JIM TOOLE, FSA, CERA, MAAA
EDUCATION
Wake Forest University, BS Mathematics Cum Laude
Princeton University
CERTIFICATIONS
Fellow in the Society of Actuaries
Chartered Enterprise Risk Analyst
Member of the American Academy of Actuaries
EXPERIENCE
Served as a designated expert in over thirty cases in the last two decades.
Aurora Actuarial, Winston-Salem, NC
2022 – present
Chief Luminary
– Litigation support services and expert witness work (defense and plaintiff) for reinsurance, life insurance, and health insurance cases
– Strategic planning, diligence, and transaction support for companies and inforce blocks of business, including assessing the potential cost and impact of reinsurance options
– Comprehensive actuarial services (ratemaking, financial reporting, and risk management) for self-insured plans, captives, and insurers
FTI Consulting, Inc., Winston-Salem, NC
2011 – 2022
Senior Managing Director
– Litigation support services and expert witness work (defense and plaintiff) for reinsurance, life insurance, and health insurance cases
– Strategic planning, diligence, and transaction support for companies and inforce blocks of business
– Business plan development and ongoing Appointed Actuary services for the first new life insurance company in North Carolina in over 25 years
– Comprehensive actuarial services (ratemaking, financial reporting, and risk management) for self-insured plans, captives, and insurers
MBA Actuaries, Inc., Winston-Salem, NC
2002 – 2011
Managing Director, Life & Health
– Design and filing of individual and group health plan offerings and ongoing financial reporting responsibilities for insurance companies and Multiple Employer Welfare Arrangements (MEWAs)
– Provide comprehensive actuarial services to self-insured plans including budgeting, plan design, and financial reporting
– Long term appointment as chief health actuary for the state of Hawaii responsible for reviewing health rate filings, triennial examinations, and provide research and support for legislative initiatives
– Litigation support services and expert witness work (defense and plaintiff) for life and health insurance cases
PROFESSIONAL ACTIVITIES
SOA Individual Life Experience Committee 2021 – Present
AAA Health Equity Working Group 2020 – 2022
SOA Latin America Committee 2014 – 2019
SOA Public Health Task Force 2016 – 2018
SOA Health Curriculum Committee 2015 – 2018
SOA Vice President 2014 – 2016
Southeast Actuaries Club Board of Directors 2012 – 2013
SOA General Insurance Track Syllabus Development Committee 2012 – 2013
SOA Board of Directors 2009 – 2012
Self Insurance Institute of America – Health Care Committee 2008 – 2010
Social Insurance and Public Finance Section Formation 2008 – 2009
SOA Health Spring Meeting Chair 2008 – 2009
SOA Health Section Council (Chair 2008) 2005 – 2008
AAA Extreme Events Working Group 2005 – 2007
SOA Marketplace Relevance Strategic Action Team 2004 – 2007
Course 8 Finance Exam Committee (ERM Track) 2003 – 2006
SOA Strategic Planning Committee 2000 – 2005
SOA Latin America Committee (founder and chair) 2000 – 2004
SOA International Policy Committee 1999 – 2004
Table Manager Update Coordinator 2001
International Section Council (Chair 2001) 1998 – 2001
SOA Ambassador Program Coordinator 1998 – 2000
SOA Ambassador to Mexico 1997 – 1998
PUBLICATIONS
Featured Research and Writing
1. “2019 Individual Life Insurance Mortality Experience Report”, Society of Actuaries, October, 2024.
2. “Potential Impact of Pandemic Influenza on the U.S. Health Insurance Industry”, Society of Actuaries, June 2010.
3. “The Economic Measurement of Medical Errors”, Chair, Research Project Oversight Group, Society of Actuaries, April 2010.
4. “Potential Impact of Pandemic Influenza on the US Life Insurance Industry”, Society of Actuaries, May 2007.
5. “Insurance Industry Mergers and Acquisitions”, Textbook editor and co-author, Society of Actuaries, May 2005.
6. “Actuarial Speculative Fiction Contest”, Founder and editor, Society of Actuaries, 1996.
Articles and Opinion
7. “Five Action Steps to Update your Risk Management Program for a Post Pandemic World”, FTI Journal, May 2020.
8. “How COVID-19 will Impact Health Insurance Payers”, FTI Journal, April 2020.
9. “Don’t Fall Captive to Self-Insurance Risks”, FTI Journal, March 2018.
10. “Is Your Company Prepared for a Pandemic?”, FTI Journal, July 2017.
11. “Realistic Steps for Improving your Return on Insurance Data”, Carrier Management, June 2017.
12. “Re-imagining Employer Healthcare”, FTI Journal, May 2017.
13. Prologue and Epilogue, “The ACA@5: An Actuarial Retrospective”, Society of Actuaries, August 2015.
14. “Developing a Robust Risk Appetite Statement”, Carrier Management, April 2015.
15. “ACA and ACOs: Incentivizing Change”, FTI Consulting, October 2013.
16. “Untapped Opportunities for Actuaries in Health: The Year in Review”, Society of Actuaries, November 2010.
17. “Accountable Care Organizations: An Untapped Opportunity”, Health Watch, Society of Actuaries, Issue 64, September 2010.
18. “Health Company Pandemic Modeling Tool”, Society of Actuaries, June, 2010.
19. “Adding Value to Plan Sponsors: Leveraging Your Captive and Self-Insured Plan Experience with ERM”, The Self Insurer, April 2010.
20. “A Catalyst for Change”, The Actuary Magazine, August 2009.
21. “U.S. Health Care System: Righting an Inversion”, Visions for the Future of the U.S. Health Care System, Society of Actuaries, May 2009.
22. “Pandemic Planning and Recovery”, Risk Management, Society of Actuaries, Issue 14, December 2008.
23. “2008 Year in Review”, Health Watch, Society of Actuaries, Issue No. 59, September 2008.
24. “Potential Impact of a Pandemic on the U.S. Health Insurance System”, Society of Actuaries, May 2008.
25. “A Healthy Future? Risks and Opportunities Facing the Health Profession”, The Actuary, Society of Actuaries, Vol. 5 No. 2, April/May 2008.
26. “Actuaries Advancing Public Health”, Health Watch, Society of Actuaries, Issue No. 58, May 2008.
27. “Maintaining Professional Relevance in a Rapidly Changing Environment”, Health Watch, Society of Actuaries, Issue No. 57, January 2008.
28. “Potential Impact of Pandemic Influenza on the US Life Insurance Industry”, Society of Actuaries, May 2007.
29. “Life Company Pandemic Modeling Tool”, Society of Actuaries, May 2007.
30. “Community Benefit: A Matter of Mission and Accountability”, Health Watch, Society of Actuaries, Issue No. 55, May 2007.
31. “Navigating New Horizons: An Interview with Eric Stallard”, Health Watch, Society of Actuaries, Issue No. 55, May 2007.
32. “Potential Impact of a Pandemic on the US Life Insurance Industry”, Life Chief Actuaries Forum, May 2006.
33. “Financial Services Convergence: Big Bang or a Whimper?”, The Actuary, Society of Actuaries, Vol. 2 No. 6, December 2005.