Actuarial Services

VCG Consultants’ Actuarial Services Team offers advanced modeling and risk management capabilities for our clients. Supporting both Self-Funded and Fully-Insured benefit plans, our Actuarial Services Team will help you:

  1. Uncover the financial consequences behind strategic initiatives
  2. Simulate benefit plan alternatives
  3. Perform advanced analytical evaluations

Below are a few highlights of our Actuarial Services Team’s most popular solutions.

Self-Funded Solutions

  • Plan Design Modeling and Pricing – calculate and compare the actuarial value and budget impact of various plan design changes
  • Contribution Modeling and Migration Analysis – compare the impact of various employee/employer contribution scenarios on your client’s budget considering the potential for migration between plans and coverage tiers based on cost and plan design differentials
  • Client-Specific Trend Rate – develop trend rates specific to the client based on past claims experience, plan design and demographics
  • Budget Rates – develop benefit plan PEPM budget rates utilizing past claims experience, anticipated plan changes and validated client-specific trend data
  • IBNR Claims Liability – project a plan’s Incurred but Not Reported claims liability to ensure adequate claims reserves
  • CMS Creditable Coverage Determination – determine whether prescription drug plan coverage is deemed creditable for required annual notice to Medicare eligible plan participants and CMS
  • Stop Loss Attachment Levels and Reimbursement Terms – evaluate the optimal stop loss attachment point and reimbursement terms based on claims experience, stop loss fees, reimbursements and your client’s risk tolerance
  • Benchmarking (beyond the Mercer report) – recommend strategic plan design changes by comparing your client’s claims data to industry specific benchmarks, from the broadest level down to specific diagnosis categories
  • Nondiscrimination Testing – preform testing for IRC Code Sections 125, 79, 105(h) and, if necessary, provide recommendations for changes to pass tests

Fully-Insured Solutions

  • Self-Funded Feasibility Analysis – assess if migrating to a self-funded plan is an appropriate strategy for your client by evaluating the difference in costs, volatility and stop-loss levels, and risk tolerance
  • Carrier Renewal Analysis and Validation – leverage plan experience data to validate and/or negotiate carrier quotes and renewals
  • Contribution Modeling and Migration Analysis – compare the impact of various employee/employer contribution scenarios on your budget while considering the potential for migration between plans and tiers based on cost differentials and plan design differences

Contact Brian Simon on the VCG Actuarial Services Team to learn more about how VCG can help support your actuarial needs.