What are the responsibilities and job description for the Policy Drafter/Compliance Specialist position at Central States Health & Life Co. of Omaha?
Policy Drafter / Compliance Specialist
Job Summary: Perform policy drafting, filing and compliance functions for the company. Assist with quarterly and annual statement filings for CSO and subsidiaries, as well as for other corporate and regulatory filings.
Essential Responsibilities:
- Maintain knowledge of state and federal legislation. Monitor and analyze articles, newsletters, and proposed changes to state rules and regulations. Inform appropriate Company personnel of the proposal and potential impact on company products. Update forms, charts, and/or company procedures to ensure compliance. Work closely with pertinent Company personnel to ensure coordination of necessary changes.
- Perform a variety of tasks pertaining to drafting new and revisions to form and rate filings for company product lines with State Insurance Departments. Research, draft, and file for approval using the SERFF electronic filing system. Ensure filings comply with pertinent state and federal regulations. Process state withdrawal filings for the Company Coordinate work with other departments as required.
- Develop and maintain contact with representatives at the State Insurance Departments, other insurance carriers, and publication associations on a regular basis for compliance issues. Assist the Legal area with responding comments on proposed revisions.
- Prepare, edit, and approve policy forms and related documents and review and edit forms drafted/filed by the Company’s Medicare Supplement Third Party Administrator (TPA), including but not limited to advertising pieces, outlines of coverage, brochures, agent notices, promotional pieces, and other applicable documents on the company website. Assist with coordinating associated activity with the TPA.
- Draft Debt Cancellation Contract (DCC) addendums and product descriptions to the specified needs of each financial institution for direct and indirect business. Review forms for compliance.
- Assist Legal with preparing, making changes, and maintaining debt cancellation contracts and agreements.
- Update and maintain charts for state information, compliance issues, agent licensing, and department procedures. Coordinate projects, legislative changes, and additional research requests. Work closely with other departments to assist in compliance responsibilities.
- Perform research for states, which includes analyzing state laws and regulations. Notify Marketing of special requirements within the state for the possibility of marketing new products. Research group versus individual products, agent and corporate licensing requirements, and specialty products.
- Monitor and analyze state loss ratios and rate changes. Work with Actuarial Department on developing new and revised rate schedules. Review rates and actuarial memorandums for accuracy. Prepare and submit rate filings with the State Insurance Departments.
- Assist with preparing and filing Company’s Quarterly/Annual Statements as assigned to meet state filing requirement due dates. Annually review the Annual Statement Checklist for statutory reporting requirements for states. Compare the state’s filing requirements with the Quarterly and Annual Statement spreadsheets and update as needed. Coordinate changes with Corporate Finance. Develop and maintain procedures to organize the filing processes.
- Ensure adherence to other annual financial statutory filings required by the National Association Insurance Commission (NAIC).
- Coordinate Company regulatory filings, processing/filings those assigned. Maintain the master regulatory reporting list. Review annually for any regulation changes or changes to individual assignees. Verify processing and documenting of filings as required throughout the year.
- Coordinate the annual filing requirements and filing fees with Corporate Finance and Actuarial departments to ensure compliance with state requirements including premium tax, assessment fees and annual renewal fees.
- Assist with the coordination of outside vendor for service of process and other corporate matters.
- Review and track laser forms created by the accounts for compliance and for consistency with the printed forms. Coordinate changes with the Laser Coordinator and work with Department Manager to ensure compliance with forms being created by the accounts.
- Prepare annual certification filings for the Legal Department for forms, compensation, and other issues such as annual renewal submissions.
- Review newsletters, notices to account and agents, and other correspondence for accuracy concerning compliance issues.
- Review advertising pieces against NAIC model.
- Claim form and authorization development for both credit insurance and DCC, along with revisions and maintaining of the forms.
- Monitor and prepare Certificate of Authority renewal and new filings nationwide for applicable companies.
- Assist with statistical filings annually to comply with state regulatory requirements.
- Assist with reviewing and approving sales/marketing/training pieces; assist with analyzing and coordinating aspects of the market release of new product and/or state regulation changes.
- Participate in trade/regulatory calls as needed.
- Interact with other department members and coworkers to share pertinent information, resolve problems and inquiries, and to allow for efficient data and information flow.
- Attend training as needed.
- Assist with the coordination and performing of audit functions.
- Perform other related duties as assigned.
Required Education and Experience:
- Bachelor’s Degree in Business, Law, or other complimentary discipline is required, or equivalent education and/or experience.
- Minimum three years compliance and interpretation of statutes and general knowledge of state/federal regulations related to insurance policies and marketing/advertising materials experience is required.
- Proficient in the use of Microsoft Office products including Excel. Ability to utilize specialized software packages (SERFF).
- Excellent written and verbal communication skills. Must be able to write correspondence regarding policy/regulation changes and change current certificates and forms accordingly. Must be able to explain compliance issues to co-workers, Accounts, and General Agents.
- Good working knowledge of insurance products and industry. Must be able to work independently and have good organizational skills.
Preferred Education and Experience:
- General knowledge of drafting, claims or underwriting experience is helpful.
- General knowledge of dental, hearing and vision plans and policies.
Position Type and Expected Hours of Work:
CSO’s overall business workdays are Monday through Friday, 7:30 a.m. to 5:00 p.m. with the incumbent’s actual work hour schedule to be determined by their supervisor. Attendance is required with a physical presence of the employee at their scheduled workplace during their scheduled hours of work.
Work Environment:
This job operates in a corporate office environment. Incumbent is expected to reasonably work through necessary stressors of the job and work well with others.
It is CSO’s practice to communicate pertinent information on job duties, company policies and benefit disclosures via its email system. Thus, employees are required to access their company email account as an integral part of their job responsibilities.
Physical Demands:
This role routinely uses standard office equipment such as computers, cell phone, laptops, photocopies, filing cabinets.
The work performed is sedentary and the job allows employees to remain seated or to sit and stand intermittently to perform most duties. Less than 10% of the time will be spent performing physical activities and the job does not involve stooping, crawling or kneeling except in occasional situations. However, a negligible amount of lifting, pulling and pushing may be required to perform the work and some walking, standing, and manual dexterity may be required in routine activities such as carrying papers, opening file drawers, operating basic office equipment and driving a car.
Travel:
Occasional travel to conventions or meetings. Sometimes take a filing to a state. Not more than 1-3 times a year.
This job description has been designed to indicate the general nature of work performed, the level of knowledge and skills typically required and usual working conditions of the position. It is not designed to contain or be interpreted as a comprehensive listing of all requirements or responsibilities that may be required by employees in this position.
To perform this job successfully, the employee must be able to perform each essential duty satisfactorily. The requirements listed above are representative of the minimum knowledge, skills and or ability required.Reasonable accommodations may be made to enable individuals with disability to perform the essential functions.
CSO is a drug free workplace and requires post offer drug testing. Generally, CSO does not hire individuals who utilize tobacco/nicotine products. For information on what defines use of tobacco/nicotine products, exceptions and inquiries about the policy, please contact Human Resources at (402) 399-3336, toll free at 800-826-6587, extension 3336 or visit CSO’s website at www.cso.com and click “Careers”. Those applicants in need of reasonable accommodations to the application, the hiring process or the position applied, should communicate the request to Human Resources.
Job offers are contingent upon the successful completion of our post-offer drug screen and a background check which includes criminal, education, and past employment. Some positions may also include credit and/or motor vehicle report where those checks are related to the position. Criminal convictions do not necessarily prevent employment. Various factors may be considered including, but not limited to, the type of conviction and its relationship to the job, the nature and seriousness of any offense and the length of time since conviction. Applicants are not obligated to disclose any sealed criminal record.
Equal Opportunity Employer
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