How to Take Over Employee Benefits When You’re New to HR

Maybe you were the office manager, the controller, or the person who “is good with details.” Now you own HR, and HR includes the company’s health insurance. Nobody handed you a manual, open enrollment is on the calendar, and employees are already asking you questions you can’t answer yet.

That’s normal. Almost everyone who inherits employee benefits starts exactly here. The good news is that you don’t need to know everything in your first month. You need to know four things: which rules apply to your company, where the plan documents are, how your benefits platform works, and whether your broker is doing their job. This guide walks through each one in the order we’d tackle them.

Step 1: Know how many employees you have, because the rules depend on it

Benefits law in the U.S. is built on headcount thresholds. The same health plan comes with different obligations for a 15-person company than for a 75-person company. So before anything else, get an accurate count of full-time employees (30 or more hours a week) and part-time hours, and ask whether any related companies share common ownership, since those are often counted together.

Here’s where the major lines fall for a Texas employer:

The ACA count is based on the prior year’s average, not today’s roster, and it includes full-time equivalents built from part-time hours. If you’re anywhere near 50, run the math carefully. The IRS explains exactly how to calculate it.

COBRA is the first compliance rule most new HR leads run into. This walkthrough covers who qualifies and what the employer has to send.

Step 2: Find the plan document. This is the most important step

If you only do one thing from this article, do this. The plan document is the rulebook for your benefits: who is eligible, when coverage starts, how much the company contributes, what happens when someone leaves. Every answer you’ll give employees this year traces back to it. Once you have it, you can build a real plan of action instead of reacting to whatever lands in your inbox.

“The plan document” is usually a small stack of documents rather than a single file. Look for:

• The plan document or ERISA wrap document, which ties your insured policies together into one plan.
• Summary Plan Descriptions (SPDs), the plain-language version employees are entitled to receive.
• Summaries of Benefits and Coverage (SBCs) for each medical plan.
• Carrier contracts or certificates for medical, dental, vision, life and disability.
• Your Section 125 cafeteria plan document. If employees pay premiums pre-tax through payroll, you need one in writing.
• The last renewal package, current rates and recent invoices.
• Your broker agreement and the broker’s compensation disclosure.

Check your predecessor’s files and email, the carrier’s employer portal, your benefits administration platform, and, the fastest route of all, your broker. A good broker can send most of this within a day or two. If they can’t, that tells you something too.

Once you have the documents, pull out the handful of facts that drive your calendar: the plan year and renewal date, the open enrollment window, eligibility rules and waiting periods, the employer contribution, and whether your plan is fully insured, level funded or self-funded. Write them on a single page. That page is the start of your plan.

Section 125 is the tax law that lets employees pay premiums pre-tax. It’s also one of the documents most often missing from a new administrator’s files.

Step 3: Learn the platform your company uses to manage benefits

Most companies don’t run benefits on paper anymore. Enrollments, life events, new hires and terminations usually flow through a benefits administration platform such as Employee Navigator, and from there to the carriers and to payroll. It’s also where small errors quietly pile up when nobody is watching it.

In your first few weeks:

• Make sure admin access has been moved to you, and removed from anyone who has left.
• Compare the employee census against payroll: names, hire dates, hours, salaries and addresses.
• Clear any pending new hires, terminations or life events waiting on approval.
• Find out which carriers receive changes automatically and which still need a manual form.
• Spot-check that payroll deductions match what employees actually elected.

Make sure deductions match every hire and every departure

This is where benefits mistakes turn into real money. Every time someone joins or leaves, three things have to line up: the benefits platform, the carrier’s bill, and the payroll deduction. When one of them is missed, the company pays for it, and often it can’t get that money back.

• When an employee leaves and isn’t removed from the carrier, the company keeps paying their premium month after month. Many carriers will only credit back a limited window, often 30 to 60 days. Anything older than that is usually gone for good.
• When a new hire enrolls but their payroll deduction is never set up, the company quietly pays the employee’s share too. Collecting it later is awkward at best. In Texas you generally need the employee’s written authorization for a catch-up deduction, and many employers end up writing it off.
• When deductions don’t match elections, for example the wrong coverage tier or a dependent added mid-year, employees are overcharged or undercharged. Either way, you’re the one who has to fix it and explain it.

The fix is a simple monthly habit: compare the carrier invoice, the platform and the payroll deduction report line by line before you pay the bill. Anyone on the invoice who isn’t on payroll, or on payroll without a deduction, gets fixed that week.

Step 4: Think twice before changing your broker right away

When someone new takes over HR, one of the first instincts is to make a big move, and changing the benefits broker is often at the top of the list. Sometimes that’s the right call. But the timing matters as much as the decision.

Your broker is a tool. Whatever you think of them, they know how your plans were built, why the contribution strategy looks the way it does, what the carrier’s underwriters saw at the last renewal, and which employee issues are still open. You don’t have that knowledge yet. Replacing them before you do means both you and the new broker are learning the account at the same time.

The biggest risk is the calendar. Renewals typically arrive about 60 days before the renewal date, and open enrollment follows close behind. A broker change made inside that window leaves almost no time to shop the market, negotiate or prepare employees. If your renewal is less than 90 days away, the safer move is usually to get through it with the current broker, watch closely, and decide afterward.

Use that time to test them. Ask your broker for:

• The renewal timeline and what they plan to do before it
• A compliance calendar for your size of group
• Any plan documents you couldn’t find
• A named contact for day-to-day service issues
• A clear, written explanation of how they are paid

Pay attention to how quickly and how completely they answer. If they’re responsive and the account is in good shape, you may have a partner worth keeping. If they only show up at renewal, can’t produce basic documents, or can’t explain their own compensation, you’ll have real reasons to make a change, and time to plan it properly: when to send the Broker of Record letter, how the data moves, and who employees call during the transition. Planned changes go smoothly. Rushed ones land in the middle of open enrollment.

Not sure whether your current broker is pulling their weight? Call us at (972) 277-1049 and we’ll give you an honest read, even if the answer is to stay put.

We cover the timing question in more detail in the best time to change an employee benefits broker.

Why a new broker alone rarely lowers your rates, and what actually moves the number at renewal.

Your first 90 days, in order

1. Days 1 to 30Count your employees and confirm which rules apply. Gather the plan documents. Get admin access to the benefits platform. Book an intro meeting with your broker.
2. Days 31 to 60Audit the census against payroll and reconcile the carrier invoice to payroll deductions. Build your one-page summary of plan year, eligibility and contributions. Put compliance deadlines on the calendar.
3. Days 61 to 90Review how the broker has performed. Map out the next renewal and open enrollment. Decide what, if anything, needs to change, and when.

Helpful resources

• Reporting and Disclosure Guide for Employee Benefit PlansU.S. Department of Labor. A quick reference for which notices and filings ERISA plans owe participants and the government.
• Health Benefits Coverage Under Federal LawU.S. Department of Labor. Covers the ACA, HIPAA, mental health parity and other group health rules, with model notices.
• Health plan compliance for employersU.S. Department of Labor. The hub for COBRA guides, fiduciary responsibilities and self-compliance tools.
• Determining if an employer is an Applicable Large EmployerIRS. How to count full-time and full-time equivalent employees for the ACA.
• Employer responsibilities for coverage continuationTexas Department of Insurance. COBRA and Texas state continuation in plain language.

Frequently asked questions

What is the first thing I should do when I’m put in charge of employee benefits?

Find the plan documents and confirm your headcount. Those two things tell you which laws apply and what your plan actually promises employees. Everything else, including decisions about carriers or brokers, should come after.

Where do I find my company’s plan document?

Start with your predecessor’s files, the carrier’s employer portal and your benefits administration platform. Your broker should be able to send the plan document, SPDs, SBCs and your Section 125 document quickly. If a document doesn’t exist, your broker or a benefits attorney can help you put one in place.

Should I change our benefits broker when I take over HR?

Not automatically. If your renewal is less than about 90 days away, changing brokers usually adds risk. Give the current broker a chance to show what they do, and if a change is still needed, plan it well ahead of the next renewal.

Do we have to offer COBRA?

Federal COBRA generally applies to employers with 20 or more employees. Texas employers with fewer than 20 employees on a fully insured plan are generally subject to state continuation instead, which allows up to nine months of continued coverage.