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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. More recently, he has assisted clients with the development of HAS-qualified insurance programs. Clients also seek his expertise regarding voluntary worksite insurance programs.
Jim assists a variety of clients with pricing and plan design, marketing and administrative management, financial reporting, and strategic planning and acquisitions. He provides advice on managed care and cost management aspects of healthcare for his clients. Jim has participated in provider negotiations and contracting related to the establishment of preferred provider networks. He also has considerable experience with profitability and experience analyses, state insurance department filings, and various product compliance issues.
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. He is also frequently retained by insurance carriers to provide similar services.
Prior to joining Milliman, Jim worked for nine years for a major individual health insurance carrier, primarily in pricing, financial reporting, and strategic planning areas.
Affiliations
Past board member, Health Section of Society of Actuaries, (2001-2003)
Member, Health Practice Financial Reporting Committee of American Academy of Actuaries
Chairperson, Health Practice Notes Subcommittee of the American Academy of Actuaries
Presentations and publications
Small Group Rate Filings and Rate Certifications, Chapter 21 of Group Insurance, ACTEX Publishing, 2003
Underwriting Small Groups, Chapter 23 of Group Insurance, ACTEX Publishing, 2003
The Actuary and Health Insurance Mergers and Acquisitions, SOA Health Section Newsletter, April 2001
Marketing Strategies for HSAs: More Coverage for Less Cost, Health Insurance Underwriter, July 2004
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 | 