Actuarial consulting: Healthcare


  • Print
  • Connect
  • Email
  • Facebook
  • Twitter
  • LinkedIn
  • Google+

Milliman's extensive actuarial services help insurers, health plans and employer groups better handle the complexity of estimating financial risk in healthcare. The following services below help entities navigate a rapidly changing industry:

Pricing and plan design

We help you design premium rates on new products and recommend which features should be part of a plan. Our extensive healthcare research, databases and tools help you price new or unusual products and estimate costs of mandated benefits and limitations. From examining varying deductible levels to examining plan elements, we ultimately help you estimate the true impact of underwriting.

Reserving and financial reporting

Insurers must be able to accurately estimate future liabilities in order to adequately set aside reserves. We help estimate your liabilities and reserves, including liabilities for incurred but not reported claims, disability reserves, premium deficiency reserves and other premium reserves. We also give clients practical advice and tools they can use to ensure the most accurate possible reporting. We can review a client's existing reporting methods and suggest improvements, or create customized financial-reporting systems.

Claim experience and financial analysis

Experience analysis looks at incurred claims experience and compares it to premiums or other customized benchmarks. This helps determine whether the insurer or plan sponsor needs to raise premiums, make changes in plan design, or target certain areas of utilization management. After careful analysis, we recommend actions you can take to ensure profitability while preserving benefits.

Regulatory filings

We make compliance much easier by handling all necessary government filings and actuarial opinions. We handle the gamut of regulatory requirements, including premium rate filings, annual actuarial statements of opinion, small group certifications, Medicare Retiree Drug Subsidy (RDS) certifications and Medicare Advantage bids.

Retiree medical benefits

Milliman estimates the accounting impact on future retiree benefits and helps you develop alternatives to manage them. In addition to pension liabilities, employers must account for other post-employment retirement benefits (OPEB), such as medical, vision, dental, life and disability. Entities that need benefits valuations can rely on the extensive employee benefits expertise of Milliman. We handle compliance with FAS 106GASB 43/45 and SOP-92 requirements.