We support health plans through the full actuarial lifecycle: product pricing, IBNR reserve estimation, premium rate filings, MLR rebate calculations, risk adjustment validation, and Medicare Advantage bid preparation. Our work pairs technical rigor with regulator-ready documentation — so when CMS, HHS, or your state Department of Insurance asks how a number was built, the trail is already there.
Actuarial Solutions
Healthcare Actuarial Services
Pricing, reserving, and rate filings for health plans, Medicaid managed care organizations, and Medicare Advantage carriers.
Who we work with
Health plan CFOs
Medicaid MCOs
Medicare Advantage carriers
Self-insured employers
What we deliver
- — Pricing memos & rate filings
- — IBNR reserve estimates with sensitivity analysis
- — MLR rebate calculations
- — CMS bid support
- — Trend studies & utilization analytics
Common questions
Do you sign rate filings as the certifying actuary?
Yes. Our principal credentialed actuaries (ASA, MAAA, FCA) routinely serve as certifying actuary on state premium rate filings and CMS Medicare Advantage bid submissions.
How do you approach trend assumptions in a high-uncertainty environment?
We blend medical economics fundamentals (utilization, unit cost, intensity, mix) with payer-specific experience and stress-test against alternative scenarios. Every assumption is documented with its source and sensitivity range.