Senior Plan Design Specialist, Self-Funded Healthcare Plans

Join our team at Cobalt Benefits Group and start an exciting new career in employee benefits solutions. As a Senior Plan Design Specialist, you’ll play an important role in helping us offer customized, self-funded insurance options to our clients and members.

The Senior Plan Design Specialist is responsible for drafting, revising, and maintaining comprehensive summary plan descriptions (SPDs), benefit summaries, and regulatory documents for our clients’ employee health and benefit plans. This role requires a deep understanding of self-insured healthcare plans, regulatory compliance, and industry best practices.

As a key contributor, the Senior Plan Design Specialist, Plan Documents will exercise independent judgment in interpreting ERISA, ACA, and other applicable laws to ensure documents remain compliant and accurately reflect benefit structures. This role involves frequent collaboration with internal teams, brokers, client representatives, and stop-loss carriers, making strong communication and analytical skills essential.
 

Key Responsibilities:

• Develop, review, and maintain Summary Plan Descriptions (SPDs), Summaries of Benefits and Coverage (SBCs), and related documents for self-insured medical, dental, and specialty benefit plans.
• Interpret and apply federal regulations (ERISA, ACA, COBRA, HIPAA) to ensure plan documents meet legal and compliance standards.
• Lead plan amendments and documentation updates, collaborating with account managers, implementation teams, brokers, and client representatives.
• Analyze and advise on plan design changes, ensuring alignment with regulatory requirements and industry standards.
• Maintain and enhance the electronic library of plan documents, ensuring version control and compliance with company policies.
• Serve as a subject matter expert on self-insured regulations, providing guidance and recommendations to internal stakeholders.
• Conduct research and stay current with evolving legislation to proactively update documents and advise on compliance matters.
• Provide strategic input on process improvements and document standardization to enhance operational efficiency.

• Bachelor’s degree in Business, Healthcare Administration, Legal Studies, or a related field (or equivalent experience).
• Minimum of 3 years of experience in benefit plan document drafting, compliance, or plan administration.
• Extensive knowledge of healthcare plan documents and self-insured industry practices required.
• Strong ability to interpret and apply federal laws and regulations (ERISA, ACA, COBRA, HIPAA).
• Experience working with third-party administrators (TPAs), stop-loss carriers, and brokers is highly preferred.
• Advanced proficiency in Microsoft Office (Word, Excel, Outlook) and document management systems.
• Exceptional analytical skills, attention to detail, and independent problem-solving abilities.
• Strong written and verbal communication skills, with the ability to explain complex concepts clearly. 

Work Environment & Physical Demands

• Hybrid or remote work availability may be offered based on meeting key performance metrics.
• Prolonged periods of sitting may be required.
• Regular use of a computer, keyboard, and mouse is necessary; reasonable accommodations will be provided upon request.
• Employees should ensure an ergonomically appropriate desk and chair setup.
• Comfort with being on camera for virtual meetings (e.g., Microsoft Teams)

Benefits:

After successfully completing a waiting period, eligible Full-time employees have access to our comprehensive benefits package, including:

• Fantastic medical, dental, and vision insurance*
• Twice annual employer HSA contributions, covering 50% of the HDHP plan’s annual deductible!
• Company provided Basic Life and AD&D
• Company paid Short-Term and Long-Term Disability**
• Flexible Spending Accounts*
• 401(k) Retirement Plan with up to a 6% employer-match** WOW! (100% fully vested after 3 years)
• 10+ paid holidays
• Generous paid vacation and sick time
• Annual Volunteer Paid Day
• Annual Tuition Reimbursement
• Annual Health and Wellness Reimbursement
• Lots of fun company events

Who We are:

As a trusted third-party administrator (TPA) specializing in self-funded benefit plans, Cobalt Benefits Group (CBG) is committed to helping employers find high-quality coverage at a cost they can afford. We administer self-funded insurance benefits through our three companies: EBPA, Blue Benefit Administrators of Massachusetts, and CBA Blue.

With over 30 years of experience and a dedicated team of more than 200 employees, we work collaboratively to build customized self-funded health plans, manage claim payments and disputes, and administer other specialized programs such as FSAs, HSAs, COBRA, and retiree billing. Join us as we match employers across our region with the right solutions for their employee benefit needs. To learn more about working at CBG, visit https://www.cobaltbenefitsgroup.com/careers/.

Benefit Waiting Period Notes:

*60 day waiting period

**90 day waiting period