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Experience
Sylvia’s expertise is in the health actuarial field. She works with HMOs, Blue Cross/Blue Shield plans, and commercial insurers, with emphasis in the Medicare market. Her client activities include:
- Product development and pricing
- Medicare bid development (Medicare Advantage and Part D)
- Medicare Advantage risk score review and analysis
- Prescription drug formulary analysis
- Financial projections
- Trend analysis
- Claim reserve estimates
Sylvia has extensive experience with the Medicare Advantage program. She has assisted clients with Part C and Part D feasibility analyses and bid preparation. She has advised an array of plans including HMOs, PPOs, and dual-eligible and chronic SNPs. She has developed expertise in Medicare risk scores. She has provided clients a variety of risk score assistance including risk score projections and thorough review of RAPS, EDS, and chart review submissions.
Professional Designations
- Fellow, Society of Actuaries
- Member, American Academy of Actuaries
Education
- BBA, Actuarial Science, Temple University
Publications
Read their latest work
Article
What court rulings say about Medicare Advantage diagnosis submissions
06 December 2021 - by Sylvia Hagin, John Miller
What is the responsibility of an insurer in returning payments received from miscoded diagnoses?
Article
Key considerations in product design for actuaries for the 2021 MA pricing season
07 April 2020 - by Luis Maldonado, Sylvia Hagin, Brian Regan
Newly available product design options will require actuaries to develop new tools and processes in order to assist Medicare Advantage organizations in bid development.
