Senior Benefits Compliance Specialist

Position Summary

We are seeking a Senior Benefits Compliance Specialist with hands-on experience in employee benefits regulatory compliance, particularly ACA reporting, ERISA, Form 5500, Medicare Part D, and federal/state benefits regulations.

This is an internal, non-client-facing compliance role supporting Benefits Administration and other internal teams that work directly with clients. The successful candidate will research complex benefits compliance questions, monitor regulatory requirements, support filings and audits, interpret regulations, maintain compliance documentation, and provide clear guidance to internal teams.

This role is best suited for someone who enjoys benefits compliance, regulatory research, data accuracy, audits, and solving complex regulatory issues**.

This is NOT a traditional benefits administration, benefits customer service, benefits brokerage, or client-facing benefits role. Candidates should demonstrate hands-on experience with benefits compliance and regulatory requirements.

• Monitor and support compliance with the Affordable Care Act (ACA) and employer shared responsibility requirements.

• Prepare, review, coordinate, and/or support 1094-C and 1095-C ACA reporting.

• Support preparation and filing of Form 5500 annual reports for PEO Master Benefit Plans.

• Interpret and apply ERISA requirements to employee benefit plans.

• Monitor federal and state employee benefits regulations and identify changes that may affect plan administration.

• Complete or support Medicare Part D Creditable Coverage disclosures and related CMS requirements.

• Support state-specific benefits compliance filings, including Massachusetts HIRD and similar requirements.

• Research complex benefits compliance questions and provide guidance to internal Benefits Administration and client-facing teams.

• Conduct periodic benefits compliance audits, review data and documentation, identify discrepancies, and support corrective actions.

• Maintain compliance calendars, SOPs, FAQs, process guides, and other regulatory documentation.

• Review benefit plan documents, SPDs, amendments, and related materials for compliance accuracy.

• Generate and analyze compliance-related reports from HR/benefits systems, including Prism, where applicable.

• Coordinate with carriers, third-party administrators, vendors, auditors, and legal counsel on benefits compliance matters.

• Monitor legislative and regulatory changes and communicate relevant impacts to internal stakeholders.

• Support open enrollment and renewal activities from a compliance perspective.

• Train and provide subject matter guidance to internal team members regarding benefits compliance requirements.

• Support special projects, audits, regulatory initiatives, and other benefits compliance activities.

• Maintain accurate documentation and ensure regulatory deadlines are met.

• Work onsite as required for secure system access, collaboration, meetings, and sensitive compliance activities.

• Approximately 2–6 years of hands-on employee benefits compliance experience.

• Experience with ACA compliance and reporting.

• Experience with 1094-C / 1095-C reporting.

• Working knowledge of ERISA and employee benefit plan requirements.

• Experience with Form 5500 preparation, review, filing, or coordination.

• Experience researching and interpreting federal and/or state employee benefits regulations.

• Experience with benefits compliance audits, reporting, governance, or regulatory documentation.

• Strong analytical and research skills.

• Ability to translate complex regulatory requirements into clear, practical internal guidance.

• Strong written communication and documentation skills.

• High attention to detail and ability to manage regulatory deadlines.

• Bachelor's degree preferred, or equivalent combination of education, training, and relevant benefits compliance experience.

• Ability and willingness to work onsite.

• PEO experience.

• Experience supporting PEO Master Benefit Plans.

• Medicare Part D Creditable Coverage.

• CMS reporting.

• COBRA compliance.

• HIPAA benefits compliance.

• Massachusetts HIRD reporting.

• Benefits plan audits.

• Summary Plan Description (SPD) review.

• Benefits governance.

• Experience working with TPAs, insurance carriers, auditors, vendors, or legal counsel.

• Experience using Prism or other HR/benefits systems.

• Experience supporting large employer or multi-state benefit plans.

The ideal candidate is an individual contributor or senior specialist with approximately 2–6 years of hands-on employee benefits compliance experience. They should have direct experience with **AC

 

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