Dirk Dallas

Dirk’s areas of expertise include Pharmacy Benefit Manger (PBM) contractual analysis, PBM pricing strategies, pharmacy network arrangements, and rebate analytics.

Since joining Milliman, Dirk has performed work for a variety of different clients in several areas, including large employers, trusts, state-based exchanges, and Pharmacy Benefit Managers.

His experience includes:

• PBM Market Check
• PBM Request for Proposal (RFP)
• Pharmacy claims analysis
• Pharmacy network optimization and evaluation
• Pharmacy product development
• Actuarial certification of qualified health plan benefit designs using the federal actuarial value calculator
• Calculating actuarial values for managed care health plan designs
• Claim reserve analysis
• Developing expected utilization and cost benchmarks for commercial populations
• Group pricing and rate filings
• Healthcare reform
• Projection of healthcare costs

Dirk has worked with multiple states in the development and analysis of Essential Health Benefits (EHB) plan options, including estimating the impact of selecting a new benchmark plan with differences in covered benefits. The analyses were a result of the requirements enacted by the Patient Protection and Affordable Care Act (ACA) for establishing EHB to be used by certain insurance plans in 2014 and later.

Prior to joining Milliman, Dirk was a personal lines underwriter for a property and casualty insurance broker.