INSURANCE BENEFITS TECHNICIAN

BASIC FUNCTION:

Under the supervision of the Associate Superintendent and work direction of the Insurance Benefits Specialist, independently perform duties to support the insurance benefits programs, providing information and guidance to employees and retirees through every phase of the benefit process;  serve as a liaison between employees and insurance company representatives and agents; organize, maintain, and distribute information, procedures, and forms regarding insurance benefits programs provided by the District for employees; enroll qualified participants.

DISTINGUISHING CHARACTERISTICS:

The Insurance Benefits Technician independently performs duties to support the insurance benefits programs, providing information and guidance to employees and retirees through every phase of the benefit process. The Insurance Benefits Specialist provides work direction to the Insurance Benefits Technician and performs a wide range of complex and highly technical and analytical duties as they relate to benefit programs.  Additionally, the Insurance Benefits Specialist provides input to the negotiation process with bargaining units.  The Insurance Benefits Assistant is the entry level of the series, receiving training to learn rules, laws, policies and procedures associated with the group employee benefit programs. 

REPRESENTATIVE DUTIES:

Process new and current employees for enrollment into all health care benefits; make dependent changes or other status changes to benefits coverage; orient employees regarding programs and coverage. 

Respond to inquiries from employees, retirees, and carriers for a variety of subjects, including, but not limited to benefits coverage, eligibility, and claims procedures.

Support the Open Enrollment process by ordering materials for insurance packets; train and supervise temporary clerical and student workers in the process of collating open enrollment materials.  Coordinate the distribution of time sensitive open enrollment materials to sites; mail information to COBRA, Board, and Leave of Absence members.  Coordinate PUSD site locations and Health Care vendors for open enrollment Help Centers, as needed.

Counsel retirees and employees entitled to Medicare regarding navigation of enrollment and opportunity to remain on District plans. Prepare correspondence to retirees and leave of absence employees; change enrollments to appropriate plans and provide annual, semi-annual, or quarterly billings as required; collect, post, and process all retiree and LOA payments quarterly; prepare deposits for Finance.

Evaluate employee requests for enrollment in voluntary life insurance/AD&D plans; process enrollments when appropriate; enter into database; notify Payroll of change; communicate status to employees.

Process life insurance claims; serve as a liaison between the family of the deceased and the life insurance company; assure proper paperwork is completed; mail appropriate forms.

Prepare invoices of insurance costs for retirees, persons on COBRA status, and persons on unpaid leave.

Prepare, process, and distribute COBRA notifications, forms, and/or correspondence to eligible employees or dependents experiencing a loss of benefits; provide information regarding eligibility for continued coverage and periodic premium changes; provide monthly payment coupons to individuals extending coverage.

Make changes in the designated database as necessary for all benefit areas; notify carrier and employee, and send verification letters and reports to employees.

Process enrollments, correct participant coverage, demographic details in self-insured pharmacy module, and order pharmacy cards as required.

Serve as an informational resource to District Personnel, Directors, and Associate Superintendents; provide information concerning District policies, procedures, and negotiated agreements.

Interpret the various Bargaining Unit contracts for active employees and retirees regarding Health and Welfare policies and procedures with direction of Benefits Specialist.

Assist in monitoring flexible spending accounts, including Medical and Dependent Care; audit accounts as necessary.

Assist in the preparation and maintenance of a variety of records and reports related to insurance benefit information and employees.

Attend a variety of meetings including in the District Insurance Committee Meetings.

Operate a variety of office equipment including computer, printer, telephone, calculator, scanner, and FAX machine. E

Perform related duties as assigned as they relate to this classification.

KNOWLEDGE AND ABILITIES:

KNOWLEDGE OF:

District policies and procedures relating to bargaining unit agreements.

COBRA regulations.

Various health and life insurance plans, coverage, and exclusions.

Laws, rules and regulations related to assigned activities.

Operation of a computer and applicable software.

Interpersonal skills using tact, patience, and courtesy.

Correct English usage, grammar, spelling, punctuation and vocabulary.

Record-keeping techniques.

Modern office practices, procedures, and equipment.

Oral and written communication skills.

Mathematical computations.

ABILITY TO:

Explain health plan coverage to employees.

Maintain accurate records and files.

Prepare correspondence to active employees regarding COBRA, and retirement or leave of absence benefits.

Work with a team.

Take direction from a supervisor.

Deal with employees and related dependents in stressful situations.

Follow work rules.

Respond to requests and inquiries from District employees.

Work collaboratively with employees, insurance carriers, and others.

Interpret, apply, and explain applicable laws, codes, rules and regulations.

Assemble, organize, and prepare data for records and reports.

Communicate effectively both orally and in writing.

Establish and maintain cooperative and effective working relationships with others.

Meet schedules and time lines.

Type or input data at an acceptable rate of speed.

Maintain confidentiality of sensitive and privileged information.

Determine appropriate action within clearly defined guidelines.

Operate a computer terminal.

EDUCATION AND EXPERIENCE:

Any combination equivalent to: graduation from high school and three years progressively responsible experience in a health care, health insurance, or related human resources position.  Additional post-secondary business-related curriculum may substitute for some experience.

WORKING CONDITIONS:

ENVIRONMENT:

Office environment

PHYSICAL DEMANDS:

Sitting for extended periods of time

Hearing and speaking to exchange information in person or on the telephone

Dexterity of hands and fingers to operate a computer keyboard

This classification description describes the general nature of the work performed, representative duties, as well as the typical qualifications needed for acceptable performance.   It is not intended to be a complete list of all responsibilities, duties, work steps, and skills required of the classification.