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Our Purpose
CSEBO is an organization that makes affordable health care coverage its primary goal. CSEBO is governed by its Members, including both labor and management representatives, to provide pooled Medical, Dental and Vision benefits. CSEBO acts as a resource to its Member Districts to help reduce, control, and/or eliminate risks, thereby saving money to use for educational purposes.
CSEBO is not an insurance company. Self-insured programs, like CSEBO, are created and administered by their Members to provide mutually what they could not obtain separately. CSEBO members are the bearers of risk, and the relationship is different from that which exists within an insurance company.
CSEBO is a family of school districts established to offer the best health benefits in the most efficient manner. What each member district has done is to self-insure by joining with other districts in lowering expenses. Everything CSEBO does is under the supervision of its member districts. CSEBO provides a stable, long-term method to protect against risk. A key element in any self-insured organization is member commitment and participation which stimulates the program to grow and prosper; this is something that does not exist in a relationship with an insurance company.
There are many advantages to pooling risks, including reduction or elimination of large profits, huge overhead costs, and other add-ons of insurance companies that would raise the costs of a program significantly above its actual experience costs.
In summary, CSEBO is an organization formed by its Member school districts to offer programs of self-insurance. By doing this, CSEBO allows its Members direct management and control.
BASIC FUNCTION:
Under the direction of the Executive Director, the Health Benefits Manager will be the liaison for current member districts, providing them with day-to-day client service, counsel and information regarding health insurance coverage in the administration of the employee benefit programs. This position will also manage the coordination, planning, organizing, implementation, evaluation and administration for health and wellness programs.
REPRESENTATIVE DUTIES
Provides proactive day-to-day member service by anticipating and responding to member district needs. E
Develops strategies to provide members with information regarding CSEBO signature products. E
Reviews and trains on administrative guidelines and/or requirements with member LEAs. E
Oversees the resolution of billing, premium and eligibility problems affecting member districts. E
Oversees the coordination of and participates in annual open enrollment events and health fairs. E
Collaborates with consultants, vendor partners and carrier representatives. E
Communicates carrier enhancements, legislative updates and benefit changes to member districts. E
Acts as a liaison and administrator to CSEBO member districts and insurance carriers regarding claim problems, issues and concerns confronting employee participants, ensuring timely resolution and response to all inquiries. E
Acts as liaison with CSEBO member districts and outside providers and carriers to develop, implement, and manage wellness programs. E
Enhance website resources for member districts and employees. E
Participates in health and wellness committee meetings as needed. E
Attend in person LEA meetings, conferences, seminars, and trainings. E
Assists with financial policies and government document adherence.
Reviews EOC and creates summary plan descriptions.
Supports RFP responses in coordination with CSEBO staff for new members, vendors, and carriers.
Assist Controller in preparing the financial analysis of claims data as directed.
Assist Controller in preparing and submitting data to actuary for reserve analysis.
Participate in meetings and make presentations on all matters relating to CSEBO’s rates, budget, finance, and accounting.
Assist with the tracking and summarizing of detailed claims data for CSEBO actuarial analysis.
Assist with the underwriting and developing of rate quotes for new members joining CSEBO.
Assist with the development and administration of CSEBO’s underwriting and cost allocation process.
Assist with retiree billing and upload.
Self-pay retiree ACA tax form.
Assists the Controller and Executive Director with the financial audit activities and actuarial studies and claims audits of CSEBO.
Assists the Controller and Executive Director in consulting with and responding to communication from various LEA member regarding problems, policy interpretations, requests, claim dispute resolutions, and other general assistance.
Perform a variety of duties in the preparation of Board and committee agendas.
Perform related duties as assigned.
KNOWLEDGE AND ABILITIES
KNOWLEDGE OF:
Health benefits, wellness programs and insurance products.
Interpersonal skills using tact, patience and courtesy.
Modem office practices, procedures and equipment.
Operation of computer equipment and related spreadsheet and word processing software.
Oral and written communication skills.
ABILITY TO:
Understand CSEBO health benefit programs and services.
Establish and maintain relationships with member districts.
Assure compliance with established CSEBO policies and procedures and governmental regulations.
Interpret and apply rules, regulations, policies and procedures.
Establish and maintain cooperative and effective working relationships with others.
Analyze situations accurately and adopt an effective course of action.
Meet schedules and timelines.
Communicate effectively both orally and in writing.
Work independently with little or no direction.
Utilize computer software to organize, sort, and report financial data.
EDUCATION AND EXPERIENCE
Three (3) years of experience in communicating and explaining health plan benefits to employees and/or clients. One (1) year implementing health benefits and wellness programs. One (1) year of experience in a position with a joint powers authority or a health benefits carrier or brokerage firm. Bachelor's Degree preferred, or completion of coursework or training in business office procedures, employee benefits administration, or closely related fields.
WORKING CONDITIONS
ENVIRONMENT:
Office environment.
PHYSICAL ABILITIES:
Vision (which may be corrected) to read small print; hearing and speaking to communicate with others, ability to stand, stoop, reach and bend; mobility of arms to reach and dexterity of hands to grasp and manipulate small objects and operate office equipment; perform work which is primarily sedentary; perform lifting, pushing and/or pulling which does not exceed 25 pounds and is an infrequent aspect of the job; to work at a computer terminal for prolonged periods.
