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 Expert  723061

Expert in Actuarial Science, Health Insurance, Managed Care, Agency Carrier Disputes


Available for your Consulting and Expert Witness Needs

Pennsylvania (PA)
USA
Education Work History Career AccomplishmentsPublicationsConsulting Services Expert Witness

Summary of Expertise:

Listed with other top experts in: 

32 Years experience as a health actuary, serving technical and leadership roles within the corporate and consulting environments.

Expertise:

Health insurance, disability income and long term care; Plan design, pricing and underwriting; GAAP and Statutory reserves, financial reporting and reinsurance; Mergers & acquisitions, for-profit conversions; Association group, Individual, and government agency consulting; Expert testimony.

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cost estimation

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econometric model

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forward pricing

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health care system

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insurance

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medical informatics

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self-insurance plan

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health insurance

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actuarial science

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actuarial health care

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managed care

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long term care

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medicaid abuse

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health care plan

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casualty underwriting

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facultative reinsurance

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finite reinsurance

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generally accepted accounting principles

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health care dispute


Show Secondary and Basic Areas of Expertise
Localities:
Expert may consult nationally and internationally, and is also local to the following cities: New York, New York;  Yonkers, New York;  Newark, New Jersey;  Jersey City, New Jersey;  Paterson, New Jersey;  Elizabeth, New Jersey;  Trenton, New Jersey;  Philadelphia, Pennsylvania;  Allentown, Pennsylvania;  and Stamford, Connecticut.

Education:
Year   Degree   Subject   Institution  
1976   FSA (fellow of the society of actuaries)   Actuarial Science   Society of Actuaries  
1972   MA   Mathematics   The Pennsylvania State University  
1971   BA   Mathematics   Elizabethtown College  

Work History:
Years   Employer   Department   Title   Responsibilities

2005 to 2005

 

Self

 


 

Independent Consulting Actuary

 

He is responsible for assisting health insurers, managed care entities, agencies, and others in pricing, reserving, evaluating benefits and agency compensation.

2003 to 2005

 

KPMG LLP

 

Health Actuarial

 

Director

 

He is responsible for assisting health insurers, managed care entities, agencies, and others in auditing, pricing, reserving, evaluating benefits and agency compensation.

1996 to 2003

 

Self

 


 

Independent Consulting Actuary

 

He is responsible for assisting health insurers, managed care entities, agencies, and others in pricing, reserving, evaluating benefits and agency compensation.

1993 to 1996

 

KPMG LLP

 

Health Actuarial

 

Partner, and National Director

 

He is responsible for assisting health insurers, managed care entities, agencies, and others in auditing, pricing, reserving, evaluating benefits and agency compensation.


Career Accomplishments:
Associations/Societies

Former national Chairman of the Society of Actuaries Health Care Section. Former chairman of NAIC Medicare Supplement Advisory Group.

Licenses/Certifications

MAAA (Member, American Academy of Actuaries)

Professional Appointments

Former Board Member for Union Fidelity Life Insurance Company, and Penn Treaty Life Insurance Company.


Publications:
Publications and Patents Summary

Frequent speaker at insurance conferences


Government Experience:
Years   Agency   Role   Description
1995 to 1995   PA Dept of Medical Assistance   Consulting Actuary   Review and testify as to the financial soundness and appropriateness of the states managed Medicaid program
2004 to 2004   Gov't of Cayman Islands   Consulting Actuary   Assist Dept of Health in structuring and implementing a national health care system.
1988 to 1992   NAIC   Consulting Actuary   Chaired and served as member of several insurance industry advisory groups on health insurance pricing and medicare

Consulting Services:
Selected Consulting Examples:
  • 2004: Comprehensive review of pricing and reserving processes for Wellpoint, Inc., one of the world's largest managed care organizations.
  • 2004: Audit review and signoff on over $1Billion of health insurance reserves for Kaiser Health Plans.
  • 2003, 2004 Audit review and signoff on over $1 Billion of health insurance reserves for Aetna Health plans.
  • 2002-3: Served as temporary Chief Actuary and head of Underwriting Division for Capital Blue Cross.
  • 2004: Supported Cayman Islands Health Minister in development of a comprehensive national health insurance program.
Click the green button above to contact Expert for a free initial screening call regarding your expert consulting needs.  Expert is available for consulting to corporate, legal and government clients.  Remember, your initial screening call to speak with Expert is free.

Expert Witness:
Expert Witness Experience Summary:
He provided support to attorneys on a class action disability income lawsuit brought in California.

He provided testimony in an arbitration between a health insurance agency and their carrier.

Recent Litigation Client Requests:
  • Health insurance expert for litigation consulting regarding cancer coverage dispute.
  • Expert actuarial long term health insurance for consulting on opinons and witness.
Click the green button above to contact Expert for a free initial screening call regarding expert testimony, litigation consulting and support, forensic services, or any related expert witness services.  A few litigation needs include product liability, personal injury, economic loss, intellectual property (patent, trademark, trade secret, copyright), and insurance matters.  Remember, your initial screening call to speak with Expert is free.

 

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