Actuarial Products and Services

 

 

The Actuarial Needs of Self-Funded Health Care Plans are briefly described and certain actuarial products and services are described:

 

1.      Annual Actuarial Report

Provides recommended funding, COBRA premiums, reserve estimates, etc. Modeling by actuarial principles is used.

 

2.      Monte Carlo Simulations

Primarily used for confidence ranges of projected claims, economic value of specific and aggregate stop-loss premiums and likelihood of an aggregate claim.

  

3.      HSA Modelling-Employer Cost Parity

• Recommended employer HSA contributions needed to maintain cost parity.

• Comparison of proposed plan terms and HSA contributions to meet IRC §223 requirements.

• Expected claims of HDHP measured with confidence limits.

 

4.      Benefit Content Analyses

Actuarially-determined economic values of Benefit A and Benefit B are compared without and/or without regard to reported claims experience.

 

5.      Claim Reserves

Both the traditional and the AICPA SOP 92-6 format are available.

 

6.      State-Mandated Certifications

Such certifications include MEWAs-government entity plans and other state-regulated arrangements (Florida, Iowa, New York, Ohio, Idaho, Montana, Oklahoma, e.g.).

 

7.      Special Actuarial Studies

Available are the results of special research projects conducted by Self-Funding Actuarial Services on a continuing basis.

 

8.      Risk-Related Analyses

Involves health care plans where both (a) risk-related plan changes including demand management and (b) consulting to other risk’s/funding arrangements are involved.

 

9.      GASB 43 and GASB45

See www.govplans.com for detailed description of those actuarial services involving retiree reserves and risk management aspects of self-funded plans of government entities.

·        Mental Health Parity Tests

·        ADA Actuarial Equivalency Tests

·        EEOC Retiree Health Benefit Parity Tests

·        Managed Care Analyses

·        IRC§419A Long Term Disability Reserves

·        AICPA FAS 112 Computations.

The firm may offer AICPA FAS 106 computations by subcontracting.

 

Unless arranged otherwise, the client of Self-Funding Actuarial Services, Inc. is the vendor (TPA, practitioner, etc.) and not the employer/plan sponsor.  The billings go to the vendor to be passed on to the employer.  Such arrangement is helpful to all parties but does not affect the actuary’s independence.

 

Current charges and fees are shown in a separate sub-site.