RiskManagers.us offers independent actuary services for self-funded health & welfare plans. This critical element forms the foundation upon which comprehensive risk management services are based. Without an actuarial analysis of plan performance a plan sponsor cannot be certain recommended risk management strategies will produce anticipated results.
Independent licensed actuaries are important resources for plan sponsors seeking to fulfill their fiduciary duties. Yet executives, who hire lawyers to review leases and accountants to audit books, routinely accept advice and work product from insurance agents, brokers, consultants and insurance company representatives that have not been examined by an independent, fee based actuary.
The Affordable Care Act (ACA) has brought unparalleled, intrusive bureaucratic oversight of employer sponsored health and welfare plans. Although the Employee Retirement Income Security Act (ERISA) was passed 42 years ago, the onus of fiduciary duties, particularly in regards to prudent management of plan assets, has become a new source of intense government focus.
ERISA imposes rigorous standards for fiduciaries – those who manage an employee health and welfare plan and its assets. As a result, under the ACA plan sponsors are increasingly at risk for government audits and sanctions. Unfortunately many employers have established self-funded employee health & welfare plans without being fully aware of their fiduciary responsibilities nor understand the added pressures and potential sanctions imposed in today’s regulatory environment.
RiskManagers.us offers independent actuary services for self-funded health & welfare plans. This critical element forms the foundation upon which comprehensive risk management services are based. Without an actuarial analysis of plan performance a plan sponsor cannot be certain recommended risk management strategies will produce anticipated results.
Actuary services provided by RiskManagers.us may be customized to meet the individual needs of plan sponsors we represent. The following services provide the foundation of our risk management services.
Level 1 Actuarial Services
RiskManagers.us will perform an actuarial analysis of the self-funded Plan’s available claims loss experience to determine the actuarially reasonable:
- Reserve appropriate for claims incurred but not reported and incurred but not paid (the “IBNR”) as of the end of the experience period for which the required loss experience was received and analyzed by RiskManagers.us; and
- health benefits funding rates for the ensuing plan year, exclusive of plan administration, excess loss insurance and other costs not directly based on the plan’s claims costs.
For the above purpose, RiskManagers.us will analyze the Plan’s claims loss experience, including related enrollment data and Plan benefits, during the three most recent Plan Years or such lesser experience period that is acceptable to RiskManagers.us, comparing year-to-year experience histories, with adjustments for cost trends and benefit modifications implemented during the experience period, utilizing experience data acceptable to RiskManagers.us that has been furnished by the Plan Sponsor or its duly authorized Third Party Administrator firm (“TPA”).
Level 2 Actuarial Services
Services provided on a per request basis:
- Multiple IBNR reserves and/or health benefits funding rates for the same Plan Sponsor, e.g. by location, division, union vs non-union, etc.;
- Estimated funding cost impact of health benefits Plan modifications under consideration;
- OPEB valuations under GASB 74/75;
- Other requested non-Level 1 actuarial services that RiskManagers.us agrees to perform.
For More Information Contact: RiskManager@RiskManagers.us
