Keith is an Executive Healthcare Risk Management Consultant, with thirty years of Healthcare financing, actuarial, and underwriting experience, with particular expertise in claims management, plan designs, rating methodologies, risk assessment measures, stop loss and other funding arrangements options.
Medical claims continue to drive the cost of employer-sponsored healthcare, and Keith leverages his claims management and financial expertise to support cities, towns, school districts, and other large and small employers and labor health funds secure comprehensive health benefits at affordable rates for their employees, retirees, and members.
Keith’s in-depth knowledge of healthcare funding options help employers and funds determine whether to “fully-insure” or “self-fund”, and if they self-fund, what type of Stop Loss is appropriate for the size and risk within the group. His knowledge of the local market’s insurance carriers, claims trends, value-based medical plan designs, formularies, pharmacy/drug rebates, dental plans, and wrap-around products like HRAs and HSAs provides employers with industry expertise when negotiating coverage.
Keith began his career at Blue Cross Blue Shield of Rhode Island, where he became the company’s Senior Underwiring Executive and AVP of Actuarial Services, and developed the rating formulas used to calculate group rates in both the large and small group markets. He was responsible for balancing both enrollment and the financial reserves of the company, managing an overall book of business approaching $2 billion in annual premiums.
Keith also oversaw the company’s stop loss reinsurance program for self-insured accounts; development of rating trends and profit margins; health plan design and pricing; regulatory compliance and legislative reform; rate filings with the Office of the Health Insurance Commissioner (OHIC); and forecasting. During his tenure, he led the company to a record level of corporate reserves.
Subsequently, Keith oversaw the development and on-going operations of a municipality healthcare purchasing collaborative - the Rhode Island Interlocal Trust, representing over 25 municipalities and $125 million in annual premiums. At the Trust, Keith directed the Employee Benefits division, where he managed the entire program, including carrier selection and negotiations, stop loss, all financial results, sales, marketing, and account management.
At the Trust, Keith improved undercapitalized pool reserves to over 200% of the necessary Risk-Based Capitol (RBC) thresholds, and grew enrollment over 50% (from 15,000 to over 24,000 covered lives) during the first three years of operations. He consulted government officials on medical, dental, and prescription drug plan designs and costs, provided consultative services for Stop Loss, plan designs, and ACA compliance. He oversaw RFP process that generated $15 million in savings to program participants.
Keith has also worked with Rhode Island’s Healthcare Exchange - HealthSource RI, helping them develop into one of one of the most successful SHOP exchanges in the nation. He has expertise in state-operated exchanges and compliance of the ACA, allowing him to provide expert consulting services and compliance guidance to small employers, guiding them in effective and comprehensive plan design selection, employee contribution schemes, and tax implications.
As Principal Consultant at Health Benefit Advisors since 2009, and as a former partner at subsidiary Legacy Benefit Advisors, Keith worked with a second, large municipality collaborative with over 7,500 employees, as well as the RI Federation of Teachers and the National Education Association of RI administrative teams. His Underwriting expertise and ability to analyze detailed claims data helped achieve millions of dollars in savings in Stop Loss costs, Medical & Dental benefits, etc.
He also works directly with individual seniors to help them navigate through Medicare, Medicare supplements, and Medicare Advantage options.
In addition to providing group consulting, Keith and the team at HBA also works directly with individual seniors to help them navigate through Retirement Planning, including Medicare options and investment strategies. Clients include retirees from RIPERC, most trade-labor funds, including the RI Laborers, Local 57 Operating Engineers, Teamsters, IBEW, Carpenters, BUW, and the Carpenters, along with RIFT, NEARI, and AFSCME.
Keith is a past chairman of the Blue Cross, New England District, Actuarial and Underwriting Committee. He holds a BS in Industrial Engineering from the University of Rhode Island and successfully completed programs in negotiation at the Harvard Business School.
