Expert Details
Actuarial Science, Health Insurance, Managed Care, Agency Carrier Disputes
ID: 723061
Pennsylvania, USA
Expertise:
Health insurance, disability income and long term care;
Plan design, pricing and underwriting;
GAAP and Statutory reserves, financial reporting and reinsurance;
Mergers & acquisitions, for-profit conversions;
Association group, Individual, and government agency consulting;
Expert testimony.
Array
2004: Comprehensive review of pricing and reserving processes for Wellpoint, Inc., one of the world's largest managed care organizations.2004: Audit review and signoff on over $1Billion of health insurance reserves for Kaiser Health Plans.2003, 2004 Audit review and signoff on over $1 Billion of health insurance reserves for Aetna Health plans.2002-3: Served as temporary Chief Actuary and head of Underwriting Division for Capital Blue Cross.2004: Supported Cayman Islands Health Minister in development of a comprehensive national health insurance program.
Education
| Year | Degree | Subject | Institution |
|---|---|---|---|
| Year: 1976 | Degree: FSA (fellow of the society of actuaries) | Subject: Actuarial Science | Institution: Society of Actuaries |
| Year: 1972 | Degree: MA | Subject: Mathematics | Institution: The Pennsylvania State University |
| Year: 1971 | Degree: BA | Subject: Mathematics | Institution: Elizabethtown College |
Work History
| Years | Employer | Title | Department |
|---|---|---|---|
| Years: 2005 to 2005 | Employer: Self | Title: Independent Consulting Actuary | Department: |
Responsibilities:He is responsible for assisting health insurers, managed care entities, agencies, and others in pricing, reserving, evaluating benefits and agency compensation. |
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| Years | Employer | Title | Department |
| Years: 2003 to 2005 | Employer: KPMG LLP | Title: Director | Department: Health Actuarial |
Responsibilities:He is responsible for assisting health insurers, managed care entities, agencies, and others in auditing, pricing, reserving, evaluating benefits and agency compensation. |
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| Years | Employer | Title | Department |
| Years: 1996 to 2003 | Employer: Self | Title: Independent Consulting Actuary | Department: |
Responsibilities:He is responsible for assisting health insurers, managed care entities, agencies, and others in pricing, reserving, evaluating benefits and agency compensation. |
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| Years | Employer | Title | Department |
| Years: 1993 to 1996 | Employer: KPMG LLP | Title: Partner, and National Director | Department: Health Actuarial |
Responsibilities:He is responsible for assisting health insurers, managed care entities, agencies, and others in auditing, pricing, reserving, evaluating benefits and agency compensation. |
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Government Experience
| Years | Agency | Role | Description |
|---|---|---|---|
| Years: 1995 to 1995 | Agency: PA Dept of Medical Assistance | Role: Consulting Actuary | Description: Review and testify as to the financial soundness and appropriateness of the states managed Medicaid program |
| Years: 2004 to 2004 | Agency: Gov't of Cayman Islands | Role: Consulting Actuary | Description: Assist Dept of Health in structuring and implementing a national health care system. |
| Years: 1988 to 1992 | Agency: NAIC | Role: Consulting Actuary | Description: Chaired and served as member of several insurance industry advisory groups on health insurance pricing and medicare |
Career Accomplishments
| Associations / Societies |
|---|
| Former national Chairman of the Society of Actuaries Health Care Section. Former chairman of NAIC Medicare Supplement Advisory Group. |
| Licenses / Certifications |
|---|
| MAAA (Member, American Academy of Actuaries) |
| Professional Appointments |
|---|
| Former Board Member for Union Fidelity Life Insurance Company, and Penn Treaty Life Insurance Company. |
| Publications and Patents Summary |
|---|
| Frequent speaker at insurance conferences |
Fields of Expertise
cost estimation, econometric model, forward pricing, health care system, insurance, medical informatics, self-insurance plan, health insurance, actuarial science, actuarial health care, managed care, long term care, medicaid abuse, health care plan, casualty underwriting, facultative reinsurance, finite reinsurance, generally accepted accounting principles, health care dispute, blue cross, disability income, insurance agency, insurance underwriting, insurance industry