The Office of the Insurance Commissioner’s (OIC) Health Care Benefit Manager (HBCM) Unit is seeking a motivated and qualified individual to fill a HCBM Contract Analyst (Functional Program Analyst 3) position. This position is assigned to the Rates, Forms, and Providers Network Division, located in our Tumwater office.

This professional-level position independently performs analytical reviews and evaluations of forms related to health care benefit management contracts and will identify compliance matters with potential recommendations for correction of contract language, thereby assisting health care benefits managers and health carriers meet legal compliance.

Duties
The duties of the position include, but are not limited to:

Analyzing and evaluating HCBM contracts using the appropriate checklists, applicable chapters of the RCWs, WACs, and case law.
Reporting, consulting, and collaborating with the Functional Program Analyst 4 – Supervisor and Program Manager about issues that restrict a company from issuing compliant contracts in the marketplace or that may impact the marketplace broadly.
Communicating issues about compliance concerns with contract provisions and HCBMs and/or their third-party filers.
Establishing what is necessary for the contracts to be considered compliant.
Conducting research to provide subject matter guidance and information to the appropriate parties.
Facilitating resolution with contracting issues or non-compliance.
Consulting and discussing contract form provisions, regulations, and case law with OIC staff to ensure consistent and uniform review standards of health care benefit management forms.

The Office of the Insurance Commissioner (OIC) is seeking a four (4) motivated and qualified individual to fill Provider Network Analyst (Functional Program Analyst 3) positions. These positions are assigned to the Rates, Forms, and Provider Networks Division, located in our Tumwater office.

These professional-level positions are responsible for independently performing analytical reviews, and evaluations of the healthcare provider networks, evaluating complaints related to potential network access gaps, and identifying contractual compliance issues with Washington State and federal insurance laws, including the Affordable Care Act (ACA) in support of the OIC’s mission to protect consumers and the public interest.

Duties
The duties of the position include, but are not limited to:

Reviewing network access reports to create trend analyses and summaries for decision-making purposes.
Reviewing provider organizations and systems for development of analysis that supports the program.
Communicating issues about compliance concerns with reporting and data quality with insurance companies and/or their third-party filers.
Reviewing and researching consumer inquiries and referrals to provide information and/or potential recommendations for corrective action.
Presenting findings of fact in report form.
Performing multi-layer, integrated analysis of network access templates.
Participating as a team member on the binder team.
Using CMS tool resources to review binder data files for compliance.
Providing written instructions and guidance to filers regarding objectionable issues with the documents.

he Office of the Insurance Commissioner’s (OIC) Market Examinations Unit is seeking a motivated and qualified individual to fill the Chief Market Conduct Examiner (WMS Band 2) position. This position is assigned to the Company Supervision Division, located in our Tumwater office.

The OIC is a regulatory agency centered on consumer protection. The Company Supervision Division is charged with protecting consumers through extensive monitoring and regulation of insurer financial condition and market activity.

This position is responsible for managing OIC Market Analysis activities including leading a staff of professionals who administer market conduct continuums and examinations. We need someone who can provide quality leadership and be highly engaged with their team and in the Continuum process.

Duties
The duties of the position include, but are not limited to:

Providing daily direct supervision and oversight of eight (8) Market Conduct Examiners and One (1) Administrative Assistant.
Conducting job analysis and identifying duties for subordinate job descriptions.
Overseeing all market conduct continuum activities and providing guidance and direction on market issues.
Coordinating with HR and Program Manager, as appropriate, to develop and manage recruitment and selection processes, to include making sound hiring recommendations.
Monitoring progress of each Analyst’s open files.
Focusing on continuous process improvement and project management.
Developing performance expectations and conducting performance evaluations.
Assigning, planning, instructing, and checking the work of assigned staff.
Determining and adjusting schedules for assigned staff.
Ensuring that continuums are completed within required timeframes.
Participating in NAIC and regulatory workgroups.
Oversee updates to the NAIC’s Market Action Tracking System (MATS).
Tracking and ensuring that all carrier reporting to the Market Conduct Unit is done timely.

The Office of the Insurance Commissioner’s (OIC) Health and Life Actuarial Services is seeking a motivated and qualified individual to fill an Actuarial Analyst 1 position. This position is assigned to the Rates, Forms, and Provider Networks Division, located in our Tumwater office.

The Actuary Analyst 1 reviews and acts on basic health and disability insurance rate filings and assists with the review of Affordable Care Act (ACA) binder filings under close supervision.

Duties
The duties of the position include, but are not limited to:

Reviewing basic actuarial calculations submitted by health insurance carriers.
Evaluating reasonableness of health carrier data and actuarial methods.
Ensuring compliance with applicable statues and regulations.
Handling all filings in accordance with established OIC and SERFF procedures.
Reviewing the rate portion of the binder filing.
Assist rate and form analysts with problems and questions related to binder filings.

Candidate will work closely with AXIS Accident & Health (A&H) underwriters to design, develop, revise, or edit and maintain policy form language to ensure policy terms accurately reflect underwriting intent and are compliant with state regulations.
Candidates will assist business units in ongoing efforts to ensure product forms are issued pursuant to approved filings and stay competitive.
The successful candidate must demonstrate an intimate working knowledge of Accident & Health insurance form requirements as well a leisure Travel, Employer Stop Loss, and Pet insurance.
The position requires a strong sense of individual responsibility, critical thinking, and attention to detail.
What will you do in this role?
• Effectively and efficiently draft policy forms to facilitate business objectives within established timelines.
• Assist in the Product Development process for new products, product re-writes, and endorsements from end-to-end, including:
o Drafting language for new products and product enhancements.
o Analyzing and developing expertise of state-specific language requirements.
o Working with A&H compliance/legal, underwriting, actuarial, claims and operations staff to ensure product, product drafts and amendments meets internal and state requirements.
o Create and maintain product issue instructions for proper issuance of MGU forms for approved products.
o Conduct research and provide competitive analysis on accident & health products and policy form language.
o Assist in review of product proposal output and marketing materials.
o Assisting with maintenance of forms library.
• Assist in the delivery of products for filing submissions.
• Review, respond and negotiate approval of form objections from state insurance departments during the filing submission process.
• Research general subject matter requests as necessary using on-line resources inclusive of insurance law applications and other available resources.
• Lead and manage projects related to form development and implementation.
• Track and report on the status of form related projects.
What you need to have:
• Bachelor’s degree coupled with relevant Product Analyst experience is required.
• Minimum 10 years prior Accident & Health insurance product drafting experience (preferably supplemental A&H products).
• Ability to effectively draft policy wordings to facilitate business objectives.
• Ability to self-start own tasks, lead and manage projects related to form development and implementation.
• Familiarity with A&H state filing and regulatory requirements.
• Ability to quickly analyze complex problems and create timely solutions.
• Ability to collaborate with various team/departments.
• Excellent oral and written communication skills
• Proficiency with Microsoft Office Suite applications

Sydney is looking for an exceptional candidate to join our best-in-class compliance team. The Compliance Counsel role involves conducting legal research and writing, interfacing directly with state regulators, peer-reviewing objection responses, SERFF filing, and managing corporate clients. The ideal candidate will be versed in Accident, Critical Illness, Hospital Indemnity, Disability, Long-Term Care, Dental, Vision, Life, and Gap products and have experience with Taft-Hartley Trusts.

Please send inquiries with attached resume to: [email protected]

Martin & Company is a leading industry consulting and advisory firm for the U. S. Insurance market. Our core business segments include State Filings; Company Licensing; Compliance & Regulatory; Product Development; Actuarial Consulting and Competitive Intelligence.

As a result of our continued growth, we have an excellent opportunity for an Insurance Product Development Specialist, and we are seeking a qualified candidate to fill this position. You will become part of an accomplished team of industry professionals with knowledge and experience across many lines of business and programs.

Shape Your Future With Us
GenStar Insurance Services, LLC is a premier provider of excess, surplus, and specialty property and casualty insurance written on General Star Indemnity Company (non-admitted) and General Star National Insurance Company (admitted) paper (collectively, the GenStar companies). The GenStar companies conduct business through a select group of wholesale brokers, managing general underwriters (MGUs), and program administrators in the United States. The GenStar companies are members of the Berkshire Hathaway Family of Companies .
GenStar currently offers an excellent opportunity for P&C Compliance Analyst – Statistical Reporting – GenStar based in our Stamford office. This is a hybrid role.

Role Description

We are looking for an analytically minded person experienced in statistical reporting to insurance regulators who will be part of our P&C regulatory compliance team in Stamford, Connecticut, reporting to the insurance business unit. Our flat organization offers diverse and challenging assignments in a hybrid schedule balancing work-life priorities.

Primary responsibilities
– Fulfill regulatory and statistical reporting requirements to ensure timely compiling and submission of all required policy, claim, or other relevant data to be reported to insurance regulators, insurance rating bureaus, and other organizations, including state DOIs, NAIC, FIO, ISO, NCCI and SFAA. Collaborate with business units, finance, IT, legal, and outside vendors for data collections and preparation of the reports.
– Specialize in computer applications necessary to make accurate and timely regulatory reports, for example, Microsoft Office and SERFF.
– Gathers information and dates due for all data calls. Maintains list of all data calls.
– File complete and timely corrections to data or report formats to avoid fines or penalties.
– Continuously monitor changes to data reporting requirements and communicate them to our internal stakeholders.
– Responsible for statistical reporting and data calls required for our admitted and non-admitted insurance companies.

Other responsibilities
– Specialize in the appointment and termination of insurance agents and agencies authorized by our insurance companies. Includes overseeing insurance agent licenses and claim adjuster licenses of our employees.
– Conduct regulatory compliance reviews including research, information gathering, analysis, discussion with management, and write audit reports about the findings.
– Monitor law changes and notify business units or stakeholders of the changes.

And responsibilities may include:
– Ability to answer questions from business units about insurance compliance.
– Support other regulatory compliance functions, for example, responding to consumer complaints received from state DOIs or assisting in the preparation of state filings.

The Chief Data Steward (GS-301-15) works under the direction of the OWCP IT PMO Director and Deputy Director, and closely with the Office of the Chief Information Officer (OCIO), the Chief Evaluation Office (CEO), the Privacy Office, and technologists to design, implement, secure and manage technology solutions that enable the effective and cost-efficient storage, maintenance, integration and use of data by agency stakeholders. This is a business data development, management, and reporting position, where the incumbent is expected to have expert business knowledge of insurance workers’ compensation and/or health/disability data for use as both tactical and strategic assets for operational needs, reporting, and public use (when appropriate).