Kevin E. Ross - Insurance Compliance Analyst
Job_Seekers_Address: 2407 15th Street NW #511 Washington DC 20009
Contact_Email: KROSS@ULLICO.COM
Contact_Phone: Work: 202-986-1235 Home: 202-986-1235
Resume_Text:
KEVIN E. ROSS
2407 15HT STREET NW #511 • Washington • DC • 20009
(202) 986-1235
OBJECTIVE:
To secure a position with a growth oriented insurance company using my regulatory compliance skills and knowledge for mutual enhancement of growth and profitability.
Regulator compliance skills and knowledge includes experience in all 50 states, the District of Columbia and Puerto Rico.
PROFESSIONAL EMPLOYMENT HISTORY
1996 – Present
Senior Compliance Analyst
The Union Labor Life Insurance Company
Silver Spring, Maryland
Responsibilities:
Develop, file and maintain regulatory compliance for all fully insured group life, accidental death and dismemberment, comprehensive major medical, dental, vision, hearing, prescription drug, short-term disability, long- term disability, and long term care products. This function includes developing, filing and maintaining regulatory compliance of all product line marketing materials.
Develop, file and maintain Exclusive Provider Organization and Preferred Provider Organization plans and marketing materials.
Develop, file and maintain Florida and Michigan small employer association group health plans and marketing materials.
Maintain product forms in automated policy and certificate delivery system using the Document Library System (DLS) publisher.
Organize and implement changes to group insurance plans to meet client needs.
Monitor and provide analyses of state and federal insurance laws to ensure regulatory compliance. This function includes weekly monitoring of state legislation, reviewing new legislation, determining any impact on current company and/or departmental procedures and/or product lines, and communicating compliance issues to the appropriate operational units.
Research and advise on compliance and legislative issues from all internal and external sources.
Assemble departmental and interdepartmental work groups when necessary to resolve compliance issues.
Maintain legislative activity reports. This function includes the development of on-line and hard copy maintenance procedures of all reported legislative activity.
Coordinate with Managed Care Unit to maintain company state utilization review licensures.
Assist the Legal Department in the development and maintenance of company compliance with federal privacy requirements.
Provide employee and agent training on company products and department procedures.
Develop and maintain compliance manuals for use by new and existing compliance personnel as guides to compliance and its function within the company and for understanding departmental work flow.
Investigate and respond to insurance department complaints.
Develop and maintain reliable follow-up procedures for all work projects to ensure prompt and satisfactory completion.
Develop and maintain research charts as requested by upper management. This function includes development and maintenance of charts and reports to provide quick and easy access to state requirements regarding topics such as filing procedures, interest rate payment requirements, prompt payment of claim requirements, state mandated benefits, etc.
Develop and maintain state filing charts to provide quick and easy access to status of state filings.
Product line consists of group insurance plans. Group eligibility includes small employer groups, large employer groups, association groups, multiple employer welfare arrangements, and Taft-Hartely Welfare Funds.
1992 – 1995
Senior Contract Analyst
John Alden Life Insurance Company
Miami, Florida
Responsibilities:
Develop, file and maintain regulatory compliance for all fully insured group life, accidental death and dismemberment, comprehensive major medical, dental, prescription drug, short-term disability, long- term disability, and long term care products. This function included developing, filing and maintaining regulatory compliance of all product line marketing materials.
Develop, file and maintain Exclusive Provider Organization, Preferred Provider Organization, and Health Maintenance Organization plans and marketing materials.
Develop, file and maintain small employer group health plans and marketing materials.
Maintain product forms in automated policy and certificate delivery system using the Text Gen publisher.
Organize and implement changes to group insurance plans to meet client needs.
Monitor and provide analyses of state and federal insurance laws to ensure regulatory compliance. This function included weekly monitoring of state legislation, reviewing new legislation, determining any impact on current company and/or departmental procedures and/or product lines, and communicating compliance issues to the appropriate operational units.
Research and advise on compliance and legislative issues from all internal and external sources.
Assemble departmental and interdepartmental work groups when necessary to resolve compliance issues.
Maintain legislative activity reports. This function included the development of on-line and hard copy maintenance procedures of all reported legislative activity.
Provide employee and agent training on company products and department procedures.
Develop and maintain compliance manuals for use by new and existing compliance personnel as guides to compliance and its function within the company and for understanding departmental work flow.
Investigate and respond to insurance department complaints.
Product line consisted of group insurance plans. Group eligibility included small employer groups, large employer groups, association groups, and multiple employer welfare arrangements.
Position eliminated due to dissolution of company.
1990 – 1992
Senior Insurance Analyst
Harcourt, Brace, Jovanovich, Inc.
Orlando, Florida
Responsibilities:
File and maintain regulatory compliance for all fully insured group and individual life, accidental death and dismemberment, comprehensive major medical, short-term disability and long- term disability products.
Monitor and provide analyses of state and federal insurance laws to ensure regulatory compliance. This function included weekly monitoring of state legislation, reviewing new legislation, determining any impact on current company and/or departmental procedures and/or product lines, and communicating compliance issues to the appropriate operational units.
Maintain legislative activity reports. This function included the development of hard copy maintenance procedures of all reported legislative activity.
Provide employee training on company products and department procedures.
Product lines included both individual and group insurance plans. Group eligibility included large employer groups, association groups, and multiple employer welfare arrangements.
Position eliminated due to company’s sale of insurance business
1983 – 1989
Group Service Technician
Security Life of Denver
Denver, Colorado
Responsibilities:
File and maintain regulatory compliance for all fully insured group life, accidental death and dismemberment, comprehensive major medical, short-term disability and long- term disability products.
File and maintain regulatory compliance for self-insured Stop-Loss product.
Monitor and provide analyses of state and federal insurance laws to ensure regulatory compliance. This function included weekly monitoring of state legislation, reviewing new legislation, determining any impact on current company and/or departmental procedures and/or product lines, and communicating compliance issues to the appropriate operational units.
Monitor Stop-Loss groups’ specific and aggregate claims experience and report increased claim activity or violations to upper management. This function also included working with upper management to develop improved claim management systems.
Provide employee training on company products.
Product line consisted of group insurance plans. Group eligibility included large employer groups and multiple employer welfare arrangements.
Resigned position to pursue employment opportunities in Florida.
PROFESSIONAL ACHIEVEMENTS
Assisted in development of stop-loss products for Harcourt, Brace, Jovanovich, Inc., Sea World Companies, Busch Entertainment Corporation, and Harris Enterprises, Inc.
Assisted in the development of Neighborhood Health Partnership’s (owned by John Alden Life Insurance Company) Health Maintenance Organization plans and advertising material.
Developed, filed, and built into the Text Gen publisher automated issue system John Alden HealthCare Management Division’s Exclusive Provider Organization product.
Redesigned John Alden HealthCare Management Division’s small employer health plan products to meet statutory compliance, readability and company requirements.
Developed and filed Ulico Casualty Company’s (owned by The Union Labor Life Insurance Company) Florida and Michigan small employer association group health plan products and advertising materials.
Assisted in development of The Union Labor Life Insurance Company’s group managed care and non-managed care major medical, dental and group prescription drug programs.
Assisted in The Union Labor Life Insurance Company’s compliance with federal HIPAA regulations.
EDUCATION
Concentration in Special Education, Bloomsburg State College, Bloomsburg, PA
Concentration in Business Accounting, Barnes Business College, Denver, CO
LOMA courses, Security Life of Denver, Denver, CO
Supervisory and Management Training Program, Security Life of Denver, Denver, CO
