Agency Benefits Coordinators

Agency Benefits Coordinator Responsibilities

  • The Agency Benefits Coordinator, or ABC, serves as a liaison between your agency, its employees and Benefits Administration.
  • One of the most important parts of your job as an ABC is ensuring that all insurance information is communicated timely and accurately during orientation with all new employees.
  • You must provide the Employee Insurance Checklist to the employee, review each item on the Employee Insurance Checklist with the employee, obtain the employee’s signature on the checklist and store the signed checklist in the employee’s file.
  • You must clearly explain that the new hire has 30 calendar days from their hire date (or date of eligibility) to enroll in insurance and advise that the enrollment must be complete within Edison or by paper enrollment submitted by eForm within that deadline. You must clearly communicate the date that the 30 day enrollment period begins and include that on the checklist.
  • Benefits Administration approval is required before you provide any agency-specific information to your employees regarding benefits enrollment or elections changes, such as additional checklists or handouts.
  • Upon request, the ABC shall provide to BA all orientation materials provided by the agency to new employees, including the signed Employee Insurance Checklist.
  • All ABCs shall participate in ABC conference calls/electronic meetings with BA staff based on a schedule defined by BA. ABCs shall review all notices emailed from BA and must check the ABC webpage weekly to review all new BA postings. ABCs shall participate in all meetings held by BA in addition to the regular conference calls and weekly messages.
  • The ABC shall promptly review notices and updates from BA, including notices regarding annual premium increases or benefit changes and updates to the Plan Document.     
  • All ABCs shall complete all training required by BA. All new ABCs shall complete the New ABC Training offered by BA and shall be required to pass a test to access Edison benefits information. New ABC Training shall be completed within 60 calendar days of becoming an ABC. Supplemental training shall be completed as required by BA, and failure to do so will result in suspension of access to benefits information in Edison. Training requirements cannot be waived unless approved in advance by BA.
  • All new ABCs shall complete the HIPAA training module in Edison within 30 calendar days of access to the system. All ABCs shall complete the HIPAA training ANNUALLY during the scheduled training month or as otherwise prescribed by BA. Failure to complete the annual HIPAA training will result in suspension of access to benefits information in Edison which will not be restored until HIPAA training is complete. 
  • The ABC shall be familiar with the insurance benefits and eligibility provisions described in the Plan Document and any applicable Certificates of Coverage for the voluntary benefits.
  • The ABC shall be responsible for certifying the Application to Continue Insurance at Retirement. The ABC shall refer all eligibility or policy questions related to creditable years of service and monetary retirement benefits to Tennessee Consolidated Retirement System staff. Questions about retiree eligibility and questions about the Annual Enrollment period for retirees shall be directed to BA.
  • The ABC shall refer members interested in obtaining information concerning the process for appeal to the member handbooks, the Summary of Benefits and Coverage and the Plan Document on the website. The ABC shall provide carrier contact information for appeals related to denial of coverage. For enrollment appeals, the ABC shall provide the employee with the steps to appeal the decision.
  • The ABC should only provide an Administrative Error Letter or Form if the agency caused a delay in enrollment or provided incorrect information. Submission of an Administrative Error Letter or Form does not guarantee approval.
  • The ABC shall assist with requests from BA to help with ensuring the agency members respond to requests for information and otherwise comply with sections "5.05, Subrogation Rights"; "5.06, Right of Reimbursement"; and "5.07, Recovery of Payment" of the Plan Document.
  • The ABC will receive quarterly reports from a data match with the National Change of Address database. The ABC shall work with their agency human resources office to update addresses in Edison each quarter based on the results.
  • The ABC shall respond to a monthly email from BA regarding invalid Social Security Numbers within the deadline specified by BA in the request. 

This list may not include all responsibilities specifically found in the Memorandum of Understanding for local education and local government ABCs, or other roles and responsibilities as previously outlined to ABCs.