The Benefit Administrator’s Role

As a health benefit administrator, your employees will often come to you with questions relating to their health care benefits. This guide will you help you answer many of those questions and provide information you’ll need to administer your group’s plan. The following will help you become familiar with your role as the benefit administrator:

1. Enroll new employees
   When new employees are hired, you will provide a brief explanation of your group’s benefits and the options being offered. Then make sure that the proper forms are completed in full, signed and returned to us on time. Enrollment and change forms are available online.
    
2. Provide all enrolling employees and new hires, with copies of member notices, including (fully insured groups only)
   1. Your Special Enrollment Period Rights;
   2. Notice of Preexisting Condition Exclusion;
   3. Women’s Health and Cancer Rights Act (WHCRA) Notice;
   4. Notice of Privacy Practices; and
   5. General Notice of COBRA Continuation Coverage Rights, if applicable.

   These notices are available online.

3. Provide the appropriate creditable or non-creditable prescription coverage notice to:
   1. New employees
   2. Current employees who are approaching Medicare eligibility
   3. All employees annually

   This notice is available online.

4. Communicate benefit changes
   Occasionally, benefits will change for reasons that may include government requirements (mandated benefits or legislative changes), the development of new technologies or treatments, or contract revisions negotiated with your group. You will be notified at the time of your renewal of any benefit or administrative changes. We rely on you to inform your employees about these changes when they occur.
    
5. Answer employee questions
   This guide will be most helpful to you when employees come to you with questions. You will find many of the answers here, along with explanations of which forms need to be completed and how and when they should be submitted.
    
6. Notify employees when group coverage terminates
   When group coverage ends, employees and their dependents have several options for continuing their Regence coverage. You must notify employees in writing at least 30 days prior to the date that group coverage terminates, and notify each employee within the appropriate time limits of their rights to continue coverage after termination. These notices must be made in writing.

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