Health benefits administration involves managing the health insurance benefits provided to employees within a company. Many employers in the United States offer health insurance, dental insurance, vision insurance or some combination thereof to employees as a part of their salary packages. Still other companies offer an additional product, called a flexible spending account or FSA, to employees to help offset certain medical costs. Health benefits administration involves managing and overseeing all these programs in compliance with the law.
Health insurance prior to 2010 was long considered a perk of some jobs within the United States. Companies would offer to subsidize premiums in order to attract employees and to make their company's benefits packages more attractive. Companies were generally able to deduct some of the cost of providing such insurance on their income taxes, making the offering of subsidized health insurance a financially advantageous way for a company to offer a job candidate a more attractive job without raising their actual salary. Not all companies, however, provide health insurance. After the Health Care Reform Bill passed in 2010 by President Barack Obama in the United States, more companies will be required to offer some type of subsidized health insurance, but those changes will not be fully in place until 2014.
Therefore, health benefits administration involves signing up employees who are eligible for coverage for the plans that the company offers. This involves providing the employees with the appropriate forms and information about the plan, explaining the types of coverage, and then submitting the documents to the group insurance company to add the insured to the benefits plan. Generally, the insurance company itself handles issues such as approving or denying claims, but the health benefits administrator in the particular company assists in getting the proper paperwork both to new employees signing up and to the insurance company, thus acting as the middle-man.
In companies that offer flexible spending accounts, health benefits administration also involves overseeing those accounts. Flexible spending accounts allow employees to put away pre-tax dollars that can be used for qualified health expenses. Health benefits administration involves establishing those accounts, reviewing claims for disbursements, and reimbursing employees for qualified expenditures from the proceeds of the given account.
Finally, health benefits administration involves ensuring compliance with the law. Various rules such as the Employee Retirement Income Security Act (ERISA) set rules on health benefit packages. For example, ERISA established the Consolidated Omnibus Budget Reconciliation Act (COBRA), which allows employees to keep their health insurance for a set period of time — usually up to 18 months — after they involuntarily are laid off from their jobs. A health benefits administrator oversees the COBRA program and helps ensure that this, and all other laws, are complied with.
