Plan Compliance & Benefits Specialist

Job Description

Job Description

Looking for a way to influence the health and healthcare of many?

If so, we’d love to hear from you! Our mission-driven organization is focused on the Triple Aim - Better Health, Better Healthcare and Lower Costs to individuals and their families who participate in our health plans.

UNITE HERE HEALTH serves 190,000+ workers and their families in the hospitality and gaming industry nationwide. Our desire to be innovative and progressive drives us to develop impactful programs and benefits designed to engage our participants in managing their own health and healthcare.

Our vision is exciting and challenging. Please read on to learn more about this great opportunity!

Key Attributes :

• Integrity Must be trustworthy and principled when faced with complex situations
• Ability to build positive work relationships Mutual trust and respect will be essential to the collaborative relationships required
• Communication Ability to generate concise, compelling, objective and data-driven reports
• Teamwork Working well with others is required in the Fund’s collaborative environment
• Diversity Must be capable of working in a culturally diverse environment
• Continuous Learning Must be open to learning and skill development. As the Fund’s needs evolve, must be proactive about developing new areas of expertise
• Lives our values Must be a role model for the Fund’s BETTER Culture and Mission (Better, Engage, Teamwork, Trust, Empower, Respect)

UNITE HERE HEALTH is seeking a Plan Compliance & Benefits Specialist to provide understandable and accurate communications that meet legally required standards and educate participants about their benefit coverages.

The purpose of this position is to develop, maintain and update all legally required / compliance benefit plan documents for the assigned Plan Units.

This involves staying current with all applicable employee benefit law (ERISA, ACA, etc.) as it pertains to each Plan Unit and working with various Staff to revise and build legally compliant, participant friendly communications.

ESSENTIAL JOB FUNCTIONS AND DUTIES

• Ensures that all Plan Units comply with ERISA reporting and disclosure requirements, including creation and distribution of :
• Plan Documents,
• Summary plan descriptions (SPDs),
• Summaries of material modifications (SMMs),
• Summaries of benefits and coverage (SBCs),
• Annual mailing of other required documents.
• Drafts plan amendments and resolutions describing the proposed benefit change
• Drafts plan related documents and communication material in a manner compliant with all applicable state, federal and benefits related legislation and regulations
• Reviews benefit related discretionary communications
• Investigates, analyzes, and provides recommendations on benefit and compliance issues
• Collaborates with Manager of Plan Compliance & Benefits and Counsel on plan compliance and regulatory matters impacting benefits
• Collaborates with other departments (Claims, Healthcare Delivery, and Operations) on plan eligibility and benefit related issues
• Collaborates and partners with other Plan Compliance and Benefits Specialist(s) / Analyst(s) to ensure consistency and uniformity in materials, responses to questions, and interpretations
• Serves as a benefit and compliance expert
• Sets goals and achieve measurable results
• Contributes ideas to plans and achieving department goals
• Diversity, Equity, and Inclusion leads, supports, and partners with the Legal team on creating a resilient, high-performing, inclusive culture of diversity and equitable opportunity for employee success and career growth
• Exemplifies the Fund’s BETTER Values in leading and fostering a respectful, trusting, and engaged culture of diversity and inclusion
• Performs other duties as assigned within the scope of responsibilities and requirements of the job
• Performs Essential Job Functions and Duties with or without reasonable accommodation

ESSENTIAL QUALIFICATIONS

Years of Experience and Knowledge

• 3 5 years of related experience minimum
• Working knowledge and experience in an insurance, benefits administration or compliance role
• Experience with welfare benefit plans, as it relates to plan design, administration, benefits, legislative requirements and eligibility
• Experience as a Paralegal or Benefit Analyst preferred
• Knowledge of Taft-Hartley Trust Funds or unions a plus

Education, Licenses, and Certifications

• Bachelor's degree in a related field or equivalent work experience required
• Preferred : Master’s degree

Skills and Abilities

• Excellent written communication skills, including strong editorial ability and the capacity to reduce legal and technical source material to a level of writing understandable by the average participant
• Strong verbal communication skills
• Strong problem solving and analytical skills
• A demonstrated ability to work independently, prioritize multiple projects, and attend to detail
• Intermediate level Microsoft Office skills (PowerPoint, Word, Outlook)
• Intermediate level Microsoft Excel skills
• Working knowledge of InDesign
• Collaboration and team skills

Salary range for this position : $72,600 $90,800. Actual base salary may vary based upon, but not limited to : relevant experience, qualifications, expertise, certifications, licenses, education or equivalent work experience, time in role, peer and market data, prior performance, business sector, and geographic location.

Work Schedule (may vary to meet business needs) : Monday Friday, 7.5 hours per day (37.5 hours per week) with potential for hybrid work-from-home arrangement.

We reward great work with great benefits, including but not limited to : Medical, Dental, Vision, Paid Time-Off (PTO), Paid Holidays, 401(k), Pension, Short- & Long-term Disability, Life, AD&D, Flexible Spending Accounts (healthcare & dependent care), Commuter Transit, Tuition Assistance, and Employee Assistance Program (EAP).