In today’s healthcare environment, the regulatory compliance stakes are high. Noncompliance can put your public reputation at risk—at worst it can mean fines, disciplinary action, or receivership. Although you intend to comply, regulations are often complicated, which makes it hard to put policies in place with confidence.
Milliman handles regulatory issues successfully every day for insurers, providers, and health plans. We are familiar with the laws and regulations governing healthcare in every state.
Among our services, we:
- calculate the actuarial items for financial and other types of statutory reporting
- develop and review contract and benefit language for insured and self-funded plans
- obtain approval of policy forms and rate filings
- track legislation and keep you informed of the impact of new legislation on your product
- advise on procedures to administer laws and regulations
- provide statements of opinion regarding the adequacy of reserves
- identify regulatory or contractual issues that could impact corporate business transactions
- review marketing materials for trade practice concerns
Obtaining a national rate increase for an insurer
An insurer engaged Milliman to perform an actuarial appraisal of its long-term care business. This client was concerned about the performance of the block. Our analysis confirmed that loss ratios were higher than desired and we recommended the insurer seek a nationwide rate increase. We prepared an actuarial justification for the rate increase and submitted the necessary statutory filings for the more than 120,000 contracts in force. The average approved increase across all policies was 15%, translating into an annual additional $33.6 million in premiums for the client.
Working with Milliman, you’ll be advised by professionals who have decades of experience providing regulatory advice and counsel. You’ll also have access to tremendous regulatory compliance resources.