Manage and Administer Benefits: Flexible Benefits RCM

A successful risk management strategy requires a strong internal control environment. The RCM format emphasizes that strong and risk-oriented internal control environments are often optimized with automated/manual controls, depending on the situation.

An RCM provides an overview of different control objectives that organizations should take into consideration and the corresponding controls to safeguard the company against risks which may arise if not checked timely. Once customized to an organization, this document can help the user in assessing each control. The control assessment can then also be summarized to develop an action plan.

This document outlines risks and controls common to the flexible benefits aspect of the 3.5.7 Manage & Administer Benefits process in a risk control matrix (RCM) format.

Sample risks include:

• A terminated employee will receive more benefits than premiums left in their MSA account and the employer will lose dollars.
• An employee’s request to change their elections is either wrongfully denied or granted.
• Ineligible employees are enrolled in the plan. Ineligible expenses are reimbursed to employees.
• Reimbursements are input incorrectly in the payroll/accounts payable module.

This document can be used as a sample RCM and is not meant to be an exhaustive list of risks and controls. The KnowledgeLeader team will periodically update this RCM with new content. Organizations should select, update and modify the risks and controls included in this document to ensure that it reflects business operations.