About Us...

Walter C. Marsh, FSA, MAAA

Actuarial Consulting, Health & Life

Fellow of the American Society of Actuaries Walter C. Marsh uses sophisticated technical tools, extensive practical experience, and people skills required to navigate the business, actuarial and underwriting needs of his clients.

Head of a Consulting Firm that has 'Done it All'

From completing Medicare Bids for 2006 and 2007 to developing a stop loss manual
From pricing universal life to valuing a block of employer stop loss for acquisition
From developing a pre-need funeral program for a group of funeral directors to pricing a provider excess loss program
From developing the mechanics for pricing, maintaining and evaluating a flexible premium annuity program to pricing a non-cancelable group long term disability program
From developing (from inception) a small group dental program to being the marketing and pricing actuary for a large debit insurance operation
From developing and implementing a managed care group pricing and underwriting system for a group of TPAs to developing a Medicare Advantage HMO from its inception
From managing a large block of HMO reinsurance to developing claim reserving techniques for health insurance

Summary of Qualifications

30 years of demonstrated ability and progressive ability in:

Formulating sophisticated analytical tools
Enhancing revenue earnings and growth
Deriving creative managed health care solutions
Creating effective business turnaround scenarios
Managing through the empowerment of people
Conceptualizing entrepreneurial start-ups
Improving strategic planning
Developing creative solutions to complex problems

Client Profile

Walter C. Marsh, FSA, MAAA is proud to serve a variety of clientele in the insurance industry:

Insurers (those assuming risk in the Excess Loss Market or acting as Fronting Carriers)
Managing General Underwriters
Reinsurance Companies
Employers (Commercial & Government) and Associations
Third Party Administrators
Health Insurance Companies
Commercial
Blue Cross Blue Shield Carriers
Managed Care Organizations
Health Maintenance Organizations
Provider Hospital Organizations
Preferred Provider Organizations
Health Care Providers
Hospitals
Physician Groups
Pharmacy Benefit Managers
Regulatory Authorities
Employee Benefit Consultants

What can Walter C. Marsh, FSA, MAAA do for you?

In his practice, Walter Marsh combines an impeccable work ethic, years of comprehensive experience, and a passion for developing solutions to address all of his clients’ actuarial and business needs…and with a much more competitive fee structure than larger firms.

Clients enlisting the services of Walter Marsh know they are getting a leader in the industry to personally address their needs, one who is focused completely on the client, and the client’s specific needs.

Walter Marsh carefully analyzes the needs of his clients, and works together with them to form an organized, succinct plan which helps his clients:

Maximize profits
Achieve goals for growth
Comply with regulatory requirements
Measure financial performance
Manage risk capital
Bring innovative products to market
Manage the due diligence process for mergers & acquisitions

Professional Associations

Society of Actuaries, Fellow
American Society of Actuaries
Group Large Claim Committee, Member
Examination Committee, Past Member

James MacDougall, FSA, MAAA
James MacDougall is Officer & Vice President of Actuarial Consulting Services for the Lexington, Kentucky office of Marsh Actuarial Consulting.

He has lead successful actuarial departments and turnaround operations as Chief Actuary for Health Maintenance Organizations. His areas of expertise include developing sound rating structures, filing rates with Departments of Insurance, re-inventing the underwriting process and strategies, and negotiating appropriate group contracts. Included in developing sound rating structures are ground up rating principles from appropriate reserving methodologies, complete administrative cost structure analysis to a complete evaluation of provider reimbursement methodologies and unit costs. With a solid basis in Financial and Statistical techniques, he wrote the ground breaking research paper “Provider Reimbursement Methodologies” for the Society of Actuaries professional development program.

With over 18 years of experience, James brings a thorough understanding of the managed care industry and a deep technical knowledge of its workings from pricing, reserving, provider contracting and underwriting.

James holds a Bachelor’s degree in Mathematics from the University of Texas in Austin. He also is a Fellow of the Society of Actuaries (the Society’s highest designation) and he is a member of the American Academy of Actuaries.

Strengths:

Managed Care pricing
Provider contracting analysis
Establishing appropriate reserves
Filing rates
Providing Actuarial Opinions
Testifying in Rate Hearings
Establishing Actuarial & Underwriting Best Practices

Sample projects:

Project manager of a team of provider relations, medical management, and executives to evaluate referral patterns and reimbursement levels for various health care providers and determined appropriate action to leverage network.
Performed a study of the impact of proposed Medicaid benefit and rate changes for an integrated delivery system (hospitals, physicians and insurer). The end product included a comprehensive report outlining various strategies to meet profit, customer satisfaction and growth objectives.
Negotiated a contracting dispute settlement with a major hospital.
Evaluated various underwriting and rating systems for a Small Group block of business.
Helped a major employer (>17,000 employees) determine the best benefits, pricing and funding for their employee welfare program.