensure alignment with unique client plan design
• Manages plan renewals and drafts plan amendments
• Supports the production and delivery of 80+ plan documents per month
• Participates in client implementation meetings to review benefit outlines
• Collaborates with cross-functional teams (e.g., implementation, compliance, operations)
• Conducts quality reviews to confirm plan documents accurately reflect approved benefit designs and regulatory requirements
• Maintains organized documentation records and version control
• Assist with regulatory audits, client compliance inquiries and review related to the plan document
• Coordinate with vendors to support required federal and state health plan filings
• Conduct the preparation, validation and submission of data and documentation for mandated filings listed above
Requirements:
• High School diploma or equivalent
• Bachelor’s degree in Business, Health Administration, Public Policy, English, or related field; equivalent experience preferred
• Strong writing, editing, and proofreading skills with attention to detail
• Strong knowledge of employee benefits and health plan concepts (medical, Rx, dental, vision, HSA/HRA/FSA)
• Working knowledge of the laws and regulations associated with HIPAA
• Strong knowledge of health plan design & terminology
• Willingness to adhere to all principles of confidentiality
• Proficiency with Microsoft Word (templates/styles), Excel, and Adobe Acrobat
• Ability to manage multiple deadlines in a fast-paced, high-volume environment
• Ability to work independently and follow through on deliverables
• Excellent communication and collaboration skills
• Proficiency with Microsoft Office (Word styles/templates, Excel), Adobe Acrobat, and redlining tools
• 2+ years of experience working for a Third Party Administrator, health insurance broker, carrier, or benefits consulting firm in a role involving benefit plans, client implementation, compliance, or plan document preparation preferred
• Familiarity with plan document generation platforms or template libraries preferred
• Exposure to ERISA, ACA, HIPAA, COBRA, MHPAEA, and state benefit mandates preferred
• Familiarity with SBC templates and plan document generation platforms preferred
• A Life Accident and Health License from state of domicile is preferred.
Benefits:
• Competitive pay
• A safe and healthy work environment provided by our robust benefit program including family health and wellness programs
• 401K
• employee assistance programs
• paid time off
• paid holidays