Insurance Contract Examiner

State of Maine•Gardiner, ME

1d•Onsite

About The Position

This is administrative work in examining life and health insurance contracts to determine compliance with Maine law. The work includes reviewing policy forms, riders, and endorsements used by insurance companies doing business in Maine; reviewing certificates issued under out-of-state group policies; and processing complaints, inquiries, and requests for assistance from the public regarding insurance matters. Work is performed under limited supervision. The position is with the Department of Professional and Financial Regulation (and Boards), Job Class Code 0367, Grade 22 (Professional/Technical), and is located in Gardiner, Maine. The listed annual salary range is $49,296.00–$68,785.60. The position is not eligible for visa sponsorship or STEM OPT extensions. The State of Maine describes its compensation and benefits package as including paid holidays and leave, health and dental insurance, retirement contributions, gym membership reimbursement, flexible spending accounts, parental leave, and voluntary deferred compensation. Benefits may vary according to collective bargaining agreements and are prorated for less than full-time work.

Requirements

Bachelor’s degree in Business Administration or a related field and two years of experience in the insurance industry, or a six-year combination of education, training, and/or experience in the insurance industry.
Knowledge of life, health, and accident insurance.
Knowledge of contract law as it relates to insurance.
Knowledge of state insurance laws, rules, and regulations.
Knowledge of practices and procedures of insurance and related industries.
Knowledge of federal insurance programs.
Knowledge of insurance examination and question development procedures.
Ability to recognize conflicts in contracts, including prohibited and required provisions.
Ability to solve problems independently.
Ability to communicate effectively.
Ability to write clearly and effectively.
Ability to read and understand insurance contracts.

Responsibilities

Review and analyze life, accident, and health insurance contracts, including policies, certificates, riders, and endorsements, to determine compliance with Maine law.
Consult with insurance company representatives to clarify, correct, and alter contract provisions that conflict with Maine laws, rules, and regulations.
Research and evaluate insurance-related problems to develop solutions, including improved procedures, regulatory changes, or proposed legislation.
Advise Bureau of Insurance personnel by providing technical information in the area of expertise.
Respond to public telephone queries and complaints, and conduct individual interviews to solicit or provide information and resolve life and health insurance-related problems.
Mediate settlements with life and health insurers to resolve complaints.
Represent the agency and speak before various groups to provide information about life and health insurance.

Benefits

13 paid holidays annually.
12 days of sick leave annually.
More than three weeks of vacation leave annually, with accrual increasing with years of service.
Personal leave for overtime-exempt employees.
State-paid employee-only health insurance premiums at 85%–100%, depending on salary; dependent coverage contributions vary.
A 5% employee-only health insurance premium credit for participation, subject to program requirements.
State-paid 100% of employee-only dental insurance premiums.
State contribution of 14.06% of pay to the Maine Public Employees Retirement System.
Gym membership reimbursement of up to $40 per month.
Health and dependent care flexible spending accounts.
Eligibility for Public Service Student Loan Forgiveness as a qualified employer.
Employee assistance through the Living Resources Program.
42 consecutive calendar days of fully paid parental leave for employees welcoming a child; additional unpaid leave may also be available under the Family and Medical Leave Act.
Voluntary deferred compensation through a MaineSaves 457(b) account.