Employer Groups & Broker Consulting
Data-driven guidance for employer groups and health insurance brokers.
For employer groups and health insurance brokers, optimizing coverage while minimizing financial risk is a difficult balancing act, made all the more difficult by the complexities of healthcare markets. Wakely is the intermediary you need to guide your decision making. We provide expert actuarial consulting and analysis for the brokerage community, multi-employer arrangements, and employers. Our in-depth knowledge of healthcare markets, unique analytical tools, and decades of experience lead our clients to data-driven solutions that balance the needs of all involved.
Actuarial services for employer groups and brokers
Wakely provides renewal projections and actuarial analysis across all major funding types, designed to help employers and brokers understand what is changing and what options are available.
Our approach goes beyond a single renewal number. We typically:
- Re-project the current plan year to establish a credible baseline
- Develop forward-looking cost projections based on experience and trend
- Break down key drivers of cost change
- Evaluate potential strategies, including plan design, funding, and contribution changes
The analysis can also be customized to reflect future plan offerings and overall strategy, allowing stakeholders to assess tradeoffs before decisions are finalized.
Wakely evaluates benefit plan options to support decisions around cost, competitiveness, and employee impact.
Our analysis leverages the Wakely Plan Valuation Model (WPVM) to assess differences in actuarial value and expected cost across plan designs. A key component of this work is consideration of induced utilization, which reflects how member behavior may change as cost-sharing changes.
We also evaluate:
- Expected migration across plan offerings
- Alignment of plan relativities and contribution strategy
This helps avoid unintended outcomes such as adverse selection or misaligned funding across plans.
Wakely’s Self-Insured Feasibility Analysis evaluates the financial and risk implications of moving from a fully insured to a self-funded arrangement.
The analysis compares funding approaches on a consistent basis and considers:
- Expected cost differences
- Claims volatility and downside risk
- Stop-loss strategy and risk tolerance
- Operational considerations
Our goal is to provide a balanced view of both opportunity and risk, rather than focusing solely on expected savings.
Wakely evaluates stop-loss strategies to help employers understand the tradeoff between fixed costs and retained risk.
Our approach combines employer-specific experience with broader benchmarking and simulation techniques. This typically includes:
- Monte Carlo modeling to assess aggregate claim risk
- Evaluation of specific and aggregate deductible options
- Analysis of expected catastrophic claimant activity
We also assess whether quoted stop-loss premiums are reasonable relative to the group’s risk profile.
Wakely develops premium equivalent rates based on actual experience and plan-specific cost structures.
This includes:
- Experience-based rate development
- Incorporation of fixed and variable cost components
- Support for COBRA rate development
This work is often closely aligned with renewal projections and broader funding strategy.
Wakely’s IBNP report uses industry-standard actuarial methodology and our proprietary model to provide estimates of outstanding claims liability, including analytics to facilitate decision-making and financial planning.
Wakely supports employers and brokers with independent review of financial reporting and underlying assumptions.
This includes:
- Review of dashboards and financial reports
- Validation of methodologies and assumptions
- Identification of potential gaps or inconsistencies
The value is both quality control and an independent actuarial perspective to support decision-making.
Wakely evaluates employer and employee contribution strategies in the context of plan design and enrollment behavior.
We assess:
- Alternative contribution structures
- Impact on employee plan selection
- Alignment with market practices
This helps ensure contribution strategies are both financially sustainable and competitive.
Wakely provides actuarial support for mergers, acquisitions, and other situations involving the combination of populations and benefit programs.
Our work focuses on helping employers understand how differences in experience and plan design translate into future costs and risk. We evaluate:
- Differences in claims experience, demographics, and overall risk profiles
- Financial implications of combining populations, including potential cost shifts
- Development of unified rate structures and funding approaches
We also assess plan design and contribution alignment to reduce disruption, support a smoother transition, and avoid unintended cross-subsidization between groups. The goal is to provide a clear, actuarially grounded path forward that balances fairness, competitiveness, and financial sustainability.
Wakely supports multi-employer arrangements, including MEWAs, AHPs, and captives, with both technical and strategic actuarial services.
These programs involve additional complexity due to variation across participating employers, regulatory requirements, and the need to balance growth with long-term stability. Our support includes:
- Development of rating tools and underwriting approaches for new and renewing groups
- Risk segmentation and ongoing financial monitoring across the block
- Support for rate filings and responses to state DOI inquiries
We also provide broader strategic guidance on pricing, participation, and program design. Our focus is on balancing competitiveness, risk selection, and long-term sustainability across a portfolio of employer groups, while maintaining consistency and transparency in how rates are developed.
Wakely provides actuarial determinations of whether prescription drug coverage meets Medicare Part D creditable coverage requirements.
We support:
- Annual creditable coverage testing
- Employer disclosures and documentation
- Consolidated reporting across multiple plans, where applicable
Wakely supports comparative analysis of quantitative treatment limits affecting mental health and substance use disorder benefits.
We evaluate:
- Application of limits across medical and behavioral health benefits
- Areas that may require further review or adjustment
This work supports compliance while also considering practical plan design implications.
Wakely provides an independent, actuarial perspective on third-party vendor solutions and cost containment strategies.
We assess:
- Reasonableness of projected savings
- Fit with the employer’s population and existing programs
- Interaction with other plan components
This helps clients make more informed decisions beyond vendor projections alone.
We back your strategies with a wealth of data.
Wakely consultants draw on a broad range of data sources to assist you in market analysis, benchmark development, strategy and more. Here are just a few:
- Medicare 100% Research Identifiable File
- Medicare Limited Data
- Wakely Medicare Advantage Aggregate Client Data
- Wakely ACA
- Large Group Commercial Data
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