Health Cost Guidelines - Reinsurance

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Anticipate future claim levels, evaluate past experience, and establish relationships between health coverage levels using the Milliman Health Cost Guidelines—Reinsurance. These guidelines contain rating structures for reinsurance used with fee-for-service or managed care plans provided to commercial or Medicare enrollees.

Use the Reinsurance Cost Guidelines to:

  • Price commercial and Medicare-based products using included worksheets.
  • Account for geographic area factors that vary by deductible level.
  • Deal with the effects of trend leveraging associated with high deductibles using included adjustment factors.

The Reinsurance Cost Guidelines provide:

  • Guidance on the impact of hospital efficiency adjustments, accounting for differences in geographic area, per diem maximums, discounts from billed charges, and overall management of the delivery system.
  • High-cost service adjustments, including transplants, neonatal services, and AIDS treatment.

The Reinsurance Cost Guidelines feature:

  • Benefit Descriptions
  • Commercial Rating
  • Medicare Rating
  • Basic Tables
  • Area Factors
  • Other Factors
  • Claim Probability Distributions

Download the brochure »

The products we sell are the tools we use

As the premier health management consulting firm, the Health Cost Guidelines are used daily by our own in-house actuarial consultants for insight into the key drivers of healthcare costs and utilization.

The Health Cost Guidelines Suite includes the following products:

Contact your Milliman consultant or the Health Cost Guidelines Manager at if you are interested in licensing any of these products.

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