Rate Review and Rate Setting

ARC’s team of actuaries has developed and reviewed premium rates in a variety of contexts. Since the introduction of the Medicare Advantage (MA) and Prescription Drug (PD) Programs, ARC has assisted the CMS Office of the Actuary in the design, review, and auditing of Medicare Advantage bids. In addition to its expertise with Medicare Managed Care plans, ARC has also assisted CMS with the review of Medicaid capitation rates submitted by states participating in the Financial Alignment Initiative, overseen by the Medicare-Medicaid Coordination Office (MMCO). ARC has also assisted numerous states developing Medicaid managed care waiver programs by developing techniques for setting target capitation rates for prepayment arrangements.

In the realm of long-term care insurance, ARC has been contracted by the Federal Office of Personnel Management (OPM) to review proposed premiums offered for the Federal Long-Term Care Insurance Program.