Rachel Benton Email and Phone Number

Strategic development of benefit plans with internal and external partners. Management of annual Qualified Health Plan submissions. Benefit research and development to ensure compliance with federal and state regulations. Create and maintain plan benefit materials including Summaries of Benefits and Coverage, Certificate of Coverage, Schedules of Benefits, and other documents as necessary. Serve as subject matter expert of SERFF and CMS portals for required state and federal filings. Interact with the regulatory agencies regarding plan filings and requirements. Coordinate plan implementation with internal and external partners and/or vendors.

Benefit development, including ensuring compliance with the Affordable Care Act as well as state-mandates. Qualified Health Plan submission specialist. Strategy and development of benefit plans, creation and maintenance of plan materials including internal/external training materials. Project management to ensure accurate implementation and benefit plan compliance with vendor partners.

Strategic development of health insurance products from plan design to implementation, for new, non-profit, CO-OP. Completed the Qualified Health Plan submission for New Mexico Health Connections to participate in the healthcare.gov and New Mexico Health Insurance Exchange (SHOP), including testing in both environments. Creation of all plan materials including member and provider handbooks, broker training materials, and internal resource documents. Participation in Outreach/Education strategy and implementation. Website development and maintenance for content and layout. Competitive market assessment and research.

Collaboration with internal, cross-organizational team members to identify, analyze and develop new health plan initiatives and offerings. Planning and execution of product strategies and programs. Identifying business opportunities to meet marketplace trends. Market assessment, competitive research, strategic planning, project planning, design and development. Maintenance of current product/program offerings including plan implementation, compliance, and ensuring customer satisfaction. Execution and administration of training programs. Project management for external vendor implementations. Creation of member materials including benefit summaries, plan comparison and coverage documents. Development of electronic and paper client communications. Website maintenance and development. Team manager for health care reform initiative.

Small group (2-99) health, dental, vision, life and disability insurance sales. Co-production with management on creating new products and broker incentive programs. Strategizing with brokers on insurance solutions for potential and existing clients. Renewals for larger clients (51-99). Delegation of service issues to appropriate team members.

Sales of health, dental, vision, life, disability and long term care insurance. Cold-calling to solicit new clients. Collaboration with local and national carriers on quotes for potential clients. Preparation of proposals for clients and assistance in selecting and setting up the policy that best meets their needs. Maintaining relationships with the clients throughout the year. Resolving claims and service issues on group and member level. Implementation of cafeteria plans and claims payment for medical and dependent care plans.

Processing quote requests and preparing the requests for the Underwriting Department. Completion of proposals for small and large accounts. Implementation of new accounts. Represent Lovelace Health Plan as a client contact, and provide customer service to existing client groups and members. Preparation and attendance of health fairs for large accounts. Preparation of renewals for commercial accounts. Represent Lovelace Health Plan at monthly client/member meetings to resolve claims or service issues. Conduct enrollment meetings for large accounts.

Represent HCH Administration and Cimarron Health Plan as a client contact, providing high level customer service to existing clients and members. Preparation of proposals for customized health insurance plans for both self-funded and HMO groups. Implementation of new group health plans including correspondence with internal departments to ensure the success of new plans. Developed and maintained strong customer relationships by designing follow-up contact with all renewing groups. Implemented renewal strategy with retention team to maintain existing clients and increase annual membership.