Who Should Manage Group Health Benefits?

Benefits administration has many elements, not the least of which is your group medical plan. First, decide whether you should assign the group medical plan administration to an existing employee or if you need to hire someone. To help make that decision, consider these facets of group benefit

administration:

General administration. All plans must meet the operational requirements of the Internal Revenue Service, and must provide timely information to the participants as well as the carrier. Your benefits administrator (BA) will work with the broker or the insurance carriers to prepare and deliver all monthly and annual reports that must be filed with the IRS and the Pension Benefit Guaranty Corporation.

Communication. Since your group health program increases your attractiveness as an employer, your benefit program must be properly represented. The BA must work together with your management and staff to communicate the plan to participants through employee meetings, handouts, and presentations.

Implementation. The installation and implementation of any qualified plan requires that certain procedures be followed. Often these procedures must be coordinated with employees, management, and legal counsel.

Consulting. As rules and regulations change, or industry trends cause employees and employers to rethink their needs, the BA should be able to assist management in analyzing these changes, and in determining how best to alter benefit programs to meet these changing requirements.

The person you select to oversee your employee benefits, including your health plan, may not need all the qualifications listed below, but considerations for this position should include:

• Demonstrated management experience in financial services and employee benefits;
• Proven organization and leadership skills;
• Excellent communications and interpersonal skills;
• Overall knowledge of health and other benefit plans;
• Working knowledge of the rules and regulations governing benefit plans;
• Understanding of service quality and performance measurements.

Daily responsibilities can include:

• Daily management of employee benefit activities, including reviewing, recommending and responding to questions regarding insurance-type benefits (life, medical, dental, vision, disability);
• Chairing the claims appeal committee for self-insured programs and making recommendation on related issues;
• Working with a stop-loss carrier on large claim issues to contain cost and obtain reimbursement as appropriate;
• Making presentations to employees and assisting with major departmental projects, such as installing plans;
• Managing and ensuring timely and accurate reporting;
• Organizing and scheduling the daily processing of plan activities;
• Reviewing and sharing quarterly participant statements.

If you plan to assign this function to an existing employee, share this information with the individual, and get their feedback to see how they feel about performing these duties.