FSA, MAAA
Professional designations
- Fellow, Society of Actuaries
- Member, American Academy of Actuaries
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 indemnity and managed comprehensive medical; other hospital, surgical, and medical plans; critical illness and specified disease coverage; Medicare supplement; 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 been very involved assisting clients and others regarding the requirements and impact of health care 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, and insurance carriers regarding small employer and individual health insurance regulation, plan design, reinsurance programs, and pricing issues. In 2010 he was retained by the NAIC to assist with the development of the credibility adjustment factors to be used in the PPACA MLR calculations that all insurance carriers must file.
Prior to joining Milliman, Jim worked for nine years for an individual health insurance carrier, primarily in pricing, financial reporting, and strategic planning areas.
Affiliations
- Member, Health Practice Financial Reporting Committee of American Academy of Actuaries (2001 – 2006, 2011)
- Member, American Academy of Actuaries PPACA MLR Regulation Work Group (2010 to present)
- Member, Actuarial Standards Board Regulatory Filings Task Force (2011)
| Presentations and publications |
- “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 of Group Insurance, ACTEX Publishing, 2007
- “Underwriting Small Groups,” Chapter 25 of Group Insurance, ACTEX Publishing, 2007
- Frequent speaker at professional and industry meetings on various subjects related to individual and small group health insurance programs
Education
- BS (magna cum laude), Mathematics, Loyola University of Chicago
- MA, Mathematics, Loyola University of Chicago
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