Management Health

KINI J. JOHNSON

R.R. #*, Box **, French Hollow Lane, Hardin, IL 62047

618-***-**** - Home

******@***********.***

618-***-**** - Cellular

CAREER ACCOMPLISHMENTS

> Developed and created attractive brand for greater membership

identification for targeted benefit communications.

> Recovered $425,000 in subrogation monies from external third party

carriers resulting in additional monies to Fund and saved $350,000 in

unnecessary medical claims payments.

> Achieved highest wellness associate online enrollment including HRA

completion out of 12 online clients within first year of implementation

to associates.

PROFESSIONAL EXPERIENCE

Seasoned benefit leader with 20 years' experience in all aspects of health,

welfare and retirement benefits including strategy, implementation, project

management, compliance and administration. Implement benefit strategies to

maintain and drive down increasing benefit costs while continuing to

provide exceptional employee satisfaction. Benefit expertise includes:

Behavioral/Mental Health Programs Employee Assistance Programs

Prescription Drugs

Claims Administration Flexible Spending Accounts

Subrogation Recovery

Compensation Statements Individual/Group Life Insurance Vision

Dental Medical Voluntary

Benefits

Disability Insurance Non-Qualified Retirement Plans

Wellness Programs

Plan Management - Implement medical, E-prescription COB, care management,

disease management and numerous wellness programs. Provide value added

analysis, create project plans, perform re pricing analysis and review

RFP's.

Project Management - Implement and manage new claims software; configure

health plan setup/group structures, implemented claims auto adjudication

and auto release to streamline internal processes.

Management - Manage and direct work activities of a team of 10 Benefit

Specialists/Claim Specialists. Responsible for recruitment, mentoring,

counseling, coaching, discipline, development of staff, training programs

and performance reviews. Act as an advisor for the Audit Committee,

Wellness Committee and Board of Trustees.

Plan Administration - Ensure consistent application of benefit plans, life

events, adherence to policy and provisions of the Summary Plan

Descriptions. Administer plans according to COB, COBRA, HIPAA, ADA, FMLA,

FLSA, LOA, MSP, USERRA, QMCSO and ERRP provisions.

Laborers' Benefit Office, St. Louis, MO

Director Benefit Services July

2008 - Current

Oversee and manage department of ten staff associates demonstrating

leadership qualities consistent with the Fund's management values and

mission. Coach, develop, recruit, train, counsel, discipline, mentor and

provide exceptional employee relations to staff. Accountable for the

overall strategic and tactical operations of the department and call center

operations. Developed metrics for monitoring staff productivity and hold

staff accountable for short and long term goals set for the plan year.

Implemented new internal procedure benefit user guides for claims,

eligibility and benefit call center. Created and developed total

compensation statements for internal office.

Manage health and welfare plans for entire Taft Hartley union organizations

for 4,500 + active members, 300+ Retirees and 350+ Medicare Supplement

members. Manage claims, eligibility, enrollment for the medical, dental,

vision, specialty drug, prescription, life and OON network re-pricing

providers. Manage, create, write and develop overall benefit communications

to include: prescription plan E-COB changes, health and welfare plan

changes, benefit newsletter, health fair, board member presentations and

all other media communications ensuring communications are clear,

understandable and seamless for company plan changes and transitions.

Manage benefit plans according to plan documents and government regulations

which include Section 111 MSP, ERISA, HIPAA, USERRA, COBRA, QMCSO, ERRP and

annual required notices. Extensive knowledge of ERISA, benefit plan

document, amendments, SSM's, and regulatory requirements. Prepared and

executed with legal consultant summary plan description changes and

successfully communicated to membership.

Manage, develop implement and recommend benefit provider and plan changes.

Monitor internal processes, policies and procedures to ensure operations

are in compliance with Fund's Summary Plan Description (SPD). Manage

internal and external eligibility and claims processes ensuring staff and

external providers and consultants are held accountable to consistently

meet company performance expectations. Manage for submission of all

eligibility files to external benefit providers and resolution of data

errors. Manage TPA for claims administration outsourced with Fund. Manage

company website ensuring all communications and plan materials are up-to-

date and accurate. Act as an advisor for the Audit Committee, Wellness

Committee and Board of Trustee monthly meetings. Identify research and

analyze benefit trends.

Manage claim and eligibility staff workload, provider refunds, claim

overpayments, high dollar member claims, workers compensation, appeals,

subrogation, eligibility, regulatory compliance, code updates and vendor

performance. Extensive knowledge of health precertification and utilization

management processes. Perform internal eligibility and claim audits to

ensure members are enrolled appropriately in health and welfare plans and

claims are paid timely and accurately. Heavily involved with data

preparation and gathering for external audits reviews. Extensive knowledge

of CPT, HCPCS and ICD-9CM coding.

Ascension Health, St. Louis, MO

Corporate Benefit Specialist

March 2006 - May 2008

Managed, developed, recommended and successfully implemented self-funded

health and welfare plans for 1,200 + onsite and remote associates.

Implemented new and revised current benefit plans. Provided guidance on

various associate benefit plans to management through monthly, quarterly

and annual reporting. Analyzed benefit costs, trends and issues. Monitored

cost effectiveness of current benefit plans for annual renewal, reviewed

associate cost share of benefit plans and recommended changes to

management. Ensured health and welfare plans were performing within company

goals and objectives.

Managed and implemented new wellness initiatives and action plan for

organization effectively communicating to all level of associates and

management. Successfully managed annual open enrolment, online benefit

enrollment, testing of benefit plan changes within HRIS benefit system,

submission of benefit eligibility files and resolution of data errors.

Developed benefit guide for internal use for associate cross-training.

Designed, wrote, prepared and distributed two separate clear and concise

communication materials for annual open enrollment, wellness

communications, redesigned benefit handbook, designed and successfully

communicated annual benefit fair. Developed presentation materials for

small and large group presentations and other media effectively

communicating to all associates through onsite presentations and web cast

of benefit plan changes.

Prepared and executed with legal consultation, benefit documentation such

as original and amended plan documents, summary plan descriptions, and

benefit agreements. Instructed benefit providers and other administrative

agencies outside of company to implement ensuring prompt and accurate

compliance within policy provisions.

Managed benefit service providers for all benefit plans to ensure providers

meet the service requirements of agreements. Proactively developed

excellent relationships with associates, brokers, consultants, management,

and internal departments. Managed benefit plans according to plan documents

and government regulations which include ERISA, HIPAA, FMLA, USERRA, COBRA

and QMCSO.

Argosy Gaming Company, Alton, IL

1991 - 2006

Corporate Benefit Specialist

Administrator of self-funded and fully-insured Corporate benefits programs

for 7,500 + union and non-union associates with multiple locations ensuring

compliance with benefit policies, procedures, plan provisions and federal

regulations. Assisted Corporate Director of Benefits in analyzing benefit

decisions to include: plan design, administration, communications, surveys

and market data. Assisted with benefit implementation of casino acquisition

successfully communicating to all level of associates through targeted

communications and onsite presentations.

Administrated open enrollment and HRIS benefit plan changes. Managed day-to-

day administration of health and welfare benefit plans, voluntary,

supplemental benefits, 401-k plan, benefit plan documents, amendments, FSA,

EAP for multi plan states. Served as Corporate liaison for 401-k record

keeper and auditors for annual government testing and reporting.

Developed and maintained company benefit user manual, trained and mentored

six property location Benefit Managers on internal & external issues

relating to benefits. Scheduled onsite visits with property managers

ensuring managers administering health and welfare plans in accordance with

plan documents and HRIS system. Acted as an advisor on human resource and

benefit programs to all levels of associates and managers throughout the

company organization.

SOFTWARE/TECHNICAL SKILLS

HRIS database systems - PeopleSoft HRMS, Ultipro, Ceridian and Cognos

Report Writing

Benefit database systems - Aliquant, Travis COBRA, Brynes

Claims/Eligibility Software, ISSI/MX Claims/Eligibility Software

Applications - Microsoft Word, Microsoft Excel, Microsoft Power Point,

Access and Adobe Acrobat

EDUCATION

Lewis & Clark Community College, Godfrey, IL General

Studies

Sanford Brown Business College, Granite City, IL

Graduated 1989

CERTIFICATIONS AND CONTINUING EDUCATION

60 hours self education every 2 years for Producer License renewals

Ingenix Essentials Conference, November 2009

Series 7 General Securities Representative, Certificate of Completion,

August 2005

Illinois and Missouri Life, Health & Accident Producers License, June 2005

- Current

Certificate in Employee Benefits Law, June 2005

Infinisource COBRA, October 2004

Certificate in Benefits & Compensation Management (IFEBP), September 2003

Certificate in Health Care Plans (IFEBP), September 2003

Certificate in Retirement Plans (IFEBP), February 2002

Certificate in Fundamentals of Qualified Plans, 2002

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