Comprehensive Actuarial Services

Wakely Consulting Group actuaries provide a comprehensive full-service array of expert actuarial services and consulting to the medical and health care sectors.

Please contact us to help you with any of the following services:

Regulatory Services

  • Risk-Based Capital (RBC) Requirements and Surplus Adequacy
  • State Insurance Department Filings State Insurance Department Filings
  • State Insurance Department Filings Medicare Advantage/Prescription Drug Plan Bid Submission/Certification
  • Actuarial Certifications and Annual Statutory Opinion
  • State Insurance Department Filings Medicaid Rate Certification
  • Turnkey Filing of HMO Certificate of Authority (COA) Turnkey Filing of HMO Certificate of Authority (COA)

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Product and Premium Pricing

  • Rating Algorithm Review
  • Product Development, Impact of Benefit Design Changes and Pricing For:
    • Commercial Lines (Medical, Dental, Vision, etc.)
    • Medicaid
    • Medicare
    • SCHIP/Healthy Kids
    • Self-Funded/ERISA Employer Group Plans
  • Experience Rating of Large Groups
  • Reinsurance Review Including Analysis of Specific and Aggregate Limits

Develop Capitation Rating Models Including but not Limited to:

  • Provider Capitations
  • Per Diems
  • Percentage (%) of Premium Contracts
  • Global Capitations
  • Medicare Prescription Drug Plan Reconciliation
    • Risk Corridor
    • Reinsurance
    • LICS
  • Risk Adjustment Systems
    • HCC
    • ACG
    • DCG
    • CDPS

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Financial Statement Support

  • Claim Liability and Reserve Determinations (IBNR)
  • Financial Projections, Profitability Studies and Valuations

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Strategy and Business Management

  • Competitor Studies
  • Mergers and Acquisitions
  • Review of Managed Care Networks, Contracts and Risk Sharing Agreements
  • Underwriting Review

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Health Care Reform Act (PPACA)

  • Employer Requirements
  • Creation of Exchanges
  • Medicare Advantage Plans / Prescription Plans
  • Medicaid
  • Regulatory Requirements

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Special Services

  • Speaking Engagements on Current Health Care Topics
  • Expert Witness Reports and Testimony
  • Custom Consulting Services

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Get in Touch for Actuarial and Healthcare Reform Services