PRINCIPAL EMPLOYEE BENEFITS REPRESENTATIVE 0428

DISTINGUISHING FEATURES OF THE CLASS

An employee in this class performs the more complex, specialized work of maintaining comprehensive employee and retiree health insurance benefits and assists in the supervision of lower-level staff in the Employee Benefits Unit (EBU) of the Suffolk County Department of Civil Service/Human Resources. Incumbents in this class make eligibility determinations and perform the more complex evaluations, calculations and problem solving tasks. Responsibility is included for explaining basic NYS Retirement System information and health plan regulations and procedures to new employees, members, dependents, third-party administrators, HMOs and department administrators according to the Employee Medical Health Plan (EMHP) Benefit Booklet and various federal legislation such as, COBRA, HIPAA and the PPACA (Patient Protection and Affordable Care Act) and others. Work requires considerable initiative and judgment and is performed under general, technical or administrative supervision. Does related work as required.

TYPICAL WORK ACTIVITIES

Assists the Employee Benefits Supervisor and Employee Benefits Coordinator in training and directing unit staff and with the assignment and review of work;

Prepares and presents new employee orientations, retirement seminars and other lectures regarding health and retirement benefits;

Assists in providing comprehensive health benefit information to County Management and Union Officials, answers questions and furnishes solutions to complex problems;

Reviews eligibility documents and bi-weekly payroll runs for enrollment, termination and status change information and updates records in the Employee Benefits System (EBS) accordingly;

Maintains and verifies payroll deductions for the various health plans;

Assists in the calculation, review and processing of EMHP vouchers for payment;

Reviews and processes HMO enrollment applications and monthly invoices and Benefit Fund vouchers for payment;

Prepares weekly and monthly subrogation log for recoupments and HMO checks, which includes reconciling monthly bank deposits and bounced checks;

Reviews and verifies new enrollments and processes applications for pre-tax flexible benefits;

Reviews and process the Medicare Part D – EGWP (Employer Group Wrap Program) response file from the Center for Medicare and Medical Services;

Reviews quarterly Medicare Secondary Payer List from third party administrator;

Prepares various financial and regulatory reports in accordance with HIPAA rules and regulations;

Provides information and responds to inquiries regarding the NYS Retirement System benefits.

FULL PERFORMANCE KNOWLEDGES, SKILLS, ABILITIES AND PERSONAL CHARACTERISTICS

Thorough knowledge of Suffolk County’s various employee health insurance plans including the County’s Employee Medical Health Plan (EMHP) and HMO plans and the coordination of plans with Medicare; thorough knowledge of the County’s Employee Benefits System; thorough knowledge of government regulations and laws governing health insurance plans including HIPAA, FMLA, PPACA, COBRA, etc.; good knowledge of the various NYS Retirement Plans; good knowledge of methods used in preparing fiscal and statistical reports; ability to establish and maintain effective working relationships with third party administrators, vendors and contract agencies; ability to prepare financial and statistical reports; ability to effectively communicate technical health insurance and retirement benefit information; ability to express oneself clearly and concisely both orally and in writing; ability to exercise independent judgment and initiative; ability to direct the activities of a staff in a manner conducive to full performance and high morale; physical condition commensurate with the demands of the position.

MINIMUM QUALIFICATIONS

OPEN COMPETITIVE

Graduation from a standard senior high school or possession of a high school equivalency diploma recognized by the New York State Education Department and six (6) years of experience in health insurance administration including reporting and record keeping utilizing a computerized information system.

NOTE: Additional education from a college with federally-authorized accreditation or registration by NY State may be substituted for up to two (2) years of the above experience.

PROMOTIONAL

Two (2) years of permanent competitive status as a Senior Employee Benefits Representative.

R10/21/2021

SUFFOLK COUNTY

Competitive