John Berkto, F.S.A., M.A.A.A.
Vice President and Chief Actuary for Humana Inc.

"Risk Segmentation in Consumer-Directed Health Plans"

March 26, 2004
12:00 - 1:30 PM

Colonial Penn Center Auditorium


John Bertko is Vice President and Chief Actuary for Humana Inc., one of the largest for-profit health insurance companies, with regional operations in over 15 markets. Mr. Bertko manages the Corporate Actuarial group and directs the coordination of work by actuaries in Humana’s major business units, including Public Programs, Commercial, Individual and TRICARE. This work includes assisting business segment actuaries and senior management in developing pricing strategies and in product development. In addition, he assists the Government Relations department with actuarial analyses of legislative and regulatory proposals.

Mr. Bertko has had extensive experience with risk adjustment in all sectors of the health care market. In his current role, he has responsibility for Humana’s actuarial use of risk adjusters and discussions with the Centers for Medicare and Medicaid (CMS). Mr. Bertko has also served in several public policy and risk adjustment advisory roles, including presentations for AcademyHealth, the American Academy of Actuaries task forces, the Society of Actuaries and the American Association of Health Plans.

In 1993, Mr. Bertko served as an actuarial auditor of the Clinton Health Care Reform proposal, working with senior Administration staff. For the American Academy of Actuaries, he served as a Board member from 1994 to 1996, as Vice President for the Health Practice area for the 1995/96 term and as a member of the Actuarial Board for Counseling and Discipline from 1996 through 2002.

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The Leonard Davis Institute of Health Economics.
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