A medical marker is a measurement based on the result of a medical or laboratory test which indicates directly or indirectly the presence of a disease or medical condition and that is expected to correlate with future mortality. The range of possible values for this measurement allows for stratifying tested subjects into different mortality risk pools. For our purpose, we will be looking at all cause mortality as the risk.

The life insurance industry has relied on medical markers to stratify their applicant pools for many decades. From the urine dipstick to PSA testing, the industry has incorporated tests that provide cost effective risk stratification to the underwriting process.

As more and more tests are developed and even directly marketed to the general public, it is important to do a periodic review of what is newly available in the world of laboratory testing and what can be profitably and justifiably incorporated in the underwriting process.

Purpose

The purpose of this project is to systematically identify laboratory tests that are not currently widely used in the life insurance industry but could have a potential use in the underwriting process. It is also to objectively determine the cost and benefit of each test that is identified as potentially useful.

The overall objective for this project is to identify markers that would provide useful and usable information for the underwriting process - that is to say, information that allows cost effective distinctions regarding overall mortality. This is to be accomplished by identifying, reviewing, compiling and analyzing data and findings from existing literature/studies and, if possible, looking at actual mortality data.

We expect that there would be between ten and twenty markers identified as potentially useful. Should the list of markers be significantly different from that expected number, further discussion between the Project Oversight Group and the researcher(s) would be needed to bring the scope back to an equivalent level of depth.

Working closely with the insurance labs will be essential to this project's success.

Tests must be tests that are currently run by U.S. commercial laboratories.

The researcher(s) will summarize findings in a report that addresses at a minimum the following items:

• What lab tests were considered for analysis and why?
• What lab tests were not considered for analysis and why?
• What data sources and literature reviews were analyzed?
• What is the cost benefit analysis method selected to evaluate each test?
• Does the test provide information not currently available (i.e. independent from information from existing tests)?
• If the test does not provide new information, is there still an advantage in using it and why?
• Is mortality data available and what does it show regarding that test?
• Based on the findings, identify areas where further research is needed.

The ultimate findings must be demonstrably free from bias towards any specific laboratory. Recommendations regarding the adoption or rejection of any lab test for underwriting purpose should not be made or suggested. The report must maintain a neutral, factual and unbiased approach.

The researcher(s) will work closely with a Project Oversight Group (POG) in finalizing the list of issues the research will address. The researcher(s) will also provide the POG with periodic progress reports and meet on a regular basis as needed. Members of this group will provide feedback and guidance to the researcher(s) as needed.

A relatively short-term project is envisioned with results within 6 months from the starting date.

To facilitate the evaluation of proposals, the following information should be submitted:

• Resumes of the researcher(s), including any graduate student(s) expected to participate, indicating how their background, education, and experience bear on their qualifications to undertake the research. If more than one researcher is involved, a single individual should be designated as the lead researcher and primary contact. The person submitting the proposal must be authorized to speak on behalf of all the researchers as well as for the firm or institution on whose behalf the proposal is submitted.
• An outline of the approach to be used, emphasizing issues that require special consideration. Details should be given regarding the manner in which appropriate published material will be identified, search techniques to be used, collateral material to be consulted, and possible limitations of the review and analysis. Time periods proposed to be examined should be noted in this outline.
• Cost estimates for the research, including computer time, salaries, report preparation, research costs, etc. Such estimates can be in the form of hourly rates, but in such cases, time estimates should also be included.
  
  Any guarantees as to total cost should be given and will be considered in the evaluation of the proposal. While cost will be a factor in the evaluation of the proposal, it will not necessarily be the decisive factor.
• A schedule for completion of the research, identifying key dates or time frames for research completion and report submission. The research should be completed in a time frame covering no longer than six months.
• Ideas regarding the form and distribution of the final report, both for immediate release and for permanent reference (e.g., submission to North American Actuarial Journal or other refereed publication, SOA Monograph Series, CD ROM).
• Other related factors that give evidence of a proposer's capabilities to perform in a superior fashion should be detailed.

The SOA's Reinsurance Section Council (RSC) is responsible for the selection of the proposal to be funded. Input from other knowledgeable individuals also may be sought, but the RSC will make the final decision. The SOA's Research Actuary will provide staff actuarial support. A Project Oversight Group (POG) will be appointed by the RSC to oversee the project upon selection of the proposal.

Any questions regarding this RFP should be directed by fax or e-mail to:

Ronora Stryker
SOA Research Actuary
e-mail: rstryker@soa.org
f: 847.273.8514

If you intend to submit a proposal, please send written notification by October 8, 2010 to:

Jan Schuh
SOA Research Administrator
e-mail: jschuh@soa.org
f: 847.273.8556

Please e-mail a copy of the proposal to:

Jan Schuh at jschuh@soa.org

Proposals must be received no later than October 15th, 2010. It is anticipated that all researchers who have submitted proposals will be informed of the status of their proposal no later than November 19th, 2010.

Note: Proposals are considered confidential and proprietary.

The Society of Actuaries reserves the right to not award a contract for this research. Reasons for not awarding a contract could include, but are not limited to, a lack of acceptable proposals or a finding that insufficient funds are available to proceed. The Society of Actuaries also reserves the right to redirect the project as is deemed advisable.

The Society of Actuaries intends to copyright and publish the results of this research. The research will be considered work-for-hire and all rights thereto belong to the Society of Actuaries. However, appropriate credit will be given to the researcher(s).