Employee Benefits Knowledge Check

1. Benefits Proposal (Employer Decision)

A broker or consultant presents a Benefits Proposal (or Renewal Presentation) to HR and leadership. This document compares plan options, costs, and recommendations and outlines the benefits that insurance carriers can offer. Employees do not see this document. The employer selects the final benefits from this proposal.

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1. Benefits Proposal (Employer Decision)

Kind of

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2. Plan Setup (System Configuration)

After the employer chooses the benefits, the selected plans are configured in tools like PlanSource (or a similar enrollment system). This includes entering plans, rates, eligibility rules, employer contributions, and uploading required documents. There is no automatic import from the proposal of the benefits that the HR/CFO chosen. But someone who manually enters all the data (account executive or someone from operations).

Is this correct?

2. Plan Setup (System Configuration)

Yes

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3. Benefits Guide Creation (Employee Explanation)

A Benefits Guide is created to explain the chosen benefits to employees in plain language. Information is typically manually copied from PlanSource (or a similar enrollment system) and carrier documents into a PDF or printed handbook. The benefits guide is not legally required but is the primary employee-facing explanation of the benefits.

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3. Benefits Guide Creation (Employee Explanation)

Yes

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Anything to correct or add?

4. Required Employee Documents (Compliance & Legal)

During enrollment or open enrollment, , including:

- SBCs (Summary of Benefits and Coverage) for each medical plan (ACA requirement)

- SPD documents (ERISA and tax compliance)

- Federal annual legal notices (HIPAA, Medicare Part D, CHIP, etc.)

These documents are usually provided as PDFs or portal links and are required for compliance, not education.

Is this correct?

4. Required Employee Documents (Compliance & Legal)

Yes

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5. Employee Enrollment

Employees enroll through PlanSource (or a similar enrollment system), where they review available plans, select benefits, and submit their elections. PlanSource acts as the system of record for enrollments and ongoing changes. This step occurs after employees have received the benefits guide and have been informed about all available benefits.

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5. Employee Enrollment

Yes

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Anything to correct or add?

6. Post-Enrollment & After Care

After an employee uses healthcare services, they receive an EOB (Explanation of Benefits) explaining how a claim was processed and what they may owe.

Is this correct?

6. Post-Enrollment & After Care

Yes

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