SUSAN PROSPERI

Employee benefits brokerage acquired by Congruity, Inc. to serve as the in‑house agency for Congruity HR’s PEO clients, along with their existing clients, offering fully insured and level-funded medical plans, dental, vision, and ancillary benefits for small to mid‑sized employers.

• Benefits Administration
• Client Service
• Account Forensics
• Compliance
• Renewal Support
• Agency Operations
• Account Management & Benefits Administration for 15-20 small, and mid-sized (3-400 employee) employer groups, the largest portion of clients falling in the 75 to 200 range.
• Uncovered $40K+ in discrepancies during a COBRA inquiry-improperly directed remittances and coverage on unreported terminations. Traced missing funds, negotiated retroactive terminations, and recovered approximately $44K.
• Discovered extensive data integrity issues in a pre-renewal census reconciliation (outdated records, unreported hires/terminations, and a deceased employee, still active). Coordinated with clients and carriers to reconcile records, and process retro terminations, recovering $15K in overpaid premiums.
• Implemented a new platform to streamline and standardize benefits materials across agency and PEO, improving efficiency, accuracy, and consistency while elevating the professional image of deliverables.
• Identified a pattern of inaccuracies in employer contribution affecting payroll reports across multiple accounts; learned contributions were often assumed without formal verification or documentation; implemented a standardized Rates & Contribution Strategy requiring annual discussions and written documentation of contributions, plan selections, and rates with client sign-off to ensure accuracy.
• Employee benefits brokerage acquired by Congruity, Inc. to serve as the in-house agency for Congruity HR's PEO clients, along with their existing clients, offering fully insured and level-funded medical plans, dental, vision, and ancillary benefits for small to mid-sized employers.

A mid sized employee-owned insurance brokerage with 9 office locations, spanning 4 states. The Benefits Services Division focuses mostly on mid sized employer groups across a variety of industries, offering self funded, level funded, and fully insured medical plans, as well as ancillary, voluntary, supplemental, and worksite benefits.

• Account Management
• Client Service
• Issue Resolution
• Compliance
• Open Enrollment
• Administration Support
• Primary contact for 15-20 clients working as part of a 7-member team, supporting a $2M+ book of business and ensuring seamless service delivery and long-term client satisfaction.
• Executed plan changes and renewals, ensuring accurate system updates and carrier file transmissions.
• Identified a plan design error overlooked during renewal that resulted in non-compliant embedded deductible structure; coordinated implementation of an agency-funded HRA to remedy the issue and maintain client trust.
• Directed technology transitions, including new carrier implementations and benefits administration platform migrations, ensuring smooth go-lives and minimal disruption.
• Facilitated open enrollment meetings onsite and virtually, delivering clear plan overviews and answering employee questions to support informed decision-making.
• Created benefits materials for new hires and annual enrollments, improving employee understanding and participation.
• Provided expert compliance guidance on ERISA, COBRA, HIPAA, and ACA requirements, helping plan sponsors avoid costly penalties and maintain regulatory alignment.
• A mid-sized employee-owned insurance brokerage with 9 office locations, spanning 4 states. The Benefits Services Division focuses mostly on mid-sized employer groups across a variety of industries, offering self-funded, level-funded, and fully insured medical plans, as well as ancillary, voluntary, supplemental, and worksite benefits.

Critical Thinking & Analysis • Problem-Solving • Communication • Attention to Detail
Previous career in nursing across multiple clinical settings and specialties, including prior authorization review and case management in the medical insurance setting. This background provides a unique advantage in employee benefits.
• Skilled at assessing complex problems, interpreting data, and making evidence-based decisions—universally valuable competencies essential to employee benefits work.
• Adept in translating complex information into clear, understandable language for diverse audiences.
• In nursing, accuracy isn't optional—it's critical. I bring that same approach to employee benefits, where details matter and mistakes are costly.
• Well-versed in medical terminology, insurance procedures, and provider networks—critical for evaluating plans, explaining benefits, and resolving claims issues.
Relevant Accomplishment —Service Recovery: Prevented contract termination by two largest home care agencies taking over as dedicated manager to streamline and improve a fragmented prior authorization process. Delivered consistent reviews, eliminated delays, implemented clear communication processes, including updates in real-time and weekly status update calls. Delivered results in under 30 days —well ahead of the 90-day window negotiated by leadership —with both agencies retaining their contracts, expressing that they were “impressed by the quick turnaround and thrilled with the changes.”