SACRAMENTO, Calif. — Covered California™ has announced that it has retained John Bertko as chief actuary/director of research for the exchange.
Bertko, engaged as a consultant under the general direction of the agency’s executive director, will manage the collection and analysis of data, trend reporting and market study information needed for the exchange’s policy development and health plan, population health costs and risk assessment.
“John Bertko is a strategic thinker, team builder and innovator, with an entrepreneurial mindset,” Covered California Executive Director Peter V. Lee said. “He works effectively with diverse stakeholders, and he has a passion for Covered California’s mission of providing quality and affordable health care to all Californians.”
Bertko most recently was an independent actuarial consultant and was the director of special initiatives and pricing in the Center for Consumer Information and Insurance Oversight at the Centers for Medicare and Medicaid Services (CMS), retiring from this position as of Jan. 31, 2014.
He served as a senior actuarial adviser on various private insurance initiatives, including risk adjustment, insurance programs and insurance oversight activities. He formerly was a senior fellow at the LMI Center for Health Reform, adjunct staff at RAND, a visiting scholar at the Brookings Institution and a visiting scholar at the Center for Health Policy at Stanford University. He retired as chief actuary of Humana Inc., where he managed the corporate actuarial group and directed work by actuarial staff for Humana’s major business units, including developing Part D, Medicare Advantage and consumer-driven health care products. His $153,600 contract with Covered California is for one year.
About Covered California
Covered California is the state’s marketplace for the federal Patient Protection and Affordable Care Act. Covered California, in partnership with the California Department of Health Care Services, was charged with creating a new health insurance marketplace in which individuals and small businesses can get access to affordable health insurance plans. With coverage starting in 2014, Covered California helps individuals determine whether they are eligible for premium assistance that is available on a sliding-scale basis to reduce insurance costs or whether they are eligible for low-cost or no-cost Medi-Cal. Consumers can then compare health insurance plans and choose the plan that works best for their health needs and budget. Small businesses can purchase competitively priced health insurance plans and offer their employees the ability to choose from an array of plans and may qualify for federal tax credits.
Covered California is an independent part of the state government whose job is to make the new market work for California’s consumers. It is overseen by a five-member board appointed by the Governor and the Legislature. For more information on Covered California, please visit www..com.