Over the years, United Health Actuarial Services, Inc. (UHAS) has worked with Health and Welfare funds, Insurance Companies, and Health Plans around the country, providing Practice Management & Support and Actuarial and Benefits Consulting.
Below are examples of our broad experience by business sector.
Public Sector Experience
- Review individual, small group and association group medical rate filings for a state Department of Insurance and for the Center for Consumer Information and Insurance Oversight (within the Centers for Medicare and Medicaid Services under the Department of Health and Human Services).
- Review small group health market data for another Department of Insurance.
- Provide financial review support to a Department of Insurance.
- Provide consulting services and actuarial rate review for Long-Term Care (LTC) product filings to a Department of Insurance.
- Perform non-pension retiree valuations for a number of public entities.
Private Sector Experience
- Project claim costs based upon historical claims and associated benefit- and census-related data for a number of clients, and has also reviewed such projections for several states as part of its regulatory practice.
- Develop, price products, and provide all rating and rate filing support.
- Complete monthly liability/reserve determination, financial reporting and experience analysis, premium rate increase recommendation development, and filing implementation and support.
- Calculate and estimate IBNR, Risk-Based Capital, and other required liabilities/reserves.
- Robust experience with cost and utilization review of client medical and pharmacy claims for the purpose of discerning health care trends. UHAS has clients for which it performs this type of analysis on a recurring basis.
- Research cost and utilization assumptions of competitor medical and pharmacy filings for the purpose of discerning industry health care trends.
- UHAS employs underwriters and actuaries who have assess risk and calculate risk scores using current practices and will do so in the context of ACA implementation (i.e., when the final risk-scoring mechanisms are released).
- Complete gross premium valuations (i.e., cash flow analyses) to determine reserve liability/adequacy and to verify sufficient liquidity exists for claim and expense payments.
- UHAS has substantial experience working with Captive insurance companies to define actuarial pricing, reinsurance, and underwriting programs.
- Support liability/reserve analysis, gross premium valuation development and litigation support/expert testimony.
Engagements with U.S. Federal Government Agencies
- Review rate filings per the requirements of the ACA.
- Provide an actuarial/financial review of the Federal LTC Insurance program.
- After serving on a technical panel to review the viability of the CLASS Act that was part of the ACA, we completed a review of the financial projection model(s) and assumptions relating to the CLASS Act LTC program.
- Review actual historical experience of federal-supported program, analyze the cause(s) for any deviations of actual experience from previously projected amounts, and project future experience.
Engagements with U.S. State Government Agencies
- Review filings (including network pricing, as appropriate), develop a rate review manual, train department personnel in the actuarial aspects of rate development, and other actuarial consulting services as requested.
- Engaged with public employee program for the actuarial and valuation support of their self-insured LTC pool. UHAS has provided direct actuarial services as well as peer review and overflow support for the program’s staff actuary.
- Perform project work related to public employee risk adjustment program.
- Review LTC, Medicare Supplement, and voluntary/supplemental new product and rate increase filings.
- Perform “post-mortem” financial reviews of the financial reports, actuarial work products, and actuarial opinions that were historically provided by other actuarial firms on behalf of multiple managed care insurance organizations that went into financial receivership.
Contact us to discuss how we can be of service to your organization.