Healthcare Costs Spiraling Out of Control?
FALL RIVER’S ACTUARIAL SERVICES HELP BREAK THE CYCLE

We get it. Your bottom line needs to improve and you need a trusted advisor to guide you beyond the typical broker’s role.

So, what qualifies us to advise you?

Our CEO spent nearly two decades making hundreds of millions of dollars for insurance companies by running or consulting to their actuarial and underwriting departments. Our team is made up of actuaries and senior consultants, each with many years of experience in the benefits industry. We believe we’re the best in the business at digging through your data to find exactly what’s causing your claims to spike and developing a powerful, long-term strategy to fix it.

We assist our clients in the following areas:

Healthcare Strategy

• Data Mining to identify root causes of rising healthcare claims
• Healthcare Strategy Overhaul and Implementation, including negotiation with executive teams and unions
• Vendor Management
  • Manage RFP/bid process, design scoring tools, conduct finalist meetings
  • ASO and stop loss and/or fully insured contract negotiation
  • Performance and discount guarantee monitoring
  • Audits of medical and pharmacy claims and dependent eligibility
  • Pharmacy carve-outs and PBM contract optimization
• International Benefits Assessment and Gap Analysis

Actuarial Analysis

• COBRA rate calculation including client-specific trend analysis
• Development of funding rate structures including internal rate structures allowing different contributions by division
• Incurred But Not Reported (IBNR) reserve certification
• FAS 106 and GASB 43/45 Valuations

Claims Experience Analysis

• Detailed analysis identifying core cost drivers
• Monthly or quarterly custom reporting packages, including benchmarking claims opposite actuarial and industry norms
• Key issue alerts, addressed with mid-year course corrections in communication, education and incentives

Start with a complimentary actuarial assessment with our lead actuary and CEO, Kristen Russell. If we both agree there’s a need we can address, we’ll provide you with a single, all-inclusive rate to fix the problem. It’s that simple.

Who said actuaries had to be complicated?