Capital and surplus requirements for a health insurer can change over time based on many internal and external factors. Regulators generally focus on the solvency of health insurers to ensure they meet obligations to consumers. However, a health insurer with capital levels that are significantly above the regulatory minimum may also get a lot of attention from regulators and stakeholders. A health plan’s target capital requirements are generally significantly higher than the regulatory minimums.
In this paper, Milliman’s David Hayes, Rachel Killian, and Shyam Kolli discuss considerations for health plans when determining capital requirements.
Healthcare providers and health plans continue to integrate vertically through consolidation and virtually through accountable care organization (ACO) risk-sharing arrangements. In this article, Milliman’s Dave Liner discusses how providers and health plans can improve their financial performance by considering strategies that optimize regulatory capital.