Tom Doran is the President of Highmark Health Plan. In this role, Tom is responsible for Commercial and Government segments, enrollment, revenue and profit/loss. He's also responsible for Financial Planning & Analysis, Actuarial, Underwriting and Network contracting. Tom brings the voice of the customer and member to our organization, driving new and innovative products and improved clinical outcomes.
He has also prioritized and optimized cross-selling for Highmark, capitalizing on opportunities for our customers to achieve better clinical outcomes and lower costs by pairing health insurance with our diversified business offerings including stop-loss insurance (HM Insurance Group), dental (United Concordia Dental) and pharmacy.
Tom joined Highmark in 2017 as the President of HM Insurance Group (HMIG) and continues to serve on the board for HMIG. In 2019, he took on the additional responsibility of CFO for Highmark Health Plan, and eventually transitioned to a COO role for the Health Plan.
His areas of expertise include Stop Loss market dynamics and strategy, reinsurance, actuarial services, network contracting, pricing and reserving. With more than 20 years of experience in the insurance industry, Tom came to Highmark from Medical Risk Managers (MRM), the largest Stop Loss MGU in the country, where he served as the company's president. Prior to that, Tom held the role of executive vice president at MRM, and he has actuarial experience at Aetna, Hartford Life and Aon Hewitt.
Tom earned a Bachelor of Science degree in Mechanical and Aerospace Engineering from Princeton University and worked as an Aerospace Engineer for Grumman Aerospace upon graduation. He is a fellow of the Society of Actuaries and a member of the American Academy of Actuaries.
Current Board of Director affiliations include:
Autism Speaks – Western PA
Children's Institute of Pittsburgh.
Light of Life, Pittsburgh
Thought Leadership Topics:
Optimizing remote workforce in sales and underwriting capacity
Predictive modeling application for underwriting and actuarial
Enterprise strategy development and implementation
All references to “Highmark” in this document are references to the Highmark company that is providing the member’s health benefits or health benefit administration and/or to one or more of its affiliated Blue companies. This website is operated by Highmark, Inc. and is not the Health Insurance Marketplace website. It also does not display all Qualified Health Plans available through the Health Insurance Marketplace website. To see all available Qualified Health Plan options, go to the Health Insurance Marketplace website at HealthCare.gov.
Highmark Blue Cross Blue Shield or Highmark Blue Shield are Medicare Advantage HMO, PPO, and/or Part D plans with a Medicare contract. Enrollment in these plans depends on contract renewal. ®Blue Cross, Blue Shield and the Cross and Shield symbols are registered service marks of the Blue Cross Blue Shield Association, an association of independent Blue Cross and Blue Shield plans. Benefits and/or benefit administration may be provided by or through the following entities, which are independent licensees of the Blue Cross Blue Shield Association: Western and Northeastern PA: Highmark Inc. d/b/a Highmark Blue Cross Blue Shield, Highmark Choice Company, Highmark Health Insurance Company, Highmark Coverage Advantage Inc., Highmark Benefits Group Inc., First Priority Health, First Priority Life or Highmark Senior Health Company. Central and Southeastern PA: Highmark Inc. d/b/a Highmark Blue Shield, Highmark Benefits Group Inc., Highmark Health Insurance Company, Highmark Choice Company or Highmark Senior Health Company. PA: Your plan may not cover all your health care expenses. Read your plan materials carefully to determine which health care services are covered. For more information, call the number on the back of your member ID card or, if not a member, call 866-459-4418. Delaware: Highmark BCBSD Inc. d/b/a Highmark Blue Cross Blue Shield. West Virginia: Highmark West Virginia Inc. d/b/a Highmark Blue Cross Blue Shield, Highmark Health Insurance Company or Highmark Senior Solutions Company. Visit our website to view the Access Plan required by the Health Benefit Plan Network Access and Adequacy Act. You may also request a copy by contacting us at the number on the back of your ID card. Western NY: Highmark Western and Northeastern New York Inc. d/b/a Highmark Blue Cross Blue Shield. Northeastern NY: Highmark Western and Northeastern New York Inc. d/b/a Highmark Blue Shield.
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