Provide actuarial expertise for health insurance companies. Functions include product development, pricing, rate filings, and UW guidelines.

Director, Actuarial Services - Responsible for overall risk and financial results of $800 Million PPO/EPO portfolio and $100 Million HMO health portfolio. Functions include pricing, valuations, product development, regulatory reporting, quarterly/annual statement filings, all rate filings, claims auditing, reinsurance monitoring and renewals, project management, vendor negotiations, provider negotiations, fee schedule development, SOX compliance, underwriting functions, DOI liaison, legal analysis, and competitive analysis for all HMO and PPO Commercial group and individual plans.

Provide actuarial expertise in health programs both domestic and international. Clients range from insurers, reinsurers, TPAs, re-pricing firms, and auditing firms.

Responsible for actuarial risk management and underwriting for large international reinsurance organization, including portfolios in U.S., Caribbean and Brazil. Functions include pricing, product development, policy review and modification, provider networks, managed care, underwriting, account management, claims management, auditing, accounting, administration, reinsurance evaluation, reinsurance contracts and reporting for group and individual international health programs. Expertise in quota share and stop loss reinsurance products.;

Responsible for overall management of health portfolio including product design and modifications, implementation of PPO plan, provider network development, managed care, pricing, underwriting, reserving, reporting, claims, systems, marketing, and administration for group and individual health plans.

Responsible for daily project management and client relationships with Health & Welfare plans. Extensive group health pricing modeling including new product and capitation models, renewal rating/experience analysis, provider and employer consulting, development of managed care products, Medicare/Medigap product development, reserving and liability estimation, preparation of state rate filings, systems consulting, employee benefits consulting.

Responsible for entire Individual health product line. Development of ancillary products including Medicare Supplement, LTC and Short-Term Major Medical. Reserving methodology development, pricing, compensation modeling, financial reporting, compliance, systems. 1991 Employee of the Year Award.