Actuarial Health Care Links

Types of Clients Supported

  • Private and Public Corporations
  • School Corporations
  • Not for Profit Entities
  • Government Entities
  • Taft Hartley Health Plans
  • Religious Organizations
Support Team

  • Randy Gomez, FSA, MAAA, EA
  • Joe Polley, ASA, MAAA
  • Evi Laksana, ASA, MAAA

If you would like to download this information as a PDF document, please click here.

Group Health Services

Evaluate Premium Renewals for Fully Insured Plans
  • Medical, HMO/POS, PPO, Dental and LTD Benefit Plans
  • Does claims experience support the renewal premium
  • Evaluate carrier reserve calculations
  • Analyze historical claims experience
  • Assess underwriting assumptions (trend, expenses, credibility factors, etc.)

Financial Analysis for Self-Insured Health Plans
  • Calculate self-funded budget rates for active and retired groups
  • Actuarial certified COBRA rates as required by ERISA
  • Incurred But Not Reported (IBNR) claim reserve
  • Assess current use of specific and aggregate stop-loss
  • Identify risk in terms of probabilities and compare to client’s risk tolerance
  • Illustrate financial impact of various levels of stop-loss reinsurance
  • Evaluate tax implications of various funding vehicles (VEBAs and other trusts)
  • LTD claimant reserves

Measure Impact of Plan Design Changes
  • Deductible, coinsurance, copays, outof- pocket maximums
  • Consumer-driven health plans (HRA, HSA, and High-Deductible Plans)
  • Prescription drug generic and formulary plans
  • Modeling of employee anti-selection for dual option plans
  • Dental, STD, LTD, and sick pay plan design changes

Claims and Employer Cost Projections
  • Single or multiple year projections
  • Discrete or Monte Carlo simulations

Develop Employer Subsidy and Employee Contribution Strategy
  • Plan design subsidies
  • Incremental approach to employee contributions
  • Flexible benefits design and pricing
  • Employee vs. dependent subsidy levels
Evaluate Retiree Health Plans
  • Employer Medicare supplement /Fill-in plan design
  • Evaluation of retiree health individual accounts
  • Postretirement health plan valuations (FASB 106 corporate accounting and GASB 43/45 government account)
  • Develop funding strategies for prefunding asset reserves

RDS Part D Tax Subsidy
  • Actuarial attestation and creditability equivalency testing
  • Online application submission
  • Postretirement health plan valuations (FASB 106 corporate accounting and GASB 43/45 government account)
  • Subsidy calculations and yearend reconciliation
  • Data eligibility updates


Copyright 2009-10, Nyhart Inc. | Home | Privacy Policy | Terms of Use | Flex | COBRA | VEBA | Retirement / 401(k) | 5500 Submission
A Member of Alliance Benefit Group