AHP Case Study
Type of Client: Health Plan vs. Reinsurer
Project Type: Serve as arbitrator in binding arbitration process for dispute between health plan and reinsurer of care management vendor
Estimated Budget: Variable
Description of Project: The health plan contracted with a care management vendor to provide care management services for specific types of patients (i.e., carve-out). The performance of the vendor was guaranteed through a separate reinsurance contract (i.e., cost savings were guaranteed). As the initial year results emerged, a dispute between the health plan and reinsurer emerged. AHP was retained to serve as arbitrator and to help resolve the dispute.
Outcome: Final award issued
Next Steps: None at this time
Primary Consulting Team: David Axene (primary contact and actuarial lead)