Process Group
Financial Operations Management
Objective
Optimize premiums to reflect realistic economic conditions while minimizing medical loss ratio.
Input
Actuarial projections (i.e. health spending projections
Claims history
Benefit plan
Output
Premium rate schedule (premiums for each benefit plan
Update premium collection amount
Measurable Outcomes
Premium rates schedule for each benefits class
Sum of premiums sufficient to meet the cost for medical claims and reserve funds for the year