What are the responsibilities and job description for the Benefits and Compliance Business Partner position at CMB Regional Centers?
The Benefits & Compliance Business Partner is responsible for overseeing the organization’s employee benefits programs, with an emphasis on managing self-funded insurance plans, and ensuring compliance with all federal, state, and local employment laws. This role serves as the subject matter expert for benefits administration and compliance initiatives, working collaboratively with the HR team and other departments to implement best practices, ensure legal adherence, and enhance employee experience.
Essential Job Functions
Benefits Administration
Essential Job Functions
Benefits Administration
- Manage and administer employee benefits programs, including self-funded health plans, dental, vision, life insurance, disability, 401(k), and other voluntary benefits.
- Work closely with third-party administrators (TPAs) to manage claims, stop-loss insurance, and plan performance for self-funded insurance plans.
- Conduct annual open enrollment processes, including employee communications, vendor coordination, and enrollment systems management.
- Collaborate with benefits vendors and brokers to ensure service quality and resolve employee issues promptly.
- Evaluate existing benefits offerings and recommend enhancements aligned with company goals and employee needs.
- Reconcile monthly benefit invoices to ensure accurate billing and resolve discrepancies in a timely manner.
- Analyze benefits utilization trends, including self-funded plan data, and provide regular reports to HR leadership.
- Ensure compliance with all federal, state, and local laws (e.g., FMLA, ADA, ACA, ERISA, COBRA, HIPAA, etc.) and monitor updates to employment legislation.
- Manage compliance audits, including ACA reporting, Form 5500 filings, and stop-loss claims filings for self-funded plans.
- Maintain and update employee policies, handbooks, and HR-related procedures to ensure legal compliance.
- Partner with payroll to ensure accurate processing of benefits deductions and compliance reporting.
- Act as a key point of contact for government agencies in matters related to compliance.
- Serve as the primary contact for employee benefits inquiries, providing timely, accurate, and empathetic responses.
- Develop and deliver benefits education programs to improve employee understanding and utilization, including detailed education on self-funded plans.
- Guide employees through complex leave of absence processes, including FMLA, disability, and other applicable leave types.
- Work collaboratively with HR Business Partners to address compliance concerns in employee relations cases.
- Build and maintain relationships with benefits providers, TPAs, brokers, and stop-loss carriers.
- Lead special projects related to benefits design, system implementation, or compliance improvements.
- Conduct regular market research to ensure the company’s offerings remain competitive.
- Monitor the financial performance of self-funded plans and work with actuaries to ensure funding levels align with projected claims.
- Bachelor’s degree in Human Resources, Business Administration, or a related field.
- 5 years of experience in benefits administration and HR compliance, with 3 years of experience managing self-funded insurance plans preferred.
- Strong knowledge of federal and state employment laws and regulations.
- Experience working with TPAs, stop-loss insurance, and managing claims under self-funded insurance plans.
- Professional certifications such as PHR, SPHR, SHRM-CP, SHRM-SCP, or CEBS are preferred.
- Proficiency in HRIS systems and benefits platforms.
- Exceptional analytical, problem-solving, and communication skills.
- Ability to handle sensitive information with discretion and maintain confidentiality.
- Constant sedentary work for prolonged periods up to 100% of the time with occasional moving and transporting up to 10 pounds. Must be able to detect, identify, inspect, observe, perceive and assess human resources tasks, processes, procedures, and projects. Must be able to constantly communicate and exchange accurate information. Constantly operates and uses computer and other relevant equipment and office machinery. Constantly works around firearms, bladed weaponry, militaria, historic relics, and valuable collectibles.