From basic benefit reporting to insurance company product and rate development, we provide a variety of clients with a wide range of data management services
Employers
· Health Plan Reporting and Budgeting
· Financial Projections/Forecasts
· Claim Liability Reserve Calculations (IBNR)
· Retiree Medical Valuations (FAS 106 and GASB 45)
· COBRA and Medical Rate Development and Certification
· Provider Network Comparison/Analysis
· Human Resource Information Systems (HRIS) and Vendors
TPAs, Brokerage Agencies, CPAs, Consultants
· Full line of pass through reporting and data mining services
· Specific valuation or actuarial projects for individual clients
· Wellness benefits ROI and outcome analysis
· Private label branding of Employers Services above
· Hospitals, Physician Groups, Dental Practices, PHO, IPA, PPO, PBM
· Managed care contract evaluation, pricing and review
· Cost/Utilization, Rate Model Evaluation
· Network and Related Contract Negotiations
· Fee Schedule Analysis/Development
· Regulatory Compliance
· Provider Risk Sharing Modeling/Analysis
· Provider Risk Education/Training
Insurance Companies, BCBS, HMOs, Reinsurers
· Financial Projections/Forecasts, Experience Studies
· Rates & Reserves/Opinions &Certificates
· Rate Manual/New and Renewal Product Design
· Product Mix/Cost & Utilization Rate Models
· Provider Network Analysis and Contract Negotiation
· Actuarial Required Compliance Services
· Underwriting Services and Temporary Staff Replacement/Peak Load
· Product Evaluation/Development
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ACTUARIAL SERVICES
