This is professional work in the administration of county group health insurance plans.

An employee in this class is responsible for performing a variety of administrative tasks in the management of employee group health insurance coverage. Responsibilities include providing information to departmental personnel officers and employees, coordinating conversion of insurance for retirees, and coordinating payroll deductions and adjustments for employees. Additional duties involve resolving discrepancies in enrollment, file and employee deduction information, and assisting in annual group insurance enrollment activities. Some independent judgment is exercised in the interpretation of the provisions of various health insurance plans. Supervision is received from a professional and administrative superior who reviews work for attainment of desired goals and objectives.

ILLUSTRATIVE TASKS

Provides verbal and written information to departmental personnel officers regarding the various employee health insurance plans and applicable procedures.

Provides information to employees concerning health insurance policies and procedures; responds to inquiries regarding payment of claims and clarifies plans benefits.

Assists individual employees with insurance problems, such as claims allegedly not paid according to provisions of plan; requests that insurance providers reevaluate payment of claims if needed; informs employees if expenses are covered or not covered.

Processes various forms and documents between employees and insurance providers such as applications for coverage, addition of new dependents, new enrollments under dependent coverage, changes in coverage and re-enrollments.

Forwards all statements of health to the insurance providers and maintains a tracking system with monthly audits; forwards insurance provider's responses to employees and clarifies the status of applications.

Controls input of payroll deductions for employees participating in county health insurance programs.

Provides conversion information regarding rates and plans to enrolled dependents of deceased employees, retirees, and former employees; prepares and forwards conversion forms.

Assists insurance providers with inconsistencies in records, such as employees enrolled in a plan without deductions being made; researches and determines causes of errors and initiates corrective action.

Verifies active employment and job classifications for enrollees in the Survivors Benefits Trust; prepares annual input.

Assists in the annual group insurance open enrollment as needed; prepares data for renewal rates.

Performs related work as required.

KNOWLEDGES, ABILITIES AND SKILLS

Considerable knowledge of the provisions of the various group health insurance plans authorized by the county.

Considerable knowledge of the policies and procedures of insurance organizations providing group health insurance coverage to county employees.

Considerable knowledge of departmental rules, regulations and procedures pertaining to insurance activities.

Knowledge of the principles and practices of modern office administration.

Some knowledge of basic accounting principles, practices and procedures.

Some knowledge of data processing requirements related to processing insurance coverage deductions and adjustments.

Ability to establish and maintain effective working relationships with supervisors, employees and representatives of insurance organizations.

Ability to understand and interpret the provisions of various group health insurance plans applicable to the county.

Ability to express ideas clearly and concisely, verbally and in writing.

Ability to exercise judgment and discretion in the application of departmental policies and procedures to group health insurance problems and circumstances.

Ability to deal tactfully and effectively with a variety of employees and officials in both the public and private sectors.

Ability to analyze administrative problems and make effective recommendations for their solution.

MINIMUM QUALIFICATIONS

Bachelor's degree. One year of professional administrative experience in insurance benefits administration is required.

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