Qualified Health Insurance Actuary

The City County Insurance Services (CIS) is seeking a qualified actuary to provide actuarial services for its self-funded medical, dental, vision, and pharmacy plans. The selected firm will be responsible for determining reserve adequacy, developing and setting rates for CIS' health plans, and providing consultation on various actuarial matters. The contract is expected to commence on June 1, 2025, and the selected firm will be required to provide services for a period of one year. Some key responsibilities include: • Determining reserve adequacy under OAR 836-011-0250 to 836-011-0260 for CIS' self-funded medical, dental, vision, and pharmacy plans. • Assisting CIS with developing and setting rates for CIS' health plans to ensure financial stability and competitiveness in the marketplace. • Providing an Incurred but not Reported (IBNR) calculation for all self-funded plans. • Developing and assisting in the annual calculation of rates for CIS health plans across multiple product offerings. • Reviewing prospective new groups for employers with less than 100 eligible employees and calculating rates, applying appropriate experience mods, for groups with 100 or more eligible employees. Some key requirements for the selected firm include: • Meeting minimum standards as set forth in OAR 836-011-0255 as a "qualified actuary" for health insurance. • Having experience in providing actuarial services to estimate incurred claim liabilities and reserve adequacy testing related to self-funded health plans. • Having experience in providing rate setting services to pools similar to CIS. The proposal should include information about the firm's approach and philosophy to setting rates for insurance pools, as well as its experience and qualifications for providing the required actuarial and consultative services to CIS. • Furnish background information about the firm, including date of founding, legal form, number and location of offices, principal lines of business, number of employees, days/hours of operation, and other pertinent data. • Describe the firm's approach and philosophy to setting rates for insurance pools and how it will accurately project rates 13 months in advance. • Provide at least two case studies of providing actuarial services to estimate incurred claim liabilities and reserve adequacy testing related to self-funded health plans. • Provide at least two case studies of providing rate setting services to pools similar to CIS.