David Hayes

David works with Blue Cross and Blue Shield plans, HMOs, health insurance carriers, providers, and non-profit organizations.

His client activities include the following:

• Pricing and rate development for commercial, Medicare Supplement, and Medicare Advantage products
• Product development, rating, and underwriting for various lines of business
• Preparation and/or review of commercial regulatory rate filings for both ACA and non-ACA products - individual, small group and large group
• ROI analyses for healthcare intervention programs including strategies surrounding components of risk-sharing arrangements
• Estimation of actuarial liabilities/assets for financial reporting, including year-end annual statement support
• Financial forecasting and trend development for commercial and Medicare plans
• Healthcare cost analytics and actuarial cost model development for use in benchmarking or performance analysis
• Small group compliance
• Evaluation of blocks of business
• Provider contract and capitation analysis and development
• TRICARE rate development and change order processing