2012 SOA Health Meeting Session #23. The health insurance environment is rapidly changing not just because of government health care reform but also due to changes in the entire health care system. This session will attempt to explain how reinsurers will fit into this new environment including new and innovative products, ways to minimize insurance risk and future trends. Speakers will specialize in: 1. Major Medical and Stop Loss Medical; 2. Senior Medical---Medicare Advantage and Medicare Supplement 3. Specialty Health Products---Limited Medical, Student Health, Critical Illness, etc.

This year’s Survey, its sixth year, further reflects the impact of health care reform and the resulting prevalence of unlimited lifetime maximums on stop loss coverage. Of surveyed plans, 88% report such coverage –a steep increase from 13% in 2010. About half pair an unlimited lifetime with an interim annual maximum of $5 million or less. Premiums continue to rise (to no surprise)and are 60% to 70% higher than levels reported in our initial Survey in 2007. The primary focus of the Survey, current premium rates, is shown in the following graphs and tables.

This is a collection of four articles from the Reinsurance Section about various catastrophic medical excess lines of business - HMO Excess, Provider Excess, Employer Stop Loss, and Carrier Medical Excess. Basic coverages, design considerations and finance issues are discussed.

The economy and healthcare reform have significantly impacted health reinsurance markets. Attendees gain an understanding of recent developments in these markets including ceding carrier considerations, reinsurer considerations, the availability or lack thereof of various coverages in the marketplace. From the SOA 2011 Health Meeting, Session 39

Continuing healthcare inflation has created challenges for employers as well as health plans and reinsurers. This session will touch on cost drivers and strategies for cost containment and impacts in the underwriting, product development and marketing of insurance and reinsurance products. From the SOA 2010 Health Meeting, Session 29

This session discusses limiting risk in employee benefit programs. A variety of benefit programs will be discussed including medical cost analysis, risk assessment and stop loss modeling for self-funded employee benefit plans. From the SOA 2010 Health Meeting, Session 53

2010 Annual Meeting & Exhibit, New York. This session provided three perspectives on negotiating life reinsurance treaties: direct company, reinsurance company and reinsurance consultant. The following resource publications were discussed: 1. ACLI Life Reinsurance Treaty Sourcebook. 3. SOA Reinsurance Treaty Discussion Document. 2. Tiller’s Reinsurance Textbook. 4. NAIC Reinsurance Regulations.

Presentations on employer stop loss from the June 2009 SOA Health Meeting. Presentations discuss claim trends and diagnosis drivers, stop-loss reinsurance, and setting expectations for non-actuaries.

Excess Reinsurance is a coverage purchased by insurance carriers to limit loss in a year from any one claim. This article addresses the issues when purchasing medical excess reinsurance on a medical portfolio. The most important consideration in the reinsurance purchasing decision is determining the risk objectives of the organization. The proper risk analysis by the carrier or in conjunction with its reinsurer will address the following questions: What is predictable risk versus unpredictable risk?

This article addresses issues of importance to HMO excess reinsurance purchasers when negotiating a reinsurance treaty.