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Primary Deliverables… Model Rating Strategies •Experience Rating •Manual Rating Compare Enterprise Level Results •Actual vs. Expected


Features Monitor Rating Strategy and impacts to the distribution of Rate Increases and Loss Ratio by:

•Health Plan •Business Segment •Group •Plan


Features Test the implications of rating variables across multiple years and apply different methodologies by user defined Group Size‌


Features Manage variations in plans from group to group with

Claims

process‌

Normalization

and

Adjustment


Features Examine and balance Pooling Charges and Pooling Credits‌

Large Claims

Total Claims

Dollar To Dollar

Excess Claims

Trend Indexing

Pooling Credit and Charges


Features Apply Trends by:

•Year •Plan •Medical and Rx


Rating Process 10 Stage Actuarial Rating Engine • Rating data is processed modularly in 10 steps. This provides for: • Simplification of rating method; greatly reducing the time and effort needed to update or change components within the rating process. • Greater flexibility in adapting to new business needs. • Easy auditing of rating data. • Rapid recalculation of rates after manipulation of rating variables.


Rating Process Rating Process Stages

Rating process Data extraction flow


Rating Process Controls Set ranges for group Pooling Class… Set Pooling Point by Class…

Set Pooling Method by Class…


Rating Process Controls

Manage size classification, Plans, and Trend‌


Rating Process Controls Set the experience period and contract duration‌

Adjust credibility‌


Rating Process Controls Create customizable Large Claim Reports‌

Apothegm Perspective Rating System  

Apothegm’s Perspective Rating System™ is our flagship health plan pricing suite. Use our Retrospective Renewal Management Tool™ experience...

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