Specifications include, but are not limited to: Assisting the Benefits Manager in administering the medical insurance plans, responding to questions from and providing information to staff and providing other consulting services during the course of the plan year. Assist in complying with laws and regulations related to medical insurance. Review claims experience, claim service, and claim administration to ensure maximum benefit. Determine and recommend the most economical funding methods for the medical insurance plan(s) and strike a balance between cost and comprehensiveness of the programs. Develop a solicitation/negotiation strategy and participate with in all negotiations with providers on all issues including those related to premiums, benefit levels, plan design, and special terms and conditions. Meet and provide reports to all representatives including Finance. Assist with the implementation and communication of new programs or changes to existing programs, which will include attending and presenting information at Open Enrollment meetings. Research any new developments in the law and employee benefit programs on an ongoing basis. As requested, prepare bid specifications and solicit proposals from insurance markets which specialize in medical insurance plan(s) as needed. Evaluate bids and bidders, including administration, coverage, claim payment procedures, customer service, networks, reserve establishment policies, financial soundness, and identify the most cost-beneficial package from among the various bidders. Interface with insurance carriers as needed to assist in the resolution of problems associated with medical insurance program(s).
