Rachel Marsiglio

FSA, MAAA

Senior Actuarial Manager

Chicago, IL, US

Tel +1 312 726 0677 | Fax +1 312 499 5685 | Direct +1 312 577 2887

Rachel Marsiglio is a senior actuarial manager with Milliman’s Chicago office. She joined the practice in 2012.

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Experience

Rachel has over 10 years of actuarial experience in the health space with a focus on Long-Term Care (LTC), pharmacy modeling, and Medicaid. In the LTC market, Rachel has assisted various clients with year-end, quarterly, and monthly valuations, as well as cash flow testing. She has experience managing rate increase requests and filings in multiple states and working with regulators with these requests. She is an experienced user of MG-ALFA, Milliman’s asset-liability modeling platform, and has used this platform for several LTC clients. Rachel has been involved in various pharmacy projects in the Medicaid space, including building a trend projection model to use with the practice’s Medicaid data, and developing a high-risk drug pool for members taking drugs over a certain threshold. In addition to her pharmacy work in the Medicaid market, Rachel has also been involved in the rate setting process for both capitation and dental for various clients. In addition to modeling the rates themselves, she analyzes encounter, eligibility, and financial data for completeness and accuracy, conducts ongoing communication with state agencies and plans to uncover data issues and formulate plans for new initiatives, and performs analyses on the data to assist in the rate development process.

Publications and Presentations

Co-Author, Anatomy of a Long-Term Care Rate Increase. Milliman Insight, January 2021.
Co-Author, Milliman’s Annual U.S. Industry LTCI Claims Projection. Milliman Insight, March 2025.

Professional Designations

Fellow, Society of Actuaries
Member, American Academy of Actuaries

Education

BA, Mathematics, Psychology, and Economics, Northwestern University

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Publications

Read their latest work

Article

Milliman’s 2nd annual U.S. industry LTCI claims projection

06 March 2026 - by Rachel Marsiglio, Juliet Spector, Robert Eaton

We forecast annual paid long-term care insurance claims to peak around $45 trillion in the early 2040s, up from around $20 billion in 2026, excluding new sales.

Article

Milliman’s annual U.S. industry LTCI claims projection

06 March 2025 - by Rachel Marsiglio, Juliet Spector, Robert Eaton

We expect long-term care insurance claims to peak in excess of $40 billion annually in the 2040s, excluding any new sales, according to our latest projections.

Article

Anatomy of a long-term care rate increase

26 January 2021 - by Evan Pollock, Rachel Marsiglio, Juliet Spector

This paper provides guidance for insurers on how to prepare clean, efficient rate increase filings and to help carriers work with regulators to incorporate the information they seek.

Rachel Marsiglio

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Experience

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Read their latest work

Milliman’s 2nd annual U.S. industry LTCI claims projection

Milliman’s annual U.S. industry LTCI claims projection

Anatomy of a long-term care rate increase

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Rachel Marsiglio

Experience

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