Healthcare cost modelling

Excess Product Suite

Milliman’s Excess Product Suite is a set of tools that can be used to improve the pricing and underwriting of medical excess products. The tools are based on the same underlying data as Milliman’s Health Cost Guidelines, an industry gold standard used by insurers, managed care organisations, and third-party administrators to estimate expected claim costs and model healthcare utilisation.

The suite was developed through the cooperative efforts of Milliman’s actuarial consultants and represents a combination of their research, experience, and judgment. It contains the following products:

  • The Milliman Stop Loss Manuals with QWiz™ calculate premium rates for specific and aggregate stop-loss policies based on national benchmarks, adjusted for the risk characteristics of the covered population. The Milliman QWiz Stop Loss Quote Wizard (QWiz) is an electronic tool that can be used to easily process quotes using the information contained in the Stop Loss Manuals.
  • The Excess Pricing Tool (ExPrT) provides a flexible but consistent basis for estimating claim costs and calculating premium rates for a wide variety of reinsurance coverages. ExPrT can be used to anticipate future claim levels and establish interrelationships between different coverages.
  • The Excess Network Discount Tool (ENDiT) allows the underwriter of excess products to calculate an appropriate network discount to use for pricing, based on current contracts and utilisation patterns. If these data are not available, ENDiT can use historical network discounts, as observed in claims data, to generate this discount.
  • The Laser Tool helps underwriters quantify the financial risks associated with known high-risk individuals. It is a simple tool that requires no clinical expertise, with the potential to improve efficiency in the laser-setting process, as well as the incorporation of lasers into a broader underwriting strategy.

These tools, which can be licensed individually or as a discounted package, are designed to assist you in managing risk while remaining competitive in existing business retention and new business acquisition. Initial training is included in the lease price.

The Excess Product Suite is available for licensing through your Milliman consultant. If you do not have a relationship with a Milliman consultant, please contact Rob Bachler or Nicholas Johnson.

MILLIMAN EXPERTS

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Johnson Nicholas

Nicholas Johnson

Principal, Consulting Actuary

Nick Johnson is a consulting actuary specializing in healthcare in Milliman's Seattle office. He joined the firm in 2009.

Bachler Robert

Robert Bachler

Principal, Consulting Actuary

Rob is a principal and consulting actuary with Health practice in the Seattle office of Milliman. He joined the firm in 2008.

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