Job Description:
Seeking an experienced Insurance Product Administrator to build and manage various health plans like MECs, fully insured, level-funded and self-funded. The ideal candidate will ensure compliance with federal and state regulations, maintain plan documentation, and oversee participant communications. This role requires strong organizational skills and in-depth knowledge of health product design and service.
Key Responsibilities:
● Oversee the administration of MEC, fully insured, level-funded and self-funded health plans.
● Ensure compliance with ACA, ERISA, and other applicable regulations.
● Manage plan documentation, participant communications, and annual filings (SPDs, 5500s).
● Collaborate with other departments to ensure seamless plan operations.
● Handle escalated participant issues and complex cases.
● Oversee the administration of MEC, fully-insured, level-funded, and self-funded health plans.
● Analyze carrier data on complex clients and provide recommendations to account teams to help
with the negotiation of rates and funding levels
● Analyze and recommend optimal funding arrangements
● Assist in marketing, analysis and placement of stop loss coverages
● Price plan design and product alternatives
● Assist in reviewing contracts, preparing RFP specifications, and identifying markets for
proposals
● Assist in the workflow for monthly and quarterly financial reporting for clients
● Assist in negotiating rates with insurance carriers and other vendors
● Provide technical expertise, product updates, and training programs
● Follow industry development, changes, and legislative updates within all types plan
administration methodology
● Conduct special projects as needed
Qualifications:
● Bachelor’s degree in Business Administration, Health Management, or a related field.
● Health and Life Insurance licensing required
● 5+ years of experience in health plan administration, preferably with MEC or self-funded plans.
● Strong knowledge of ACA and ERISA regulations.
● Excellent communication and organizational skills.
Skills Required:
● Critical thinking and problem-solving skills
● Excellent organization skills
● Self-motivated, goal-oriented individual
● Positive attitude and friendly demeanor
● Excellent written, verbal, and interpersonal communication skills
● Work independently and in a team environment
● Strong computer skills and working knowledge of Google software
