Overview

  • POSITION SUMMARY: Develop and implement compliance policies and procedures for group benefits business. Work with internal and external business partners on compliance and related matters. File policy forms with the states and Interstate Insurance Compact for approval.

Compliance Management: Taking business and legal priorities into account, develop and implement compliance policies and procedures to achieve general corporate and insurance compliance goals including:

  • Actively participating in compliance change management initiatives (including Compliance Action Team);
  • Analyzing and responding to compliance questions;
  • Managing the resolution of regulatory inquiries and reviews (including complaints, market conduct exams, and surveys);
  • Developing and maintaining a compliance program that includes providing guidance to internal and external partners, as a subject matter expert, and implementing policies and procedures;
  • Overseeing compliance matters related to group benefits business, including compliance with HIPAA and other privacy and security laws;
  • Conducting and overseeing audits of third party business partners; and
  • Developing and rolling out compliance training.

Product Development and Policy Filings:  Draft, amend, analyze policy forms for Group Life and Health products (i.e., life, accident, and health products, including vision, dental and other limited benefit health products) to ensure compliance with state and federal laws.  Obtain approvals from Insurance Departments and the Interstate Insurance Compact.  Work with external business partners, as necessary.

Procedure Manuals / Development and Maintenance:  Ensure that documented compliance guidance is in place for internal associates as well as external business partners.  Responsible for developing and updating general compliance and product manuals for life and health products, as well as, Standard Operating Procedures (SOP) for Group Benefits businesses.

Legal Research:  In consultation with Legal, research and analyze laws and regulations to provide written guidance to appropriate business units and partners for implementation.

Advertising Compliance Oversight: Work with internal and external business partners in reviewing and approving group benefits advertising for compliance with legal requirements.  File advertising for approval as required.

State Compliance Reports:  Work with internal and external business partners to collect and analyze data , and manage timely reporting to federal and state regulatory departments and agencies .  Maintain filings’ calendar to track key dates for filing such regulatory reports.

REQUIREMENTS AND MINIMUM EDUCATION LEVEL:

·     Bachelor’s degree, Advanced degree (preferred)

 

EXPERIENCE:

  • Minimum 5 years compliance or regulatory experience, insurance experience preferred, particularly in group health
  • Knowledge of legal research engines (e.g., Westlaw)
  • Proficient with Microsoft Office

 

SKILLS:

  • Leadership skills with the ability to energize and coach others
  • People skills including the ability to influence, gain commitment and effectively handle conflict
  • Ability to take decisive action.
  • Excellent research skills, interpersonal skills
  • Ability to identify and analyze insurance laws and regulations for application to business operations
  • Ability to identify and effectively manage and resolve compliance issues
  • Excellent verbal and written communication skills
  • Ability to organize and prioritize work
  • Ability to learn and use electronic compliance programs (e.g. RegEd (Code)  and Serengeti)

 

Please email resumes to Jack Kelly at JKelly@ComplianceSearch.com

 

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