Services › Self-Insured Group Health
Independent actuarial services for employers and governmental entities that self-insure their group health benefits. IBNR reserve calculations, ACA compliance certifications, stop-loss analysis, and financial projections for plan sponsors in Arkansas, Texas, Louisiana, Tennessee, Kentucky, Alabama, Mississippi, Florida, Indiana, Oklahoma, Ohio, and West Virginia.
Self-insuring group health benefits can offer significant cost advantages for employers and governmental entities — but it also introduces financial risk and regulatory complexity that require careful actuarial management. From setting accurate IBNR reserves to navigating Affordable Care Act compliance requirements, self-insured plan sponsors need an independent actuary who understands both the technical and practical dimensions of self-funded health plan management.
Osborn, Carreiro & Associates provides a full range of actuarial services for self-insured group health plans. Our health actuarial team has deep experience in healthcare benefits, including expertise in ACA implementation, and serves employers and governmental entities throughout the South, Midwest, and Southeast.
We serve self-insured group health plan sponsors in Arkansas, Texas, Louisiana, Tennessee, Kentucky, Alabama, Mississippi, Florida, Indiana, Oklahoma, Ohio, and West Virginia. Our fee-for-service model ensures that our actuarial work is always independent — we have no financial relationship with stop-loss carriers, TPAs, or health plan vendors.
Incurred but not reported (IBNR) claims represent one of the most significant financial risks for self-insured health plans. At any point in time, a substantial volume of claims have been incurred by plan members but not yet submitted or processed. Accurately estimating this liability is essential for financial reporting, stop-loss reconciliation, and plan budgeting. Our actuaries use established actuarial methods — including development triangle analysis, completion factor approaches, and lag study techniques — to calculate defensible IBNR reserves for self-insured plans of all sizes. We serve plan sponsors in Arkansas, Texas, Louisiana, Tennessee, Kentucky, Alabama, Mississippi, Florida, Indiana, Oklahoma, Ohio, and West Virginia.
The Affordable Care Act imposes specific actuarial requirements on employer-sponsored health plans. Self-insured plans that do not use the HHS actuarial value calculator must obtain an actuarial certification of their plan's actuarial value — the percentage of total average costs for covered benefits that the plan pays. For large employers subject to the ACA's employer shared responsibility provisions, we provide minimum value determinations certifying that the plan pays at least 60% of the total allowed costs of benefits provided under the plan. Our ACA actuarial certifications are prepared by credentialed actuaries and are accepted by auditors and regulators throughout our 12-state service territory.
Stop-loss insurance is the primary risk management tool for self-insured health plans, protecting plan sponsors against catastrophic individual claims (specific stop-loss) and aggregate claims that exceed expected levels (aggregate stop-loss). Selecting appropriate attachment points is a critical actuarial decision — set too high, and the plan retains more risk than intended; set too low, and stop-loss premiums erode the cost savings of self-insurance.
Our actuaries analyze your plan's claims experience, enrollment demographics, and benefit design to evaluate whether your current stop-loss attachment points are appropriate. We provide independent analysis that helps plan sponsors make informed decisions about their stop-loss program — without the conflicts of interest that can arise when stop-loss carriers or brokers provide the analysis. We serve self-insured plan sponsors in Arkansas, Texas, Louisiana, Tennessee, Kentucky, Alabama, Mississippi, Florida, Indiana, Oklahoma, Ohio, and West Virginia.
The Affordable Care Act created a complex compliance landscape for self-insured group health plans. Our health actuarial team has specialized expertise in ACA implementation — including the essential health benefits requirements, actuarial value metal tier determinations, minimum value certifications, and the interaction between self-insured plan design and ACA reporting obligations. We help plan sponsors in all 12 states we serve navigate ACA requirements with confidence.
For governmental employers that self-insure their employee health benefits, we provide actuarial support that addresses both ACA compliance and the unique financial reporting requirements that apply to public-sector health plans — including the interaction between active employee health benefits and OPEB obligations for retirees who remain on the same plan.
We provide self-insured group health actuarial services to employers and governmental entities in the following states.
AR
Arkansas
TX
Texas
LA
Louisiana
TN
Tennessee
KY
Kentucky
AL
Alabama
MS
Mississippi
FL
Florida
IN
Indiana
OK
Oklahoma
OH
Ohio
WV
West Virginia
Arkansas: Our home state, where we serve private employers, municipalities, school districts, and other governmental entities that self-insure their group health benefits.
Texas & Oklahoma: Large and mid-size employers throughout Texas and Oklahoma self-insure their health benefits to control costs. We provide independent IBNR, ACA, and stop-loss actuarial services for these plan sponsors.
Louisiana, Mississippi & Alabama: Gulf Coast employers rely on our team for timely, accurate self-insured health plan actuarial work — from annual IBNR calculations to ACA compliance certifications.
Tennessee, Kentucky, Indiana, Ohio, Florida & West Virginia: Employers throughout the mid-South, Midwest, and Southeast benefit from our independent, fee-for-service approach to self-insured group health actuarial services.
Our Senior Health Actuarial Analyst brings over 30 years of healthcare insurance experience, including deep expertise in ACA implementation and self-insured plan management.
We are a fee-for-service firm with no financial relationships with stop-loss carriers, TPAs, or health plan vendors. Our analysis is always independent.
You work directly with experienced health actuarial professionals — not a junior analyst. We are accessible, responsive, and committed to clear communication.
Contact us to discuss your self-insured group health actuarial needs. We serve employers and governmental entities in Arkansas, Texas, Louisiana, Tennessee, Kentucky, Alabama, Mississippi, Florida, Indiana, Oklahoma, Ohio, and West Virginia.