Scott A. Weltz
FSA, MAAA
Principal and Consulting Actuary
Brookfield, WI, US
Scott Weltz is a principal and consulting actuary with the Milwaukee office of Milliman. He joined the firm in 2008.
Experience
Scott provides financial and strategic risk management support to the insurance and healthcare industries. He assists various entities, including government programs, health plans, employers, insurance companies, and administrators. He has helped clients with product development and pricing, risk adjustment optimization, experience analysis, valuation of reserves, financial reporting, and appraisals for mergers and acquisitions.
Examples of Scott’s expertise include the following:
ACA Individual and Small Group Issuers
Scott is an expert on commercial market issues related to the Patient Protection and Affordable Care Act (ACA). His recent work includes:
- Identified ACA market strategic opportunities based on competitive intelligence consolidated from various public use files, statutory filings, and Milliman’s proprietary analytic engines.
- Helped an ACA issuer predict its competitor rate increases three years in a row.
- Helped ACA issuers identify members with the most potential for increases in risk adjustment transfer receipts.
- Worked with Milliman’s prescription drug experts to optimize ACA issuer formularies while testing for discriminatory features.
- Assisted health plans in multiple states with ACA individual and small group pricing and filing. Clients included provider-owned plans, Medicaid MCOs entering ACA individual market, traditional insurers, and start-ups.
Innovation
- Scott spearheaded the development of Milliman’s IMPROVE medical coding optimization tool for ACA issuers and Medicare Advantage organizations. It is one of the few products in this niche that "looks both ways" so plans can identify both under-coding and over-coding, as required by regulation.
- Scott helped launch Milliman’s EDGEAssist product to assist ACA issuers with EDGE server submissions with a focus on high-quality EDGE data that maximizes revenue.
- Scott is also a core member of the ideation team that identifies new product development opportunities for his practice.
Commercial Health Plans and Insurers
- Assisted several health plans with their rate renewals, including plan design changes to maintain competitive premiums while meeting minimum capital surplus requirements.
- Assisted numerous health plans with their annual statements of actuarial opinion regarding their statutory liabilities.
- Assisted health plans with large group product launches, including competitive analysis, sales projections, rating manual development, and state filing.
Employee Benefits
- Reviewed and developed a strategy for an employer to manage its employee health plan costs while still offering meaningful benefits under the challenges of the ACA.
- Worked with a business foundation on a report quantifying a region’s healthcare costs versus regional and national benchmarks.
- Assisted union and employer trustees of a Taft-Hartley multi-employer health and welfare fund with net asset projections, contribution rate setting, plan design changes, and vendor selection during collective bargaining negotiations.
Professional Designations
- Fellow, Society of Actuaries
- Member, American Academy of Actuaries
Education
- BBA, Actuarial Science, Risk Management and Insurance, University of Wisconsin
Publications
Read their latest work
Article
2021 Milliman Medical Index
27 May 2021 - by Paul R. Houchens, David M. Liner, Annie Man, Andrew L. Naugle, Doug Norris, Scott A. Weltz
Our 2021 healthcare trends report predicts that healthcare spending will grow by 8.4% to $28,256 for a family of four.
Article
2020 Milliman Medical Index
21 May 2020 - by Christopher S. Girod, Paul R. Houchens, David M. Liner, Andrew L. Naugle, Doug Norris, Scott A. Weltz
In 2020, the cost of healthcare for a hypothetical American family of four covered by an average employer-sponsored preferred provider organization plan is $28,653, according to the Milliman Medical Index.
Article
2019 Milliman Medical Index
25 July 2019 - by Christopher S. Girod, Susan K. Hart, David M. Liner, Thomas D. Snook, Scott A. Weltz
In 2019, the cost of healthcare for a hypothetical American family of four covered by an average
employer-sponsored preferred provider organization (PPO) plan is $28,386.
Article
Health and Group Benefits News and Developments, July 2018
26 July 2018 - by Jennifer M. Fleck, Christopher S. Girod, Susan K. Hart, Sean Silva, Scott A. Weltz
Health and group benefits news and developments in the United States.
Article
2018 Milliman Medical Index
21 May 2018 - by Christopher S. Girod, Susan K. Hart, Scott A. Weltz
Healthcare costs for the typical American family of four rose to over $28,000 in 2018.
Article
2017 Milliman Medical Index
16 May 2017 - by Christopher S. Girod, Susan K. Hart, Scott A. Weltz
In 2017, the cost of healthcare for a typical American family of four covered by an average employer-sponsored preferred provider organization plan is $26,944, according to the Milliman Medical Index.
Article
Repeal, replace, or reform: Key policy discussions affecting the individual health insurance market
18 January 2017 - by Frederick (Fritz) Busch, Nicholas Krienke, Scott A. Weltz
How will the Patient Protection and Affordable Care Act (ACA) be affected by the incoming Trump administration?
Article
2016 Milliman Medical Index
24 May 2016 - by Christopher S. Girod, Susan K. Hart, Scott A. Weltz
Healthcare costs for the typical American family of four rose to over $25,000 in 2016 according to the Milliman Medical Index.
Article
Cost-sharing reduction subsidies: Requesting adjustments to the advance payment formula to reduce cash flow strain
22 December 2015 - by Esther M. Blount, Frederick (Fritz) Busch, Scott A. Weltz
The cost-sharing reduction (CSR) program is contributing to financial strain for many insurers participating in the individual health insurance marketplace.