actuarial analysis

ActNova Consulting provides actuarial solutions and data analytics for insurance companies, including loss reserves analysis, pricing strategy, risk management, and data-driven insights for sustainable growth. Located in San Antonio, Texas.

Data Analyticsloss reserves analysispricing strategyrisk management

Axene Health Partners, LLC (AHP) was established in 2003 to provide high value/high quality health consulting services in the healthcare space. It describes itself as healthcare-focused actuaries and consultants providing data-driven insights, clinical expertise and strategic guidance to transform healthcare operations and improve patient outcomes. It serves health plans, hospitals and health systems, government agencies, and providers.

Employee Benefits Consultingfinancial advisoryhealthcare analyticsIBNR consultingIT developmentmodelingprice transparencyvalue based contracting

Continuing Care Actuaries has over 100 combined years of national experience in consulting to the Life Plan Community (CCRC) industry. Its actuaries are credentialed by the Society of Actuaries and the American Academy of Actuaries. CCA has performed actuarial analyses for over 450 CCRCs and At Home Programs and possesses one of the largest databases of CCRC residents with over 800,000 life years of residential and health care data.

audit supportcontract pricing analysisexpert witnessfinancial and facility planningfinancial underwritingpopulation and financial modelingsoftware development

Clear Blue Insurance Group is a US fronting carrier specializing in Program Business, rated A- (Excellent) by AM Best with a Financial Size Category of IX. The Group includes Clear Blue Insurance Company (CBIC), Clear Blue Specialty Insurance Company (CBSIC), Rock Ridge Insurance Company (RRIC), and Highlander Specialty Insurance Company (HSIC), all domiciled in Texas and writing nationwide. Its US-domiciled property and casualty companies hold national authority to write Programs across all classes of business.

analytics and reportingclaims handlingfronting carrierportfolio managementprogram managementreinsurance negotiationunderwriting

Examination Resources, LLC (ER) is a woman-owned small business providing insurance regulatory consulting services exclusively to regulators since 2002. ER conducts financial examinations, market conduct reviews, actuarial and financial analysis, health consulting, IT and cybersecurity assessments, MLR and PBM compliance, and receivership support for state and federal insurance regulators.

Cybersecurity assessmentsdata analysisfinancial analysisFinancial Examinationsform reviewIT consultingmarket conduct examinationsMHPAEA auditsMLR ExaminationsPBM examinationsreceivership supportregulatory training

Highlight Health is an independent reviewer of large healthcare claims for self-funded health plans and the people who fund them. It performs pre-payment review of high-dollar medical claims, producing a Documented Record of what the price should be and why. The work draws on claims specialists, certified coders, clinicians, actuaries, and attorneys. Founded 2020 and based in Philadelphia, it takes no fees from the providers, networks, PBMs, or carriers it reviews.

claims reviewcoding verificationlegal reviewpre-payment claim reviewpricing verification