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Research

Medical Large Claims Experience Study

Experience Studies – Group Health

The Medical Large Claims Experience Committee, Committee on Health Benefit Systems Research and Health Section are pleased to announce the availability of the 1997–1999 Group Medical Insurance Database and Analysis Report. The database and report were prepared by Kyle Grazier and Bill G’Sell of the University of Michigan. The database is a follow-up to the 1991–92 Group Medical Large Claims Database.

The motivation for the study was to explore and analyze factors affecting incidence rates and the distribution of claim sizes. The database contains claims from three years: 1997, 1998 and 1999. While the 1991–1992 database focused only “large claims” (i.e., claimants with annual paid charges of at least $25,000), the 1997–1999 database contains all claimants, regardless of charge amount. Data from seven insurers are represented. For the three years combined, the database contains 4,294,030 claimants and total paid charges of approximately $7.1 billion.

Please note each of the annual database files are over 40 MB in zipped format. Therefore, depending on your internet connection speed, download times will vary. A CD-ROM containing the database is available for $15.00 from the Society of Actuaries.

Please contact Steven Siegel, SOA Research Actuary, or Korrel Crawford, SOA Research Administrator, if you have questions or would like to purchase the CD-ROM.