Service for HMO's and Insurers

ROSS HEALTH ACTUARIAL


MANAGED CARE RISK MODELING DECISION SUPPORT

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Services for:

HMO's and Insurers

Providers

The Medicaid Market

Compliance Programs

Litigation Support

SERVICES FOR HMO'S AND INSURERS

In Response to Regulatory Requirements:

  • Claim reserve analysis and reserve certifications.
  • Rate filings and certifications for state insurance departments.
  • Risk-Based Capital calculations and strategy.

In Response to Opportunities:

  • Product development.
  • Pricing of benefit options.
  • PPO, POS plan design and pricing.
  • Proposals and renewal rating/underwriting of large groups.
  • Provider contracting assistance.
  • Medicaid rating and product development.
  • Risk adjustment methodologies for rating and provider contracting.

In Response to Prudent Management Objectives:

  • Data analysis and data mining to extract full value from your data.
  • Risk modeling and reinsurance review.
  • Underwriting process review.
  • Premium management system development and implementation.

 

 

 

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