Health Consulting Services

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The Health Consulting Services Division provides professional services to state and federal regulators. Our team is comprised of seasoned regulatory professionals skilled in managing audits, examinations, and investigations across the full spectrum of complex health insurance regulations and reforms.

Major Areas of Specialization

  • Compliance with the requirements of the Affordable Care Act (ACA)
  • Mental Health Parity and Addiction Equity Act (MHPAEA) specialist reviews
  • Review of Life and Health form filings for federal and state health regulations
  • Qualified Health Plan Certification Application Materials and Review Tools
  • Comprehensive and targeted market conduct examinations, including MHPAEA Compliance, Reproductive Health Benefits, Essential Health Benefits, Preventative Services Benefits
  • No Surprises Act (NSA) enforcement with a focus on qualifying payment amount (QPA) audits and overlapping specified state law
  • Transparency in Coverage data and the Claims Payment Policies
  • Network Adequacy reviews
  • Pharmacy Benefit Management (PBM) audits
  • Drug formulary and pharmacy claim reviews
  • Clinical Pharmacy-focused EHB, Clinical Appropriateness, and MHPAEA reviews
  • Training, audit design and development, and process improvement
  • Health regulation research projects for state and federal partners
Division Leadership

Mitchell Ristine, JD, CIE, FAHM, MCMAssistant Director and In-House Counsel

Mitchell began his regulatory career in 2014 working with the Minnesota Department of Commerce as a…

Melinda Domzalski-Hansen, MCM, AIE, PAHMSenior Manager

Melinda Domzalski-Hansen has worked in the insurance industry for 20 years. For the first half of…

Reba Leonard, CIE, CRMP, FAHM, MCMManager

Reba Leonard has more than 30 years’ experience as an analyst, project manager, regulatory affairs consultant,…

Caroline Bergh, CIE, FAHM, MCMManager

Caroline began her career in insurance regulation and compliance at Examination Resources performing market conduct exams…

Chris Cagle, JD, CIE, MCMSupervisor

Chris is the Supervisor of the qualifying payment amount (QPA) Audit team and leads ER’s consulting…

Whitney Ederer, JD, MPH, CIE, FAHM, MCMSupervisor

Whitney began her regulatory career in 2017 working with the Wisconsin Department of Health Services within…

Tiffany Caverhill, CIE, HCP, MCMAssistant Supervisor

Previous to joining ER in 2021, Tiffany worked for the Office of the Montana State Auditor,…

Maggie McCandless, PhD, MEd, CIE, FAHMAssistant Supervisor

Maggie is an Assistant Supervisor of Examination Resource's MHPAEA NQTL Team. She is an applied sociologist…

Rebecca Palasek, CIE, FAHM, FHIAS, HCP, MCM, MHPAssistant Supervisor

Rebecca is the Assistant Supervisor of the QPA Audits team for ER’s health consulting division. In…