ERISA Plan Document Specialist

The Health Plan (THP); Wheeling (WV); On-site; USD 45,000 - 65,000; Full time

Job summary

The Health Plan in Wheeling, WV is seeking a Document Coordinator responsible for developing and maintaining Summary Plan Documents (SPD) and Evidence of Coverage for self-funded and fully insured clients. The role requires meticulous document development and regulatory compliance with ERISA standards.

You will coordinate amendments, interact with state departments via SERFF, and support pricing, audits, and compliance initiatives in a fast-paced team environment.

Qualifications

• High school diploma or GED required.
• Preferred associate degree or relevant experience in document development.
• Strong experience with Word and Adobe Acrobat.
• Excellent organization, prioritization and detail orientation.
• Ability to work independently in a fast-paced environment.
• Knowledge of ERISA and regulatory requirements in OH/WV helpful.
• Paralegal experience helpful but not required.
• Ability to work in team-oriented environments.

Responsibilities

• Develop and maintain SPD for self-funded line of business.
• Amendments and restatements to SPDs as needed.
• Interact with State Insurance Departments on form filings via SERFF.
• Develop EOC per plan code/design for fully insured line of business.
• Create and maintain Summary of Benefits and Coverage per ACA guidelines.
• Create and maintain Benefit Plan Grid for Fully Insured and MEWA.
• Prepare quarterly RX Rebate listing.
• Keep PDM updates and follow regulatory updates via PHIA webinars.
• Perform quality reviews and editing of documents.
• Provide documents to compliance for audits as needed.
• Assist in creating renewal and sale pricing proposals.
• Maintain the quoting log and contracts for ASO clients.
• Create and maintain Policies and Procedures for the department.
• Assist with external reporting.
• Support Director and SVP on special projects.

Skills

Organization

Attention to detail

Adaptability

Independent work

Teamwork

Verbal & interpersonal skills

Education

High School Diploma or GED

Associate degree or related experience

Tools

Microsoft Word

Adobe Acrobat

Job description

The Health Plan in Wheeling, WV is seeking a Document Coordinator responsible for developing and maintaining Summary Plan Documents (SPD) and Evidence of Coverage for self-funded and fully insured clients. The role requires meticulous document development and regulatory compliance with ERISA standards.

You will coordinate amendments, interact with state departments via SERFF, and support pricing, audits, and compliance initiatives in a fast-paced team environment.