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James T. O'Connor, FSA, MAAA

Principal, Consulting Actuary
Chicago, IL, US

Tel: +1 312 7260677

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Professional Designations

  • Fellow, Society of Actuaries
  • Member, American Academy of Actuaries

Education

  • BS (magna cum laude), Mathematics, Loyola University of Chicago
  • MA, Mathematics, Loyola University of Chicago

Current Responsibility

Jim is a principal and consulting actuary with the Chicago office of Milliman. He joined the firm in 1987.

Experience

Jim has considerable experience consulting in individual health and employer group insurance as well as managed healthcare programs. His product knowledge encompasses PPO and managed comprehensive medical; other hospital, surgical, and medical plans; critical illness and specified disease coverage; and other health insurance plans.

Jim assists a variety of clients with pricing and plan design, marketing and administrative management, financial reporting, and strategic planning and acquisitions. He has assisted clients and others regarding the requirements and impact of healthcare reform. He also has considerable experience with profitability and experience analyses, state insurance department filings, and various product compliance issues. Clients also seek his expertise regarding voluntary worksite insurance programs.

Jim has provided consulting services to the National Association of Insurance Commissioners (NAIC), numerous states including the Massachusetts Connector, insurance carriers, and industry groups and associations regarding small employer and individual health insurance regulation, plan design, reinsurance programs, and pricing issues. He was retained by the NAIC to assist with the development of the credibility adjustment factors to be used in the ACA MLR calculations, as well as researching the use of stop-loss reinsurance for self-funded employers.

Jim has made numerous presentations and written articles and papers regarding ACA and the individual and small group markets.

Presentations and publications

  • "Comprehensive Assessment of ACA Factors that will Affect Individual Market Premiums in 2014," Prepared for AHIP, April 2013
  • "ACA Impact Illustrations—Individual and Group Medical," Prepared for Center Forward, May 2013
  • "Design and Implementation Considerations of ACA Risk Mitigation Programs," Prepared for the Society of Actuaries, June 2012
  • "New Medical Loss Ratio Regulations: How to Maximize the Minimum," AIS Webinar, February, 2011
  • "Plans Face Such MLR Rule issues as Contract Reserves, Rebates," AIS's Health Reform Week, Volume 2, Number 5, February 14, 2011
  • "Patient Protection and Affordable Care Act: Implications of Status as a Grandfathered Plan," Benefits Quarterly, First Quarter, 2011
  • "Credibility Adjustment Factors for Use in PPACA MLR Refund Calculations", NAIC, August 2010
  • "Small Group Rate Filings and Rate Certifications" (Chapter 21) and "Underwriting Small Groups" (Chapter 25), Group Insurance, ACTEX Publishing, 2007

Affiliations

  • Past board member, Health Section of Society of Actuaries, (2001-2003)
  • Member, Health Practice Financial Reporting Committee of American Academy of Actuaries
  • Chairperson, Health Practice Notes Subcommittee of the American Academy of Actuaries
  • Work at Milliman

    • “I was offered a chance to come in, shake things up, create something."
    Work at Milliman