Brian Weible, Julia Lambert, Alison Pool, Greg Fann, George Hawkins, Ross Winkelman, Mary Hegemann


Brian Weible		Ross Winkelman
Julia Lambert		Mary Hegemann
George K. Hawkins Jr.		D. Dale Hyers
Alison Pool		Ron Burkhart
Greg Fann

Brian Weible, President, Wakely Consulting Group
Experience	Prior to joining Wakely Consulting Group, Brian was chief actuary and underwriting manager for a Florida HMO offering commercial and government (Medicare/Medicaid) plans as well as piloting a 24-hour health/workers' compensation insurance product. Prior positions include work as a consultant for a large Florida-based health insurance and managed care actuarial consulting firm and positions with a multi-state indemnity carrier offing fully insured and self-funded accident and health products. Brian offers professional advice and opinion to several periodicals including the New York Times and local business journals regarding actuarial and related insurance and benefit issues. Brian began his actuarial career in 1991.
Professional Credentials	• Fellow, Society of Actuaries (F.S.A.) • Member, American Academy of Actuaries (M.A.A.A.)
Areas of Specialization	• Managed care strategic planning, pricing and analysis (HMO, PPO, EPO, PHO) • Risk sharing arrangements (capitations, withholds, joint ventures, provider fee • schedules) • Point-of-Service plan development and HMO/Insurer contract development • Pro Forma and Business Plan review and certification • Claim Reserve analysis • Premium/Deficiency Reserve analysis • Medicare Parts A/B and Part D bid development • Medicaid rate development and projection • SCHIP/Healthy Kids product development and prices • Self-Funded employer funding/contribution rate development • Provider fee schedule analysis • Rate manual development and review (health, dental, prescription drug) • Underwriting and Experience Rating of large groups or business segments
Publications	• New York Times • St. Petersburg Times • Medicare Advantage News • Health Watch, Society of Actuaries • Healthleaders/Interstudy • DWG Cost Management Report • Various business journals
Education	• B.S. Mathematics, University of Missouri

Julia Lambert, Principal, Wakely Consulting Group
Experience	Julia Lambert joined Wakely Consulting Group as a Principal in April 2008. Prior to Wakely, Julia was a Managing Principal and Medicare Actuarial Practice Leader at Reden & Anders where she served in a consulting capacity for eight years. Prior positions include work as a consultant for Leif Associates, and student actuary positions at Great-West Healthcare and Physicians Mutual.
Professional Credentials	• Fellow, Society of Actuaries (F.S.A.) • Member, American Academy of Actuaries (M.A.A.A.)
Areas of Specialization	• Medical expense projection and budgeting, premium rate development and rate filings for start-up and established commercial managed care entities, including HMO, PPO, POS, High Deductible and other insurance company product lines • Development, analysis and review of physician and hospital fee schedules, capitation, and other risk sharing arrangements • Development of Medicare Advantage and Part D bids • Periodic financial and trend reporting, including leading trend driver analysis • Medicaid and SCHIP/Healthy Kids risk feasibility analysis and development of medical expense projections • Medicaid rate review in several states and certification of Medicaid checklist • Analysis and review of risk adjustment methods • Review of unpaid claim liability, including premium deficiency analyses, and preparation of actuarial certifications • Review of small group rating practices and compliance issues
Education	• B.S. Secondary Education, University of Nebraska – Lincoln • M.S. Applied Mathematics, University of Colorado – Boulder

George K. Hawkins Jr., Senior Consulting Actuary
Experience	George has experience in group life, medical, dental, disability, and various governmental programs. He started his career in 1969 with a mutual insurance company, was the chief actuary for a large third-party administrator, and was also with the predecessor firm to Wakely Consulting Group. He joined Wakely Consulting Group in 2005.
Professional Credentials	• Fellow, Society of Actuaries (F.S.A.) • Member, American Academy of Actuaries (M.A.A.A.)
Areas of Specialization	• Health Benefits • Life Insurance Benefits • Experience Rating • Experience Studies • Dental Benefits • Funding Techniques
Education	• M.S. Actuarial Science, Northeastern University, Boston • B.A. Mathematics University of Virginia

Alison Pool, Senior Healthcare Specialist
Experience	Since entering the actuarial profession in 1983, Alison was employed with a Blue Cross/Blue Shield company, and the nation's largest independent third party administrator (TPA) of health insurance plans for small employers. Prior to joining Wakely Consulting Group as a consulting actuary, she was employed at a large Florida-based actuarial consulting firm.
Professional Credentials	• Associate, Society of Actuaries (A.S.A.) • Member, American Academy of Actuaries (M.A.A.A.)
Areas of Specialization	• Third-party plan administration • State rate filings and actuarial certifications • Claim liability and rate adequacy analysis • Effectiveness and pricing of managed care products
Education	• M.S. studies, Statistics, University of South Florida • B.S. Mathematics, Birmingham-Southern College

Gregory G. Fann, Senior Consulting Actuary
Current Responsibility	Greg is a Senior Consulting Actuary with Wakely Consulting Group. He joined the firm in 2006 and has worked as a health actuary for 13 years.
Experience	Prior to joining Wakely Consulting Group in 2006, Greg served as chief actuary of a provider owned HMO and in leadership roles of several managed care organizations, specializing in Individual, Small Group, and Medicare Supplement markets.
Areas of Specialization	• Managed Care Rate Development • Underwriting • Product Development • Claim Reserve analysis • Premium Deficiency Reserve Analysis • Forecasting • Managed Care Contracting • Cost Containment Strategy • Pro Forma and Business Plan review and Certification • Provider-Owned Managed Care Organizations • Federal Employees Health Benefit Plan Pricing • Medicare Supplement Regulatory Filings • Medicare Advantage/Prescription Drug Plan Bid Process
Publications & Presentations	Greg was the Chairman of the Southeastern Actuaries Conference Scholarship Committee in 2000 and has moderated the health discussion at the semiannual meeting. He has been a key contributor for many years on the Society of Actuaries examination committees and is currently Vice Chairman of the Group and Health Company/Sponsor Perspective Examination Committee. Greg has been a contributing columnist to HealthWatch and volunteered on the actuarial task force analyzing the impact of sudden changes to the U.S. Health Care System.
Professional Credentials	• Fellow, Society of Actuaries (F.S.A.) • Member, American Academy of Actuaries (M.A.A.A.)
Education	• M.A.S Actuarial Science, Georgia State University • B.S. Mathematics, Furman University

Ross A. Winkelman, Managing Director (Denver Office)
Current Responsibility	Ross is the Managing Director of the Denver office of Wakely Consulting Group. He joined the firm in 2007 and has worked as a health actuary for over 13 years.
Experience	Ross has experience in healthcare financial analysis, valuation, pricing and product development. He has recently been focused on the use of risk adjusters for various applications. He has worked on most types of health products including individual, small group, large group, Medicare Supplement, Medicare Advantage, Medicaid, vision, dental, LTC and disability. Ross led his former firm’s efforts to identify optimal rating and underwriting methods for small groups at renewal, and is in the midst of an important research project for the Society of Actuaries (SOA) on risk adjusters. He has been involved in the development of Health Cost Guidelines for two countries outside of the U.S. Ross has experience managing large projects and multi-disciplinary teams of individuals, including managing the healthcare portion of a multi-billion dollar bid for the TRICARE military healthcare system. He has worked on triennial examinations of insurance companies on behalf of state insurance departments and has experience estimating liabilities in support of financial statement audits and litigation cases. Ross led Milliman’s efforts to audit health plans’ 2004 ACRP filings on behalf of the Centers for Medicare and Medicaid Services. Ross has developed Medicare Advantage feasibility studies and bids for dual eligible and other special needs populations. Ross has advised state insurance organizations, military health services companies, PHOs, HMOs, PPOs, other managed care organizations including Medicaid managed care companies and has supported Medicaid litigation projects. He has developed rating models for many health plans, including developing the rating structures for the Chilean ISAPRE system. Ross is the Associate Editor for the SOA Health Section’s newsletter, vice-chair of the SOA’s Communications and Publications sub-committee, and a former member of the Society of Actuaries managed care exam committee. Ross was also a contributing author for the book, “True Group Long Term Care”.
Publications	• SOA Research Project, 2007 – A Comparative Analysis of Claims Based Tools for Health Risk Assessment • SOA Research Project, 2006 – Health Plan Provider Network Risk • SOA Health Section News, August 2005 – Optimal Renewal Guidelines for Small Group Rating • SOA Health Section News, August 2005 – Coverage of Spring SOA Meeting in New Orleans
Presentations	• “SOA Risk Adjuster Research Project”, SOA / DMAA Predictive Modeling Conference, 2006, Orlando, FL • “SOA Risk Adjuster Research Project”, SOA / DMAA Webinar, 2006 (Webinar) • “Health Network Risk”, SOA Spring Meeting, 2006, Hollywood, FL • “Small Group Renewal Rating”, LOMA Health Underwriting Study Group, 2005, New Orleans, LA • “Optimal Renewal Guidelines for Small Group Rating”, Milliman Health Forum, 2005, Tucson, AZ • “Optimal Renewal Guidelines for Small Group Rating”, Web Seminar, 2005, Denver, CO • “Chile Health Cost Guidelines”, Milliman Health Forum, 2003, Phoenix, AZ • “Issues in Employer Health Insurance”, SOA Spring Meeting, 2002, Colorado Springs, CO • “Health Insurance Valuation”, Mexican Actuarial Association, 2001, Mexico City, Mexico • “Prescription Drug Rating”, Milliman Health Forum, 2001, Orlando, FL
Professional Designations	• Fellow, Society of Actuaries • Member, American Academy of Actuaries

Mary Hegemann , Senior Consulting Actuary
Experience	Mary joined the Denver office of Wakely Consulting Group as a Senior Consulting Actuary in November 2008. During the prior 12 years, she was a health actuary holding positions with Reden and Anders (now Ingenix Consulting), Leif Associates, and Great-West Life.
Professional Credentials	• Fellow, Society of Actuaries (F.S.A.) • Member, American Academy of Actuaries (M.A.A.A.)
Areas of Specialization	• Medicaid and SCHIP rate development and actuarial certification of CMS checklist • Review of Medicaid and SCHIP rate development performed on behalf of health plan associations • Analysis and review of risk adjustment methods • Medicare MA and Part D Bid actuarial certifications including feasibility studies and bid preparation for special needs plans serving chronically ill, institutionalized, and dual-eligible populations • High-risk pool consulting including fund projections, carrier assessments, drafting Bills with state legislators, premium rates, plan designs, audits, feasibility studies, and setting reserves • Year-end reserve actuarial opinions, small group certifications, and rate filings • Provider contracting analyses and negotiations • Evaluating the cost impact of proposed legislation
Education	BA, Actuarial Science and Mathematics, University of Nebraska-Lincoln

D. Dale Hyers, Managing Director (Louisville Office)
Experience	Prior to joining Wakely Consulting Group, Dale was the President and co-founder of Hyers & Levy an actuarial, insurance management and health care management consulting firm. His actuarial training and experience began in 1964 at Ætna Life & Casualty Insurance Company in Hartford, Connecticut. It continued at Integon Life Insurance Corporation in Winston-Salem, North Carolina, and Providian (formerly Capital Holding Corporation) in Louisville, Kentucky. He left Capital Holding to start Hyers & Levy in 1983. Dale has written a chapter on pricing of health care benefits that appears in a book published by the American Hospital Association. This book is titled HOSPITAL-SPONSORED HEALTH MAINTENANCE ORGANIZATIONS: Issues for Decision-Makers. His chapter is titled "Understanding the Rate Making Process." He is also the editor of a study Hospital Cost Analysis by DRG to provide a "standard" for measuring the effectiveness of hospital medical cost management programs. Dale is a past President of the Southeastern Actuaries Conference. He has been a consulting actuary for the Kentucky Department of Insurance, Georgia Department of Insurance, Hawaii Insurance Division, Indiana Department of Insurance, Maryland Insurance Administration, Michigan Insurance Bureau, Vermont Department of Insurance, Tennessee Department of Commerce & Insurance and the Pennsylvania Department of Insurance. He has also been the State HealthCare Chairman of Kentucky on behalf of the Health Insurance Association of America.
Professional Credentials	• Fellow, Society of Actuaries (F.S.A.) • Member, American Academy of Actuaries (M.A.A.A.) • Member, American Society of Chartered Life Underwriters (C.L.U.)
Areas of Specialization	• Product Development • Pricing • Valuation • Provider Capitations • Managed Care Contracting • Insurance Operations Management • Expert Witness & Testimony
Education	• M.A. Mathematics, University of Kentucky • B.S. Carson-Newman College

Ronald D. Burkhart, Consultant (Louisville Office)
Experience	Prior to joining Wakely Consulting Group, Ron was a Consultant with Hyers & Levy an actuarial, insurance management and health care management consulting firm. Ron’s actuarial and analytical training began in 1979 at National Life and Accident Company in Nashville , Tennessee , and continued at two Blue Cross/Blue Shield organizations, and a hospital-based HMO insurer. For Wakely, he has been a consulting actuary for the Kentucky Department of Insurance, Hawaii Insurance Division, Indiana Department of Insurance, Maryland Insurance Administration, Vermont Department of Insurance, Tennessee Department of Commerce & Insurance and the Michigan Insurance Bureau. Ron has many years of experience in observing, analyzing and measuring health cost data and the effect of cost management techniques on the cost of health care. He was the primary analytical contributor to the study Hospital Cost Analysis by DRG. This study was published by Hyers & Levy to provide a "standard" for measuring the effectiveness of hospital medical cost management programs.
Professional Credentials	• Associate, Society of Actuaries (A.S.A.) • Member, American Academy of Actuaries (M.A.A.A.)
Areas of Specialization	• Product Development • Pricing • Valuation • Provider Capitations • Managed Care Contracting • Expert Witness Support
Education	• B.S. Mathematics, David Lipscomb College

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