Legislative Costing

Costing of proposed legislation is also included among our practice specialties. Pinnacle has performed costing studies of proposed insurance legislation in California, Colorado, Florida, Hawaii, Louisiana, Maryland, New Jersey, New York, Pennsylvania, Texas, Virginia and Wisconsin. Clients have included state associations of physicians, hospitals and even trial lawyers; state insurance regulators, and state legislative committees. Analyses have examined topics such: as the impact of damage caps, patient compensation funds, mandatory medical review panels, and physician apology “I’m Sorry” legislation. We closely monitor legislative, judicial and regulatory activity in all fifty states and the federal level. In fact, we have had several engagements where clients have engaged us to compile these by state summaries into formats suitable for their own use.

Government Insurance Programs

Pinnacle has developed an excellent working knowledge of patient compensation funds and other government insurance programs in many different jurisdictions. Previous client assignments that are of particular relevance include work for: the Ohio Department of Insurance, the New Mexico Department of Insurance, the Virginia Birth Related Neurological Injury Program, Texas Medical Liability Insurance Underwriting Association (TXMLIUA, the Florida Office of Public Policy and Government Accountability (OPPAGA), and the Louisiana Department of Insurance.

Self Insurance/Captives

Pinnacle as a firm focuses on property and casualty actuarial consulting. Within that arena, Pinnacle has extensive experience in almost every aspect of the healthcare industry including regional physicians groups, specialist groups, nursing homes, residential adolescent centers, occupational medicine clinics and University Hospitals.

Pinnacle provides valuable insights during the design stage of the development of self insurance and captive programs. This advice is based on our work with the various forms of self insurance (e.g. “pure” captives, segregated cells, RRGs, agency captives, large deductible plans). Pinnacle’s feasibility studies allow you to make informed decisions about the capitalization for your captive. An essential analytical foundation of these feasibility studies is Pinnacle’s actuarial funding studies and tools for equitable funding allocations by member. Once a program is up and running, Pinnacle provides loss reserve analyses and statements of actuarial opinion (SAOs) that meet the highest professional standards.

Regulatory Support

We have also frequently been the actuarial experts for state regulators on medical professional liability insurance matters. This work has ranged from reviews of rate filings to loss reserve analyses supporting financial examinations to development of indicated rates and reserves for government insurance programs to review of captive applications to legislative costing to staff training seminars.

These clients include organizations such as:

• Connecticut Department of Insurance
• Florida Office of Public Policy and Governmental Accountability (OPPAGA)
• Indiana Department of Insurance
• Iowa Department of Insurance
• Maine Bureau of Insurance
• Michigan Office of Finance and Insurance Services
• New Mexico Patient Compensation Fund
• New York State Insurance Department
• Ohio Department of Insurance
• Oregon Bureau of Insurance
• Vermont Department of Insurance

Closed Claims Studies

Pinnacle has also been engaged by governmental bodies in states such as Florida (Office of Public Policy Analysis and Governmental Accountability), Maine (Bureau of Insurance), Michigan (Office of Financial and Insurance Services), New Mexico (Division of Insurance), Ohio (Department of Insurance) and Oregon (SAIF Corporation and the Oregon Professional Panel for Analysis of Medical Professional Liability Insurance) to provide unbiased information and legislative costing for medical malpractice legislation. In each of these states, Pinnacle developed and analyzed closed claims databases for the purpose of evaluating claims trends and the potential impact of legislation. Sometimes these databases were based on closed claims reporting forms, other times Pinnacle needed to develop data calls to leading insurers in the state and work with them to receive accurate and compatible data transmissions from all of the program participants.