WHAT DOES A BENEFITS SPECIALIST DO?

The Benefits Specialist develops standard operating procedures for benefits administration and reporting. Additionally, conducts benefits orientation meetings and enrolls new employees in benefit plans. Furthermore, assists with the annual open enrollment process and group presentations, ensuring timely processing of benefit forms and accurate premium calculations.

A Review of Professional Skills and Functions for Benefits Specialist

1. Benefits Specialist Duties

  • Benefits Program Management: Implement and administrate new and current benefit programs
  • Open Enrollment Oversight: Oversee the Annual Open Enrollment process
  • Benefits Communication: Develop benefits communication materials
  • Employee Advising: Advise employees on complex benefits questions and appeals
  • Compliance: Ensure required disclosures are completed and distributed in a timely fashion
  • Committee Participation: Actively participate in the Health & Welfare Committee
  • Meeting Coordination: Responsibility for the meeting minutes, follow-up action items, and calendaring
  • Annual Benefits Renewal: Assist in the annual benefits renewal process
  • Broker Partnership: Partnering with benefits broker, conducting RFPs, and determining final employer/employee rates
  • Audit Coordination: Be responsible for coordinating audits, plan testing, and any required filings
  • Invoice Reconciliation: Reconcile and submit invoices for payment

2. Benefits Specialist Details

  • Communication: Assist employees regarding benefits claim issues, plan changes, and inquiries.
  • Enrollment Management: Manage and process all new hire enrollment in the ADP benefits module.
  • Leave Administration: Administer firm-wide leave processes, including COBRA, terminations, short and long-term disability, maternity, accident, and death claims.
  • Legal Compliance: Effectively interpret FMLA and ADA implications as they relate to leave of absence/disabilities.
  • Orientation: Responsible for conducting firm orientation for new hires.
  • Offboarding: Process offboarding for voluntary/involuntary terminations, conduct exit interviews, and manage benefit transitions.
  • Regulatory Knowledge: Maintain knowledge of changing Federal and State regulations and legislation that may affect employee benefits.
  • Data Coordination: Coordinate the transfer of data to external contacts for services, premiums, and plan administration.
  • Process Improvement: Evaluate and revise internal processes to reduce costs and increase efficiency.
  • Documentation: Document and maintain administrative procedures for assigned benefits processes.

3. Benefits Specialist Responsibilities

  • Client Communication: Calling clients who have requested benefits.
  • Appointment Scheduling: Scheduling Zoom appointments.
  • Client Meetings: Meeting with clients and building benefits packages.
  • Application Writing: Writing and submitting applications for benefits.
  • Liaison: Serve as the key liaison between producers, customers, and the company to drive sales goals and personal success.
  • Resource Utilization: Effectively utilize the full range of resources we provide to meet clients’ needs.
  • Product Knowledge: Develop and continually improve product knowledge, sales skills, and competitive intelligence.
  • Event Coordination: Coordinate blood drives, flu shot events, lunch & learn webinars, and benefits fairs.
  • Document Management: Maintain proper documents to ensure regulatory compliance and readiness for yearly 5500 audits.

4. Benefits Specialist I Job Summary

  • Program Administration: Plans, develops, and administers the benefits program administration activities.
  • Benefits Administration: Administers various employee benefits programs including group health, flexible spending accounts, health savings accounts, dental, and vision benefits.
  • Documentation Management: Prepares, distributes, and maintains benefits description booklets, annual statements, and certificates.
  • Employee Education: Educates employees on company benefits and assists, as needed, with enrolling in benefits and making permitted changes.
  • Orientation Delivery: Conducts benefits orientations and explains the benefits self-enrollment system.
  • Intranet Management: Ensures that the department page on the Company intranet is updated with current content.
  • Transaction Processing: Processes approvals, follow up, and documents all Workday transactions.
  • Legal Compliance: Processes Qualified Medical Support Court Orders.
  • Data Accuracy: Helps ensure the accuracy of all benefits elections in the system.
  • Information Provision: Provides vendors and payroll with accurate eligibility, enrollment, and payroll deduction information.

5. Benefits Specialist Accountabilities

  • Program Management: Direct and plan the day-to-day operations of group benefits programs.
  • Vendor Liaison: Serve as the primary contact for plan vendors and third-party administrators.
  • Leave Management: Facilitate start-to-finish FMLA and other leave of absence processes for employees.
  • Collaboration: Collaborate with People, Operations, Legal, and other teams to ensure Wix benefits are well-designed, administered, and enjoyed by employees.
  • Regulatory Compliance: Ensure compliance with applicable government regulations, timeliness, and accuracy of required reporting and fees.
  • Material Design: Design and distribute materials for benefits orientations, open enrollment, and summary plan descriptions.
  • Program Improvement: Research new benefits programs, improve existing programs, and supervise and monitor benefits administration.
  • Data Analysis: Analyze and reconcile benefit information with billing and payroll deductions to ensure the accuracy of records and payments.
  • Wellness Initiatives: Assist with employee wellness initiatives in the areas of mental, physical, financial, and social well-being.
  • Administrative Support: Provide administrative support including data entry and responding to employee and vendor phone and email inquiries.

6. Benefits Specialist Functions

  • Material Preparation: Prepare/revise and distribute benefit materials.
  • Audit Participation: Participate in audits and enrollments.
  • Data Accuracy: Ensure dependent information is correct.
  • Record Maintenance: Maintain employee records and participate in and assist with projects.
  • Enrollment Administration: Administer new hires enrollment/paperwork and terminations (COBRA).
  • Program Administration: Administer benefit programs including daily inquiries, life events, and open enrollment.
  • Disability Management: Administer Short-Term and Long-Term Disability, including Leave of Absences.
  • Education Facilitation: Assist with annual open enrollment through testing of the system and conducting employee education sessions.
  • Regulatory Compliance: Remain current on all government regulations involving payroll and benefits.
  • Report Compilation: Compile and audit periodic and special reports on benefits matters for senior HR management.

7. Benefits Specialist Overview

  • Collaboration: Partner with M+A team on benefits activities including due diligence and integration.
  • Data Management: Input benefits data into HRIS and related HR software applications as well as vendor portals.
  • Responsibility Completion: Complete all day-to-day Benefit Responsibilities, ensuring accuracy and compliance.
  • Wellness Program Development: Build wellness programming to help employees focus on preventative health measures.
  • Administration Management: Manage the administration of group benefits plans to ensure accurate, timely, and efficient processing.
  • Data Analysis: Identify drivers of claim trends and associated costs.
  • System Management: Manage Namely Benefits Module, approving and troubleshooting enrollments and employee access, and verifying files sent to vendors.
  • Relationship Building: Build strong relationships and collaborate with all levels of the organization to ensure benefits strategies align with and support organizational business and HR strategies.
  • Liaison Role: Serve as a liaison to benefit brokers and insurance carriers regarding claim problems, issues, and concerns confronting employee participants.
  • Strategy Development: Establish strategies for employee benefits to contain costs and improve choices, as well as oversee compliance with all fiduciary responsibilities.

8. Benefits Specialist Details and Accountabilities

  • Orientation Delivery: Deliver Benefits Orientation to new hires and lead annual open enrollment.
  • Correspondence Management: Create and maintain employee benefit correspondence and spreadsheet files tracking leave of absences.
  • Accommodation Management: Manage requests for reasonable accommodations under the Americans with Disabilities Act (ADA).
  • Enrollment Processing: Process edits to enrollment, change status, and termination of employee benefits.
  • Documentation Development: Develop process documentation to be utilized as a reference for the People and Culture team.
  • Operations Management: Manage daily operations of enrollments to help ensure appropriate customer service levels are maintained.
  • Communication Responsibility: Responsible for communication of all education materials, open enrollment processes, etc.
  • Communication Implementation: Implement effective communication strategies in daily/weekly meetings.
  • Reporting: Report daily/weekly results to the executive team.
  • Analysis: Analyze claims activity results to establish trends, identify opportunities, and determine areas of concern.

9. Benefits Specialist Tasks

  • Procedure Development: Develop standard operating procedures for benefits administration and reporting.
  • Orientation Conducting: Conduct benefits orientation meetings and enroll new employees in benefit plans.
  • Enrollment Assistance: Assist with the annual open enrollment process.
  • Presentation Support: Assist with group presentations and prepare, distribute, and receive materials and forms.
  • Form Processing: Process all employee benefit enrollment and change forms within required time limits to meet payroll deadlines.
  • Statement Review: Review and verify the calculation of monthly premium statements for all group insurance policies.
  • Problem Resolution: Resolve administrative problems with the carrier.
  • Billing Management: Balance and submit billing statements to accounting for payment.
  • Notice Distribution: Ensure distribution of required employee notices.
  • System Learning: Learn new systems and complete reporting requirements for the Center for Medicare & Medicaid Services, Affordable Care Act.

10. Benefits Specialist Roles

  • Reporting Assistance: Assist with the Paid Sick/Safe Leave reporting and administration.
  • Policy Adherence: Comply with and adhere to all ISO policies and procedures.
  • Reporting Submission: Submit periodic reports to management.
  • Data Entry: Enter all benefit deductions required for accurate and timely payroll processing.
  • Compliance Support: Provide assistance with compliance testing, annual audits, ACA reporting, and other special projects.
  • Report Generation: Generate reports, review files, investigate variances, and research plan provisions.
  • Invoice Processing: Generate internal reports for self-billed benefits and process related invoices.
  • Invoice Review: Review and update any incoming list of billed invoices and prepare for payment.
  • Custom Report Preparation: Generate monthly customer medical enrollment reports for managers upon request.
  • Leave Management: Prepare and process Paid Sick/Safe Leaves, Disability, Family Medical Leave, and Paid Family Leave requests for all employees.

11. Benefits Specialist Additional Details

  • File Maintenance: Maintain accuracy of client files and proper forms for each carrier.
  • Correspondence Preparation: Prepare written correspondence, reports, and analyses.
  • Multi-site Administration: Administer benefits for multiple sites within the company.
  • Data Management: Manage benefits-related data in the HRIS system.
  • Communication Management: Manage communications to client worksites and co-employees regarding changes in benefits.
  • Professional Development: Attend appropriate industry functions and participate in relevant industry training.
  • Knowledge Development: Develop and maintain an extensive knowledge of insurance coverage and markets.
  • Positive Communication: Communicate with associates, clients, and carriers in a positive manner.
  • Liaison Role: Act as a liaison between clients and insurance carriers to independently resolve service problems.
  • Customer Service: Provide superior customer service by answering questions from client worksite and co-employees via phone, email, or mail.

12. Benefits Specialist Essential Functions

  • Benefit Administration: Administers employee benefits including insurance flexible spending accounts, and retirement and transitional retirement programs.
  • Resource Provision: Serves as an informational resource to the campus community regarding policies, procedures, and best practices.
  • Employee Briefing: Conducts potential/new employee benefits briefings, new hire orientations, and open enrollment for Faculty, Administrative Professional, and Classified employees.
  • Data Entry: Enters all benefit changes into the associated vendor system.
  • Event Coordination: Coordinates the annual employee Health and Benefits Fair.
  • Leave Management: Coordinates Family and Medical Leave (FMLA) program and associated paperwork, tracking leave, reporting, advising, and employee and University compliance.
  • Issue Resolution: Works with employees to solve eligibility issues and resolve application issues.
  • Workers Compensation Coordination: Coordinates workers' compensation program from first report of injury to return to work, coordinating care, tracking leave, contesting claims.

13. Benefits Specialist Role Purpose

  • Legal Representation: Preparing for/appearing in court, and communicating with insurance carriers and State Risk Management.
  • Advisory Analysis: Advises the Executive Director of potential issues, provides analyses of claims and their impact on University costs.
  • Guidance Provision: Provides guidance to supervisors on work restrictions and other claim provisions.
  • Leave Management: Manages all employee leave, including tracking both electronically and manually, interpreting relevant rules, and researching and resolving leave issues.
  • Reporting Compliance: Files mandatory reports such as Medicare disclosure, FSA Discrimination Testing, 1095 C tax forms for ACA, and annual life insurance renewals.
  • Benefit Administration: Administers tuition discount and reimbursement program for employees/dependents and other miscellaneous benefits.
  • Process Improvement: Identifies issues and suggestions to improve processes in and out of the office.
  • Policy Input: Provides input on policies and procedures related to HRIE.
  • Committee Participation: Serves on committees and attends campus meetings.

14. Benefits Specialist General Responsibilities

  • Premium Management: Ensure timely preparation, filing, and submission of annual Pension Benefit Guaranty Corporation premiums.
  • Calculation Preparation: Prepare defined benefit calculations for review by Plan(s) actuaries.
  • Estimation Preparation: Prepare Firm’s Retirement Income Plan pension estimates.
  • Benefit Calculation: Calculate final benefits, establish pension payroll, and handle all aspects of retiree pension administration.
  • Calculation Coordination: Prepare partners' frozen unfunded pension plan calculations in coordination with plan(s) actuaries and partner payroll group.
  • Testing Participation: Actively participate in and monitor all non-discrimination testing schedules.
  • Census Preparation: Prepare annual census for partners and employees defined benefit pension plans for submission to plan(s) actuaries.
  • Plan Administration: Responsible for the daily administration of the Firm’s defined contribution Savings and Investment Plan.
  • Collaboration: Work closely with Payroll(s) and plan trustee and recordkeeper to maintain an automated and streamlined process.
  • Vendor Relationship Management: Maintain strong relationships with outside vendors and consultants.
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