Employee Benefits & Wellness Administrator

City of Sunrise, FL•Sunrise, FL

67d

About The Position

This classification involves highly responsible professional and supervisory work providing advice, recommendations , and assistance to the Assistant Risk Manager and Risk Manager. The incumbent is primarily responsible for the administration of industry best practices of employee group benefit programs for employees and retirees including but not limited to; fully-insured medical plan, dental, vision, life, long-term care, long-term disability, and supplemental illness and accident. Incumbent is also responsible for compliance and regulatory reporting to various governmental agencies including; COBRA administration, Patient Protection and Affordable Care Act and 1095-C IRS tax reporting, Medicare Creditable Care disclosures, and Federal and State legislative requirements. Incumbent oversees and works closely with Employee Benefits Specialist to deliver customer service focused New Hire and Retiree Benefit Orientations, complex Qualifying Life Events changes, annual Open Enrollment, and Wellness and Educational Initiatives to promote overall population health management and fiscal responsibility with a focus on health promotion and disease prevention. An incumbent in this classification is responsible for the oversight of the Administrative Services Organization (ASO) providing the city with the fiduciary responsibility of claims administration, reporting of monthly, quarterly, and yearly claims experience, affording an on-site customer service claims representative for the self-insured Health Insurance program Other responsibilities include development of employee benefit policies and procedures, manual and educational material, and group policy plan document updates. Oversees maintenance of employee benefit records, changes, bi-weekly deductions and adjustments, ensures billings are reconciled with employee records and processed; oversees deductions and adjustments; and processes retiree insurance benefit payments and coordinates with applicable retiree pension administrators. Incumbent also responds to complex employee inquiries regarding benefits and assists employee to resolve/explain claim issues. This position is deemed an essential employee. Supervision and delegation is exercised over subordinate Risk Management Employee Benefits Specialist for necessary assignments. General direction and strategic guidance is received from the City's Assistant Risk Manager and Risk Manager who monitors the incumbents performance for desired results.

Requirements

Graduation from an accredited college or university with Bachelor's Degree in Risk & Insurance Management, Health Administration/Health Services, Human Resources, Public or Business Administration or a closely related field. Master's Degree preferred.
Considerable experience in administering, implementing and monitoring self-funded employee group insurance plans, dental, life, disability insurance programs, supplemental, employee wellness, COBRA, and state and federal regulatory reporting requirements.
Thorough knowledge of self-insurance benefits administration.
Knowledge of all benefit related laws and regulations including, but not limited to, Affordable Care Act, Health Insurance Portability and Accessibility Act (HIPAA), Consolidated Omnibus Budget Reconciliation Act (COBRA), federal and state laws, and other applicable regulations.
Possession of a valid driver's license with an acceptable driving record
Must obtain a valid Florida license within thirty (30) days of residency or accepting employment
Knowledge of employee group health, dental, life, vision, long-term care, disability insurance programs, plan administration and implementation, COBRA regulations, and state and federal compliance requirements.
Knowledge of self-insurance benefits administration.
Knowledge of the policies and procedures of insurance organizations providing group health and life insurance coverage.
Knowledge of department rules, regulations, and procedures pertaining to insurance activities.
Considerable knowledge of the administration, terminology, technology and best industry practices related to self-funded employee group health insurance plans and several fully-insured employee group insurance benefit plans.
Considerable knowledge of the administration, terminology, and technology and best industry practices related employee wellness events and initiatives for population health management.
Considerable knowledge of the administration, terminology, and technology of payroll benefit and deduction codes.
Considerable knowledge of monthly and annual financial reports, medical and pharmacy utilization reports, and various confidence funding levels with actuarial reports.
Considerable knowledge of applicable prominent Federal and State laws affecting these self-insured, self-funded or fully-insured programs.
Considerable experience and knowledge with public speaking and conducting open enrollment meetings. Comfortable making presentations to large groups of employees or smaller groups of management staff.
Ability to develop, coordinate, and conduct various training seminars related to employee benefits and wellness.
Ability to effectively and professionally communicate information regarding employee group insurance benefits, including relevant findings and recommendations, to all levels of employees and management in a relevant, clear, concise, and comprehensive manner. Skilled in both oral and written communication. Confident in coaching others for understanding and making informed decisions.
Ability to establish and maintain effective working relationships with subordinates, peers, and supervisors and various City employees, outside agencies, consultants, adjusters and insurance carriers.
Considerable knowledge of administration, terminology, and technology to develop an employee benefits handbook with assistance from the Employee Benefits Specialist.
Knowledge of general office procedures, practices, and equipment.
Skill in the use of a personal computer.
Ability to assemble information from office records and prepare accurate and complete reports.
Ability to understand and interpret the provisions of various group health insurance plans applicable to the City.
Ability to exercise judgment and discretion in the application of department policies and procedures to group health insurance problems and circumstances.

Nice To Haves

Experience in a self-insured, governmental and union environment preferred
Experience utilizing Tyler-Munis ERP preferred
Certified Employee Benefit Specialist (CEBS) preferred
Registered Employee Benefits Consultant (REBC) preferred

Responsibilities

Provides verbal and written information to employees regarding the various employee health insurance plans and applicable procedures.
Responds to inquiries regarding payment of claims and clarifies plan benefits.
Assists individual employees with complex insurance problems, such as claims allegedly not paid according to provision of plan; requests that insurance providers re-evaluate payment of claims as needed; and informs employees if expenses are covered or not covered.
Oversees the processing of various forms and documents between employees and insurance providers such as applications for coverage, addition of new dependents, new enrollments under dependent coverage, change in coverage, retirements, and terminations.
Oversees additions and deletions of enrollment through direct interface with various carriers' portals.
Audits carriers' records for errors and inconsistencies; directs corrections.
Provides COBRA/conversion information regarding rates and plans to enroll dependents of deceased employees, retirees, and former employees; prepares and forwards forms in compliance with COBRA laws and contract parameters.
Reconciles records of the City with those of the insurance providers; coordinates corrections.
Oversees retiree recurring invoice payments for continuation of retiree insurance coverage; sends past due letters and makes arrangements to collect payment of NSF checks.
Reviews reconciliation of monthly bills for health, dental, disability, long-term care, vision, supplemental, life insurance, EAP, COBRA, and ACA reporting for payment.
Assists the Employee Benefits Specialist and outside consulting firm with collecting, preparing and organizing the data to file the any required Internal Revenue Service's form 1094-B Transmittal of Health Coverage Information Returns and form1095-B Health Coverage.
Facilitates the development of new benefits programs and modifications to existing benefit programs.
Oversees new hire orientation, retirement orientation, and annual open enrollment for health benefits.
Develops and oversees health and wellness initiatives that promote physical, mental, emotional and financial well-being across the organization.
Conduct surveys, assessments, and data analysis to identify the health and wellness needs of the organization.
Manage funds allocated to wellness activities and vendor services ensuring cost-effective program delivery.
Leads the management of the benefits administration software and self-service portals to improve employee access and engagement.
Acts as Risk Manager's a designee to authorize execution of various contracts, amendments and related insurance applications or documents per City resolutions and procurement procedures.
Assists Risk Manager and Assistant Risk Manager in the preparation of Requests for Proposals specifications for fully-insured or self-funded employee benefit plans and other related contracted risk management services for professional services, consultants, actuarial services and regulatory compliance.
Participates in the evaluation of proposals and in negotiating contracts; prepares documents for review or approval by the Risk Manager, City's administration and is responsible with monitoring contracts to ensure compliance with negotiated terms and conditions as well if updated language is necessary to clarify intent or compliance with various legislative mandates.
Assists with managing the renewal and procurement processes for fully-insured and self-funded employee benefit plans in collaboration with internal stakeholders and benefits consultant. Assists with coordinating services from benefit consultants, auditors, benefit lawyers, and actuaries providing rate studies, mandated plan filings and certifications for the employee group health insurance plans.
Assists with analyzing monthly and annual medical plan utilization reports to determine recommended changes to plan design based on claim patterns and utilization in comparison with City's peer group national averages.
Assists in reviewing the self-funded employee benefit plan claims experience reports at various modes.
Monitors legislative changes, including financial impact and implementing remedial measures for compliance; assists Risk Manager with conducting surveys and market research.
Performs related work as required.

Benefits

5% Supplemental Pay: Supervisory/Professional employees shall receive a five percent (5%) supplemental pay calculated on the employee's base rate of pay.
Group Health Insurance: The City pays for 100% of the cost for single coverage for full-time employees and 66.66% of cost for Dependent/Family Coverage. Upon retirement and separation from City employment, employee receives a monthly stipend of $350 per month, applicable toward retiree health coverage.
Life Insurance: $50,000
Accidental Death & Dismemberment (AD&D): $50,000
Eye Care Reimbursement - Up to $250 every two (2) fiscal years (Employee only)
EKG/Stress Test - Up to $150 reimbursement per fiscal year (Employee only)
Physical Examination - Up to $250 reimbursement per fiscal year (Employee only)
Employee Assistance Program (EAP) through Cigna Behavioral
Employee Contribution = 8%
Vesting = 10 Years
Average Final Compensation (AFC) = 2.5% of pensionable earnings for each year of creditable service
Maximum Benefit = 80% of AFC, not to exceed $80,000.
Normal Retirement = Age 62 and ten (10) years of creditable service.
Early Retirement = Age 57 and ten (10) years of creditable service, 3% annual reduction for each year prior to normal retirement age.
13th check based on monthly retirement, payable if the pension plan funding status is equal to or greater than 100%. Paid in December each year following retirement.
Deferred Retirement Option Plan (DROP) = 4 years/48 months maximum.
DROP Interest Rate = 4%, compounded annually.
Based on successful completion of full-time, continuous service with the City, employee shall receive the following:
Longevity Benefit calculated on employee's base rate of pay
Employees receive the following City-paid holidays:
Annual leave may be taken as earned. Maximum accumulation each fiscal year is 360 hours. At time of resignation or retirement, employee is paid for all annual leave accrued at their current rate of pay. Annual leave is accrued based on continuous, full-time service with the City, as follows:
Employee can opt to receive a one-time per year non-pensionable cash payment for up to forty (40) hours of annual leave, provided accrued annual leave bank does not fall below eighty (80) hours.
Upon completion of (26) weeks of full-time employment with the City, employee shall be entitled to utilize up to five (5) floating holidays per fiscal year. Floating holidays shall not carry over to the next fiscal year.
For every six (6) months period (April 1 - September 30) and (October 1 - March 31) in which, no sick or unpaid leave is utilized, an employee shall receive 10 hours of annual leave credited. Employees who qualify for a consecutive Perfect Attendance benefit shall receive 14 hours of annual leave credited for each applicable consecutive earning period.
Each employee earns (96) hours (12 days) of sick leave annually with no waiting period for use and maximum accrual of 1,440 hours. Upon separation of City employment due to resignation, employee shall receive payment of all accrued sick leave at a rate of twenty-five percent (25%) of the employee's current rate of pay at time of resignation. Upon separation of employment due to retirement, employee shall receive payment of all accrued sick leave at a rate of fifty percent (50%) of the employee's current rate of pay at the time of retirement.
After completion of one (1) year of continuous, full-time employment with the City, an employee may convert their unused portion of their first six (6) days (maximum of forty-eight (48) hours) of accrued sick leave into annual leave. Conversions are subject to the following: A minimum of 96 unused sick leave hours accrued prior to hours being converted, total eligible sick leave hours to be converted shall be reduced hour-for-hour by any sick leave hours utilized during the eligible benefit period, and conversion subject to annual leave accrual cap.
Qualifying City-paid Bereavement Leave as follows:
After (2) two years of full time employment
100% reimbursement for a grade of A or B
50% reimbursement for a grade of C
$500 books/lab reimbursement per semester
We Florida Financial Bank & Credit Union - 8890 NW 44th St, Sunrise Fl 33351
Supervisory/Professional employees hired on or after 10/1/09 shall receive a five percent (5%) supplemental pay calculated on the employee's base rate of pay to offset the costs of voluntary medical benefits. The City offers the following optional voluntary benefits paid by the employee:
Single or Family Dental Insurance Coverage
Single or Family Vision Insurance Coverage
Accident Indemnity Advantage
Life Insurance Coverage
AD&D
Long Term Disability Insurance Coverage
Long Term Care Insurance Coverage
Short Term Disability
Catastrophic Health & Intensive Care
ICMA Retirement Compensation Programs
ICMA 457 Deferred Compensation Plan
ICMA Governmental Purchase Plan within 60 days of employment