J. Patrick Kinney, Chairperson Donna Kalin, Vice-Chairperson Andrea Bykerk Christopherson, Secretary/Treasurer HEALTH SECTION HEALTH SECTION COUNCIL Kara Clark Eric Goetsch Thomas Handley Nancy Hubler Olga Jacobs Valerie Nelson Dewayne Ullsperger Gregor Vigen Karl Volkmar INSTRUCTIONS Please vote for up to four candidates. Ballots with five or more votes are invalid and will not be counted. The top four candidates will receive three year terms. Only names of persons who have indicated they would serve, if elected, are listed on the ballot. The following applies to each section. Biographical information and answers to the question are as provided by the candidates. Biographies are limited to identification of employment, major fields of professional activity, service in the Society of Actuaries, and other relevant experience. Candidate names are listed on the ballot in the order in which biographies were received.
John W.C. Stark, FSA, MAAA, CERA Retired Richmond, VA For the bulk of my career, I worked in health insurance. My experience covered a variety of areas including pricing, forecasting, reserving, and valuing medical management initiatives. In addition, I served as the appointed actuary for four Virginia entities. Early in my career, I worked in life insurance where I was involved in pricing and reserving. SOA Head of the original health risk management committee; served on exam committees and project oversight groups; facilitator at FAC; initiated and lead the Behavioral Finance subgroup of the Health Section AAA Professionalism Committee; Committee on State Health Issues; worked on committees that wrote or revised health standards of practice (most recently the new ERM ASOPs). At this time, I believe that health actuaries need to expand their view of the industry they serve and the skills they use in their practice. I feel that I can provide some guidance for our members. James Whisler, FSA, MAAA Principal Health Actuarial Practice Leader Deloitte Consulting Minneapolis, MN For the past 20 years I ve been a health care consultant. In this role, I ve worked with health plans, providers, state and federal government, life sciences companies and employers. I ve been focused on helping them to understand the health care data, manage risk, improve care (cost and quality) and design products and provider reimbursement mechanisms that encourage improvement. For the past seven years, I ve led our health actuarial practice of about 100 actuaries. The projects I lead sometimes include clinical, operational and strategic experts as well as actuaries. I have not been a frequent volunteer for SOA activities. I have participated in sessions as a speaker. I participate in the value based care workgroup and the bundled payment subgroup. I have served as a reviewer for SOA sponsored research. Various roles with volunteer organizations such as the United Way. The only titled role I have is Treasurer for our local Historical Society. I want to contribute to assuring our profession plays a significant role in fixing the issues with our health care system. In this role I can contribute to education that guides health actuaries towards skills and roles that are highly valued by the industry.
This role is particularly important right now. Due to the unsustainable increases in cost, among other issues, something needed to change in our health care system. Health care reform was passed to address many of these issues. Whether or not you agree with the form of health care reform it will be disruptive enough to force us to confront systemic issues. As is frequently the case when significant change occurs, there are significantly increased risks. This, of course, is a core competency for actuaries. Actuaries can, and should be key assessors, analyzers and enablers of change in the health care system. Troy W. Holm, FSA, MAAA Actuary, Humana, Inc. Louisville, KY My extensive actuarial experience includes five years in casualty and 12 years in health care, serving a variety of organizations (a consulting firm and three health insurance corporations) in mostly traditional roles. My background includes reserving, health care provider contracting and networks, pricing and trend analytics. Most currently, with Humana, Inc., my responsibilities have allowed me to experience a more non-traditional role that includes; trend analytics, wellness outcomes & ROIs, and benchmarking studies. As a volunteer I serve as a commissioner for my local Parks and Recreation department and I also have held an officer position at my local church. My involvement in the Society of Actuaries started when I first received my ASA in 2006 as a member of the Younger Actuaries Network sponsored by the Actuary of the Future Section. I served on the staff for two years and began the early stages of the mentoring program. I have also attended at least one Spring or Annual meeting per year since to further my growth and knowledge in the health care industry issues and leadership. Active in Humana s Managing/Hiring talented actuarial candidates Active in Humana s Annual Actuarial Sub-Committee team that finds professional speakers, develops breakout sessions for groups, and networking and other activities) As a volunteer I serve as a commissioner for my local Parks and Recreation Department and I also have held an officer position at my local church. I have been told that I am not your typical actuary. I have very good social skills and lots of positive energy. I would like to use my social skills to add values to the actuarial community and offer my energy towards leadership to the Health Section Council and their diverse initiatives, especially the ones that stretch beyond the traditional health care actuarial role. Thank you for your consideration.
Syed Muzayan Mehmud, ASA, FCA, MAAA Director and Senior Consulting Actuary Wakely Consulting Group Englewood, CO I have worked as a healthcare consulting actuary for about 10 years, first at Milliman and currently with Wakely Consulting Group. I have been involved in a variety of healthcare projects, from reserving and pricing to applying ideas from machine learning to predictive modeling applications. One particular predictive modeling application, healthcare risk adjustment, has been a constant theme through my career. I have advised health plans, healthcare providers, state and federal agencies in healthcare matters. I have been an active member of the Health Section since 2009. I helped organize and present the 2012 SOA 3Rs and Predictive Modeling Boot Camp, a sold-out event that, for the first time, included substantial hands-on training of predictive modeling tools and techniques for attendees. I have enjoyed the privilege of being a speaker at several SOA health and annual meetings, including the predictive modeling symposia. I recently represented the Society of Actuaries at a meeting of the National Quality Forum. I have contributed to SOA publications such as Health Watch as well as to textbooks on the SOA syllabus (Group Insurance). I have had the privilege of contributing to several Society of Actuaries research efforts. The Health Section provides a tremendous value to healthcare actuaries, and I wish to contribute to that strong tradition. A focal point of my efforts will be the delivery of timely and important information to members. The Health Section serves this goal by recruiting talented speakers and writers, sharing relevant expertise through webinars, and carefully reviewing member feedback. I have the energy and enthusiasm to support these efforts. Furthermore, the section has an important thought leadership role, and I look forward to volunteering my time and expertise towards helping current and future members of the Health Section. Lastly, I believe that health actuaries need to continually work on their toolkit in order to provide greater value to their organizations. Advances in analytics and data are allowing for important questions to be asked that were deemed impossible to answer before, and I believe that actuaries have an important role to play in replacing appearances with facts in this rapidly changing landscape. It is also for this reason that I feel compelled to seek your vote in order to support the dissemination and promotion of important ideas through my leadership in the Health Section.
Tove Stigum, FSA, MAAA Government Programs CFO, Excellus Health Plan Rochester, NY I started my health actuarial career at a small not-for-profit insurer. It was a great learning ground, giving me the opportunity to work on lots of different types of actuarial areas from reserving to pricing to provider contracting, HMO budget creation and reconciliation to trend work. From there I moved to a large national forprofit carrier as a pricing actuary heading up first a state and eventually a multi-state region. Today I work for a not-for-profit Blues plan in upstate NY as the Government Programs CFO. Making the switch from a commercial role to handling Medicare and Medicaid business has been an incredible education in managing highly regulated books of business, as well as a great opportunity to learn about risk adjustment mechanisms. My past commercial experience combined with my current government programs experience should serve me well in supporting the Health Section council navigate the changing regulatory landscape of health care reform. Health Section member Management and Personal Development Section member Exam committee volunteer (Exam 8 and CSP) Youth ski coaching. I started my actuarial career over 18 years ago, working for a life insurance company. The only thing I knew with great certainty at the start of my actuarial career was that I d never ever be a health actuary; I didn t want my friends complaining about their policies to me. Not long after, I decided to change course and work for a local Blues plan. I thought it would be a good rotation that would last a few years, but 17 years later I m really glad I made the switch to health care; working to improve the financial security of Americans through making health insurance affordable is a daunting, but rewarding endeavor. By being a Health Section leader, I hope to help shape the educational and professional opportunities available to health actuaries and continue to work to improve our evolving health care delivery and payment systems.
Theresa S. Bauer, FSA, MAAA Senior Actuary, Aetna Hartford, CT Terri Bauer is an accomplished financial professional with over 20 years of experience in actuarial roles, more than half as a health actuary working across Medical, Dental, and Pharmacy products. She currently is the Northeast Regional Actuary for Aetna s Commercial Businesses (small and middle markets) and the Small Group Head Actuary. Terri has been with Aetna since 2005, and was previously at CIGNA. She graduated from Penn State University (We Are!) in 1991 with a BS in Mathematics. Terri has proven ability to step into new disciplines and quickly add value. Her expertise ranges from health care to corporate actuarial to asset/liability management. Her health care experience spans: Health care reform, which she has worked on since PPACA s passage, for both large and small groups Traditional health product pricing and filing for both small and large groups Consumer-directed products, including having led Aetna s annual Aetna HealthFund study for several years, the longest-running study in the industry of the impact of consumer-directed plans and health care consumerism Pharmacy including Medicare Part D Dental product development, pricing and filing Product management Medical cost and trend analysis, including identification, valuation and tracking of action items to mitigate medical costs. Terri has three crazy kids, an 11-year-old boy, and 9- and 6-year-old girls. They are smart and sassy and loud and she wouldn't want them any other way. Her hobbies are reading, movies, and sleeping in; refer back to the part about the three crazy kids. No section or committee memberships; Past SOA speaker. Treasurer and Board of Directors member for Raising Berlin, Inc. (January 2011 Present) o Moms Moving Forward By Giving Back o Raising Berlin is a non-profit organization of Berlin, CT moms who give back to the community and lead by example. We strive to teach and exemplify to our children what being a part of a community really means and, in doing so, build lasting memories for our families and the town of Berlin. Co-Treasurer for Griswold Elementary School PTO (July 2011 July 2013) Co-Leader of Girl Scout Troops 66209 and 66495 (September 2009 Present) Health care reform is dramatically changing the landscape we health actuaries work within. It is more important than ever that health actuaries are up-to-date on the changes and what they can mean, and that we are prepared to advocate for our profession, our employers, and our customers (plan sponsors and individual members) at the state and federal level and within the media. I feel passionately that actuaries need to take a leading role, and believe I can help section members become prepared to do so. I also would like to see more representation on the section council from large national insurers; my past experience at Aetna and CIGNA would enable me to provide the large insurer perspective.
Tia Goss Sawhney, FSA, MAAA Director of Data, Analytics, and Research Illinois Dept. of Healthcare and Family Services Chicago, IL As an executive team member with Illinois Medicaid, I work at the intersection of insurance, healthcare, and government policy. Within that domain, my responsibilities include leveraging Medicaid data in order to provide quality healthcare and meet the data needs of diverse stakeholders. In addition to being a FSA, I have a doctorate degree in public health. My doctoral dissertation concerned risk adjustment and indirect selection under healthcare reform and was written to help educate regulators. I have previously worked for Milliman and Blue Cross Blue Shield of Illinois. Health Section Council Research Committee, inclusive of several project oversight groups, 2010+ Develop Knowledge Team, Knowledge Management Initiative, 2009-2012 Centers of Actuarial Excellence Evaluation Committee, 2011-2014 Social Insurance & Public Finance Section Council, 2010-13 SOA James C. Hickman Scholar, 2010-2011 Moderator and speaker at SOA meetings and seminars, 2009+. Risk Sharing Work Group, American Academy of Actuaries, 2011-2012 Articles in actuarial and insurance publications, such as Contingencies, 2006+ Student leadership roles, University of Illinois at Chicago School of Public Health, 2008-2011 Non-profit education work with disabled children, India, 2006-2012. I bring several, potentially unique perspectives, to the Health Section Council: government actuary, non-traditional actuary, public health and policy, academic, and long term care (Medicaid pays for most LTC). I am a big picture thinker who can get down in the weeds to get things done. I have a history of active contribution in my volunteer roles.
Michelle Roark, FSA, MAAA BlueCross BlueShield of North Carolina Durham, NC I have over 13 years of actuarial experience with a major corporation. I have been a credentialed FSA for over eight years. The majority of my career was spent with consulting firms working on large national employer groups, where I worked on a broad range of projects: funding rate development, employee contribution strategies, benefit redesign, consumer high deductible strategy and rating, IBNRs, retiree medical, M&A, and stop loss. I have a few years of experience in insurance working on various projects: trend development, rate reviews, benefit adjustment analysis, underwriting, business strategy, and market segment financial analysis. I have been very fortunate to work with some of the best and brightest within the industry throughout my career. I have taken advantage of all the great learning opportunities I have been given throughout my career track to challenge myself and provide the best value to my clients and employers. In my current role at BCBSNC, I am the Director of 51+ Group Medical, ASO, Dental, Vision, and Stop Loss products. I am very excited to be working at an insurance company with the dramatic changes that are occurring within the industry as a result of health care reform. I feel fortunate to have an opportunity to make an impact within our company as we transition into a new wave of how health care will be provided and regulated. I am a member of the Health Section. This is my first time running for office. I would like to play a more active role in the SOA, and make a contribution to the actuarial profession. I am excited to get involved with the SOA and more actively participate in the council. I have served on numerous work groups, national task forces, and committees within my professional career at my employers. I am interested in running for the Health Section Council because I feel it is a terrific opportunity for me to contribute and give back to the profession. I have a broad range of consulting and insurance experience that I can bring to the table. It is also a great way for me to practice my skills while possibly teaching others in the process, as well as to learn from other members on the committee. I enjoy working on different types of projects and working with other thought leaders in the profession. The Health Section Council will play an important role within our profession as we respond to a changing industry, and I would like to be a part of this positive change and make a contribution. I have evaluated ways to divest my time and feel that being a member of the Health Section Council is the most impactful way for me to make an impact and a difference.
Julia S. Lambert, FSA, MAAA President, Wakely Consulting Group Clearwater, FL I have spent the majority of my 20 year career in health care consulting with the companies Reden & Anders (now OptumInsight) and Wakely Consulting Group. My primary area of focus is Medicare Advantage, providing strategic planning, feasibility, and actuarial certification of bid pricing tools for clients. Providing a full range of actuarial services for regional HMO plans, I have also had broad experience in valuation, pricing, trend analytics, and provider contracting for multiple lines of business including individual, group, and Medicaid work. I enjoy performing actuarial work on a very hands-on basis, working on projects by leading and mentoring those new to the field as well as working with and learning from other senior actuaries and health care leaders. For a little over a year, I have been privileged to serve as President of Wakely Consulting Group. As I am still working to fulfill the expectations (mostly my own!) of this position, it has been extremely rewarding to lead and have an opportunity to think about our company in the ever changing world of health care. Prior to becoming a consultant, I worked for Great West Life and Physicians Mutual Insurance Company. Prior to joining the actuarial field, I worked as an educator in both high school and college settings. I have been extremely blessed to have had great minds and great people to work with in every part of my career. Medicaid Rate Setting Group Volunteer Speaker at various SOA education meetings I have been rewarded personally and professionally from the actuarial career, and I would like to find a role to serve the SOA in a meaningful capacity. I would very much enjoy serving in a position with other health care leaders where I can bring my set of experiences to bear on the broader actuarial community. I believe I have a good sense of what types of information are found to be practical to the daily work of various levels of health actuaries. If elected to the council, my focus will be to promote programs that are meaningful to and will enhance the daily work of health care actuaries.