The Importance of IBNR in Self-Funded and Traditional Health Plans
Understanding and accurately predicting future liabilities is crucial to the sustainability and success of insurance companies and self-insured employer-sponsored health plans...
Mother May I? Interpreting ACA Pricing Allowances
“Mother-May-I” is a classic kids’ game that teaches little ones to honor their mother by having players request to take steps towards their mother but only taking steps if their mother allows it! While it would be strange...
3rd Annual ACA Consumer Value State Rankings
The story of consumer value in the Affordable Care Act (ACA) individual marketplaces echoes one of the great epochs of our nation’s history where a sense of manifest destiny culminated in a quest to unite the coasts...
Pandemic Reserves
As I sit at my desk looking out the window at the rain covered streets, barely a person in sight and cars randomly scattered on the curb, it is hard not to think, “should we have seen this...
Should You Be Concerned About Low Rate Increases?
Health care costs are too high. What health care products or services come to mind when you read that sentence? Depending on your personal experience...
So How Much Profit is Enough? Guidance for Pricing Health Benefits
One of the key assumptions in health product premium rate development is the profit margin (i.e., contribution to [...]
Resource Based Pricing
Introduction Some of the confusion about the US health care system is directly tied to prices. How [...]