Healthcare Services

United Actuarial Service, Inc. (UAS) has provided full-service actuarial consulting to multiemployer plans since 1951.  We specialize in providing services to multiemployer (Taft-Hartley) pension and health care plans, and are one of the few employee benefits consulting and actuarial firms that focuses exclusively on servicing this community. In fact, we established many of the multiemployer benefit plans operating today.

We currently service over 200 client funds across 30+ states.  As a testament to our commitment to delivering expert service at a fair price, our average client relationship has been maintained for over 10 years.

We are an original and long-time member of the International Foundation of Employee Benefit Plans and the Society of Professional Benefit Administrators.  Over the years, our employees have been active directors and committee members of these organizations.  We have also been speakers and authors for them on a wide range of employee benefit topics at educational seminars and programs they conduct around the country.  The UAS Research Department is recognized as one of the leading sources for analysis of new laws, regulations, and judicial developments from the perspective of multiemployer benefit plans.

Our comprehensive healthcare fund services include: 

General Consulting

We generally attend up to four Board of Trustees meeting per year in an actuarial and advisory capacity, including presenting both quarterly and annual funding analysis reports. Throughout the year, UAS is available to consult with the Trustees in reaching decisions on issues that arise in the course of operations or that flow from the annual report, compliance with ERISA and other federal legislation affecting the fund and/or its participants, and to answer questions about plan design, budgeting, funding, reserve requirements, communications, administration, national and industry trends and public policy.

Annual and Interim Reports

Our annual report analyzes claims experience, benefits paid, contributions, administrative expenses, gross and net costs of insured benefits, net cost of self-insured benefits, incurred but not reported (IBNR) calculations, extended eligibility liability calculations, and other relevant items that pertain to the Fund.  UAS also provides quarterly updates of the financial condition of the Fund, reflecting the most recent claims and expense experience on which to project future funding levels.

Reserve Calculations

UAS performs in depth analysis of the Plan’s individual reserves in order to monitor such key funding measures as Net Assets, Average Monthly Expenses, and current and projected Net Months of Assets and Net Cash Flow.

UAS consultants have also authored a recent article on published in the IFEBP’s “benefits” magazine, titled “Multiemployer Health Plan Funding Targets”, exploring the many variables that must be addressed to develop and maintain effective Plan funding management.

Real-Time Modeling

At each meeting we attend, UAS can utilize our Real-Time Model, which can provide live updates of the Plan’s financial standing and estimates future reserves and net months of assets.  Variables that can be changed in the model include but are not limited to:

• Benefit inflationary trend
• Total work hours next three years
• Asset return next three years
• Contribution rate changes
• Changes in benefit design

Vendor RFP Coordination

UAS can assist in coordinating Plan vendor RFPs (e.g., PPO, PBM, dental, vision, etc.), including analysis of any such proposals. Such RFP services can include RFP drafting, issuance, analysis, and issuance of related executive summaries.  As UAS supports a large number of similarly situated healthcare plans, we keep current with which vendors are performing better or worse than others and strive to leverage our market reach to the betterment of our Plan sponsors and participants, both financially and clinically.

Medicare-Related Support Services

UAS services cover a wide range of services related to a Fund’s Medicare-eligible (post-65) population, including annual Medicare Part D actuarial attestations, Employer Group Waiver Program (EGWP) support, and custom-designed group Medicare Advantage and Supplement arrangements.

FASB ASC 965 Post-Employment Benefit Valuations

UAS can prepare the Post-Employment Welfare Benefit Valuation in accordance with FASB ASC 965 valuation report (formerly called SOP 92-6 Report) signed by an actuary. Such report will include the expected and accumulated post-retirement benefit obligations to comply with FASB ASC 965, reconciliation of changes in benefit obligation, and a 28-year benefit payout projection of the retiree welfare benefit plan.

Compliance Support – ACA/CAA/MHPAEA

UAS supports our Plan Trustees and Professionals address the variety of evolving compliance landscapes applicable to multiemployer health and welfare benefit plans.  From the Affordable Care Act (ACA), the Mental Health Parity and Addictions Equity Act (MHPAEA), and the recently passed Consolidated Appropriations Act of 2021 (CAA 2021), the UAS team of consultants, actuaries, and ERISA attorneys help out clients navigate the latest updates in legislation, new laws, and emerging trends in plan benefit design.

The UAS Research Department is recognized as one of the leading sources for analysis of new laws, regulations, and judicial developments from the perspective of multiemployer benefit plans, and typically issues over 70 publications per year.  Please click here for more information about our Research Services.

Plan Design Studies

UAS is available to perform standard benefit studies involving changes to core plan design features like deductible, coinsurance, copayments, and out-of-pocket amounts.  We can also perform plan design analysis involving a variety of other plan components involving plan eligibility, plan vendors, and cost control programs.

UAS supports health and welfare fund cost management through two general strategies.

1. Proactive strategies, including but not limited to:
   • Wellness Programs
   • Employee Assistance Programs
   • Targeted Large Case Avoidance Programs
   • Maternity Care Programs
   • Working Spouse Programs
   • Plan Design:
     1. Risk management techniques – e.g. self-funded versus insured (stop loss) large claim management
     2. General benefit design – a.k.a. cost shifting/re-allocation

2. Concurrent & Reactive Strategies, including but not limited to:
   • PPO and PBM Analysis
   • Concurrent/Utilization Review
   • Disease Management
   • Large Case Management
   • Organ Transplant Case Management / Centers of Excellence
   • Independent Medical Reviews
   • Identification and analysis of high cost outliers – review cost control program’s effectiveness for such participants and seek opportunities to improve outcomes

UAS supports these programs through applicability analysis, Trustee education, vendor benchmarking, and vendor searches (when warranted).  In those cases where the Fund already has contracted with specific vendors for certain programs, we support such programs in up to four ways:

1. Assess—Review existing programs and determine if other cost control programs may add value.
2. Benchmark—Establish basis by which each program’s success will be measured
3. Monitor—Evaluate program success.  Review/adjust combination of carrots and sticks to incentivize appropriate program participation, as appropriate
4. Compare—Evaluate how this vendor’s program compares to its competitors

Ultimately, our cost management goal is to determine what is driving the expenses of the Fund, and work towards maintaining/updating a benefit design (including the ideal mix of integrated cost management programs) that best manages that risk and meets the Trustees’ funding objectives.