Health Plan Compliance Specialist

Job Description: • Creates, maintains, and updates PHIA-regulated Summary Plan Descriptions (SPDs) and Plan Documents for ERISA and non-ERISA health plans • Produces Summaries of Benefits and Coverage (SBCs) in accordance with federal and state compliance requirements and ensure alignment with unique client plan design • Manages plan renewals and drafts plan amendments • Supports the production and delivery of 80+ plan documents per month • Participates in client implementation meetings to review benefit outlines • Collaborates with cross-functional teams (e.g., implementation, compliance, operations) • Conducts quality reviews to confirm plan documents accurately reflect approved benefit designs and regulatory requirements • Maintains organized documentation records and version control • Assist with regulatory audits, client compliance inquiries and review related to the plan document • Coordinate with vendors to support required federal and state health plan filings • Conduct the preparation, validation and submission of data and documentation for mandated filings listed above Requirements: • High School diploma or equivalent • Bachelor’s degree in Business, Health Administration, Public Policy, English, or related field; equivalent experience preferred • Strong writing, editing, and proofreading skills with attention to detail • Strong knowledge of employee benefits and health plan concepts (medical, Rx, dental, vision, HSA/HRA/FSA) • Working knowledge of the laws and regulations associated with HIPAA • Strong knowledge of health plan design & terminology • Willingness to adhere to all principles of confidentiality • Proficiency with Microsoft Word (templates/styles), Excel, and Adobe Acrobat • Ability to manage multiple deadlines in a fast-paced, high-volume environment • Ability to work independently and follow through on deliverables • Excellent communication and collaboration skills • Proficiency with Microsoft Office (Word styles/templates, Excel), Adobe Acrobat, and redlining tools • 2+ years of experience working for a Third Party Administrator, health insurance broker, carrier, or benefits consulting firm in a role involving benefit plans, client implementation, compliance, or plan document preparation preferred • Familiarity with plan document generation platforms or template libraries preferred • Exposure to ERISA, ACA, HIPAA, COBRA, MHPAEA, and state benefit mandates preferred • Familiarity with SBC templates and plan document generation platforms preferred • A Life Accident and Health License from state of domicile is preferred. Benefits: • Competitive pay • A safe and healthy work environment provided by our robust benefit program including family health and wellness programs • 401K • employee assistance programs • paid time off • paid holidays Apply tot his job Apply tot his job

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