The following represents an offer to provide certain actuary services to self-funded health & welfare plans:
We will welcome the opportunity to provide actuarial services to (______________) for the benefit of your clients’ self-funded Health benefit plans. This letter outlines the services we propose to furnish and our fee structure.
Scope of Annual Actuarial Services for Your Plan Sponsor Clients
- Actuarial analysis of the available self-funded Health plan’s claims loss experience during the three most recent plan years, with adjustment for cost trends and benefit modifications implemented during the experience period;
- Calculation of the reserve for claims incurred but not reported and incurred but not paid (“the IBNR”) as of the end of the period for which the required loss experience was furnished to us;
- Calculation of the actuarially reasonable 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;
- Review the employer’s current plan document for compliance with PPACA’s Minimum Value, Attestation of Creditable Coverage (including prescription drug coverage for Medicare Part D plan participants, if any) and identify plan modifications, if any, required for ongoing compliance;
- Furnish your firm for delivery to your client an actuarial evaluation report of our analysis and findings.
- Interface with (_______________) regarding modifications, if any, of the Plan Sponsor’s plan document, information systems & reporting that may be required to electronically furnish our firm in a mutually acceptable format with the data necessary for completion of our actuarial analysis.
The scope of our assignment will not include an audit of the data furnished to us. Accordingly, we will perform our analysis and report our conclusions in reliance upon the accuracy of the data furnished to us by your firm.
Our Fee Structure (Per Employee Per Month Basis)
200 – 499 Employees $0.75
500 – 999 Employees $0.50
1000 -1999 Employees $0.40
2000+ Employees $0.25
Fees for Plan Sponsor’s with less than 200 covered employee lives and/or for services not described above will be determined on a case-by-case basis.
In addition, our work-related expenses are to be reimbursed by your firm. “Work-related expenses” are limited to expenses for business travel and parking, lodging, meals and entertainment expenses we incur, with your firm’s approval, in connection with travel for the purpose of attending one or more meetings with your firm and/or your client.
Our fee structure will apply to work we do for your firm during 2024, except as may need to be modified as a consequence of Federal, State or other regulatory laws, rules, regulations, judicial decisions and/or legal opinions that alter the scope and/or complexity of our work.
We appreciate the opportunity to be of service and look forward to your response. We also welcome any questions or suggestions you may have, whether now or at any time during the project itself.
