Milliman Healthcare Investment Solutions

Milliman has developed Healthcare Inflation Strategies that are designed to meet or exceed the various components of healthcare cost inflation, while mitigating market declines.

Milliman has a unique combination of expertise and access

Healthcare Consultant

Since 1947
over 2,000 clients

  • Largest employer of healthcare actuaries in the world
  • Consulting to most major payers and providers
  • Detailed insights into industry risks

Index Provider

Since 2013
Publishing over 70,000 indices monthly

  • Leading actuarial market expertise in healthcare cost and trend forecasts
  • Development of Milliman's Health Trend Guidelines and resulting indices

Investment Advisor

Since 1998
$229.2B in AUA as of 9/30/2025

  • Risk management specialists
  • Trusted hedging provider to insurers
  • Leading subadvisor for annuities and ETFs
  • Trade implementation

How Milliman Healthcare Inflation Strategies Work

How The Health Trend Guidlines (HTG) Index Works

Step 1: Milliman collects historical claims data that is a few months lagged
Step 2: Milliman uses correlated up-to-date economic data to forecast the claims data
Step 3: The final index is published and the projected monthly HTG forecast value is used to determine investment allocations
Milliman FRM uses the HTG Index Forecast to allocate between various asset classes
JanFebMarAprMayJunJulAugSepOctNovDecJanFebMarAprMayJunJulAugSepOctNovDecMonthly InputsForecast DataHTG Index ForecastClaims CostsUtilization DataEnrollmentCPIPersonal IncomeWorking DaysSeasonality
Risk LevelRisk Level EquitiesCommoditiesandAlternativesActivelyManagedBondsHealth Trend GuidelinesIdentifies healthcareInflation trendsMilliman’s riskmanagement processFinal PortfolioAllocationHTG factorizationdetermines equitysecurity selectionHTGIndexForecast

Strategy Performance

PerformanceAs of 10/17/2025
3 MonthsYTD Total Returns1 Year3 Year5 YearSince Inception
(4/22/2024)
Milliman Healthcare Inflation Strategy10.41%16.95%12.19%--13.03%

Solid lines indicate actual historical data and performance. The dotted line for the HTG index represents the anticipated changes in the future levels of healthcare costs. Data for the HTG Index is lagged on a trailing 3-month basis and then combined with up-to-date economic data that is correlated with the costs of healthcare and used to forecast expected claims data for these services in the future. It is important to note that the indices created through the Milliman Health Trend Guidelines are not standard market indices. They do not measure the price or total return performance of specific securities, but rather serve as a guideline as to expected changes in the general cost of healthcare.

Top 10 Holdings

As of 09/30/2025
SymbolSecurityValueAllocation
XFIVBondbloxx Bloomberg Five Year Target Duration Us Treasury Etf$195,940.6842.6%
IAUIshares Gold Trust$149,324.0432.5%
SPYSpdr S&P 500 Etf Trust$17,320.683.8%
USD CASHUSD CASH$8,166.491.8%
UNHUNITEDHEALTH GROUP INC$7,941.901.7%
XHLFBondbloxx Bloomberg Six Month Target Duration Us Treasury Etf$7,613.421.7%
LLYELI LILLY & CO$6,104.001.3%
ABTABBOTT LABORATORIES $5,223.661.1%
JNJJOHNSON & JOHNSON $4,450.081%
TMOTHERMO FISHER SCIENTIFIC INC$4,365.180.9%
ABBVABBVIE INC$3,936.180.9%
Top 10 Holdings Total$410,386.3189.2%
RISK DISCLOSURES

Milliman Health Trend Guidelines ™ - a series of indices providing data on the cost, utilization, and unit cost of healthcare services - both in total and broken down separately for professional services, inpatient and outpatient services, as well as prescription pharmaceuticals. Data used to calculate the indices is provided by leading commercial health insurance plans and data firms that cover approximately 60 million insured individuals. Data is lagged on a trailing 3-month basis and then combined with up-to-date economic data that is correlated with the costs of healthcare noted above and used to forecast expected claims data for these services in the future. It is important to note that the indices created through the Milliman Health Trend Guidelines are not standard market indices.  They do not measure the price or total return performance of securities, but rather serve as a guideline as to expected changes in the general cost of healthcare. These expected changes inform the investment process for the Milliman Health Trend Managed Accounts.

Investments in a separately managed account ("SMA") are subject to market risk, including the potential loss of principal.

This Separately Managed Account (SMA) offering is intended exclusively for institutional investors. Participation is subject to a minimum investment requirement of $50 million.

Past performance is not indicative of future results. Performance may fluctuate across individual accounts depending on individual investment goals and objectives.

There is no guarantee that the investment objectives of the SMA will be achieved.

The SMA may incur fees and expenses, which will reduce the overall return on investment. Please refer to the fee schedule for detailed information.

Performance reports provided by the SMA are based on historical data and are for informational purposes only. They should not be relied upon as a sole basis for investment decisions. Any performance shown is "net of fees" referenced above.

Information provided by third parties, including market data and research, is believed to be reliable but is not guaranteed for accuracy or completeness.

The recipient should not construe any of the material contained herein as investment, hedging, trading, legal, regulatory, tax, accounting or other advice. The recipient should not act on any information in this document without consulting its investment, hedging, trading, legal, regulatory, tax, accounting and other advisors. Information herein has been obtained from sources we believe to be reliable but neither Milliman Financial Risk Management LLC ("Milliman FRM") nor its parents, subsidiaries or affiliates warrant its completeness or accuracy. No responsibility can be accepted for errors of facts obtained from third parties.

The products or services described or referenced herein may not be suitable or appropriate for the recipient. Many of the products and services described or referenced herein involve significant risks, and the recipient should not make any decision or enter into any transaction unless the recipient has fully understood all such risks and has independently determined that such decisions or transactions are appropriate for the recipient. Investment involves risks. Any discussion of risks contained herein with respect to any product or service should not be considered to be a disclosure of all risks or a complete discussion of the risks involved.

Milliman FRM is an SEC registered investment advisor (SEC#:801-73056) since 2012. You can find Milliman FRM's ADV filings at https://adviserinfo.sec.gov/firm/summary/159377.

Investment Products Offered:

Are Not FDIC Insured | May Lose Value | Are Not Bank Guaranteed