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Job Summary

The Plan Document Analyst Associate drafts, revises and maintains Employee Retirement Income Security Act (ERISA)-compliant Plan Documents and amendments, Summary Plan Descriptions, and Affordable Care Act (ACA)-compliant Summaries of Benefits and Coverages as directed by the Plan Administrator, ensuring these documents are in compliance with all applicable federal laws and regulations. The accuracy of these documents is crucial due to potential excess loss and/or Plan Fiduciary financial impacts. The pursuit and acquisition of signed and approved documents supports satisfaction of the BlueCross BlueShield Association’s Membership Tracking Module (MTM) Source of Truth requirements.

Requirements

EDUCATION

Bachelor’s degree in Technical Writing, Business, Healthcare Management or related field. In lieu of degree, five (5) years' non-clerical experience with an insurance, managed care or healthcare organization will be considered.

EXPERIENCE & KNOWLEDGE

Experience writing documentation or instructional materials preferred.

Analysis and/or research experience preferred.

In-depth knowledge of managed care, health insurance or third-party administrative services preferred.

Knowledge of products and services associated with self-funded clients preferred.

Knowledge of federal and state laws and regulations impacting self-funded clients preferred.

Project Management experience preferred.

Skills

• Collaborative Communications • Continuous Learning • Cross-Functional Communications • Cross-Functional Planning • Customer Relationship Management (CRM) • Interpersonal Relationship Management • Microsoft Excel • Microsoft Word • Oral Communications • Problem Sensitivity • Process Improvements • Researching • Service Oriented • Writing • Written Communication

Responsibilities

• Analyzes and resolves issues reported by external and internal users. • Attends and/or facilitates new group implementation meetings to obtain detailed benefit information. • Collaborates with Legal department to resolve compliance issues. • Coordinates Plan Document language with the Benefit team for purposes of system configuration and benefit administration. • Develops, maintains, and manages health plan documents—including Plan Documents, amendments, Summary Plan Descriptions (SPDs), and Summary of Benefits and Coverage (SBCs)—while coordinating timely Plan Administrator approvals and overseeing secure electronic document storage for internal and client access. • Ensures systems configuration leadership is aware of problems and the actions taken to resolve issues. • Performs other duties as assigned. • Provides support to the Benefit Team and other applicable internal teams. • Utilizes an internet-based plan document system to create and customize health plan document templates, maintaining content libraries that align with plan administration requirements, benefit designs, and client-specific practices.

Certifications

Security Requirements

This position is identified as level three (3). This position must ensure the security and confidentiality of records and information to prevent substantial harm, embarrassment, inconvenience, or unfairness to any individual on whom information is maintained. The integrity of information must be maintained as outlined in the company Administrative Manual.

Segregation of Duties

Segregation of duties will be used to ensure that errors or irregularities are prevented or detected on a timely basis by employees in the normal course of business. This position must adhere to the segregation of duties guidelines in the Administrative Manual.

Employment Type

Regular

ADA Requirements

1.1 General Office Worker, Sedentary, Campus Travel - Someone who normally works in an office setting or remotely and routinely travels for work within walking distance of location of primary work assignment.