Description: The U.S. health care industry has gone through a dramatic change during the past several years. The business model has moved from a risk selection model to a risk management model. People can shop online for their health care coverage. Everyone is welcome! Annual and lifetime dollar limits, underwriting and the pre-existing conditions exclusion are all in the history book now. Facing the challenges of the post-reform era, many health insurance carriers began using big data analytics on all aspects of their decision-making processes. The goal is to be able to compete on analytics in this quickly changing environment. However, becoming an analytics competitor is not easy. It requires the belief from the leadership and a group of dedicated analytical professionals to solve emergent business problems that existing strategies cannot address in an evolving market. These problems include marketing for acquisition and retention, coding accuracy, revenue growth, health care disparity, payment integrity, quality of care, health care cost reduction and, ultimately, personalized care management. In this section, audience will learn a basic understanding of the role of predictive analytics in US Healthcare marketplace.

Description: In the United States, there has been much industry discussion of the challenges associated with a sustained low interest rate environment, which impacts both the asset and liability sides of the balance sheet in unfavorable ways. The intent of this article is not to focus on these strategic issues. Rather, we attempt to shine a spotlight on some of the modeling challenges that practicing actuaries may experience when incorporating negative interest rates into their models.

Description: 1) Vision of the applications and development of data analytics in life insurance industry in Asia; 2) How big is the pie and what are the current obstacles insurers are facing; 3) Utilization of data and analytics target operating models as a competitive advantage, with focus on future readiness, controls, efficiency and effectiveness; 4) Potential roadmap ahead: a) Assessment of the current state of maturity levels of data and analytics initiatives; b) Identification of technology and competency gaps; c) Establishment of data integration and management process within BUs, alignment of advanced analytics tools across departments, with centralized data governance, technology structure and decision making framework; d) Definition of criteria and metrics to measure key outcomes and business value added. 5) Case study on agency behavior management: a practical example on how data analytics is being used in practice: (a) key business objectives: improve agent behaviors and maximize productivity with the lowest possible compensation costs; (b) data collection and current state assessment; (c) detailed predictive modeling process, modeling outcomes, and business implications; (d) implementation and monitoring process.

Description: "Explore a general introduction to the opportunity of applying a relatively newer area in machine learning called uplift modeling, which has been successfully used in retail (Wayfair etc). The concepts are parallel to the intervention programs in health care, where we are interested in measuring the treatment effects and ultimately directing the right members to the most effective programs, driving the highest value for the programs both from a financial and health outcomes perspective. Uplift modeling can also be viewed in context of causal modeling where we are interested in assigning cause to a treatment relative to a member not receiving the treatment. Check out an introduction on the concept, seehow it relates and builds on existing work, and use a demo to showcase the potential of integrating this ML approach to current work."

Description: Discussion on modeling Medicare Supplement insurance and the considerations when choosing an Actuarial Modeling Software (AMS). Focuses on model risk management, key modeling assumptions and inputs, and the complex interactions between modeling assumptions and why its critical to have a model that can handle that complexity. This article also touches on the incorporation the of accounting and regulatory regimes into the model, including Statutory, GAAP (Legacy and LDTI), and Tax regimes, and the modeling considerations for sensitivity testing and capital planning. Lastly, the article highlights the capabilities to look for when choosing an AMS for Medicare Supplement

Description: This article is the final installment of our three-part series on economic scenario generators (“ESGs”). Part I and II were published in the November 2019 and August 2020 issues of The Modeling Platform. Part III contextualizes the framework for selecting, building, and validating ESGs and focuses on the Academy Interest Rate Generator (“AIRG”), the most commonly used real-world ESG for US actuaries

Description: This article is the first installment of a three-part series that aims to provide an overview of ESGs and will focus on the general motivation for stochastic modeling, its advantages and its limitations. Future articles will further break down the key factors of ESGs and the application of these factors to better understand the Academy Interest Rate Generator (AIRG).

Description: 2003 Valuation Actuary Symposium, San Diego, CA. In this Teaching Session the instructor discussed the importance of making sure the correct inferences were drawn from stochastic testing exercises. Topics included: 1. Applying the assumption of a normal distribution. 2. Drawing inferences about, and creating confidence intervals around, a population mean. 3. Drawing inferences about, and creating confidence intervals around, tail percentiles. 4. Certifying anticipated mortality under XXX in a mathematically concise way.

Description: Market consistent valuations require path-dependent discounting for scenarios. IFRS 17's requirement to discount best-estimate cashflows using locked-in rates could give non-sensical results in many instances. This article describes a technique for calibrating each of the scenario's cashflows so that they can be discounted with other discount factors or curves without distorting the value of underlying options and guarantees.

Description: According to the Actuarial Standards Board’s Actuarial Standard of Practice No. 49 (ASOP 49), actuarially sound Medicaid managed care capitation rates will include a provision for underwriting gain in order to provide compensation for the risks assumed by an MCO. However, there is no generally accepted method for quantifying underwriting gain in managed Medicaid capitation rates. This article discusses a new model developed to address this void and calculate underwriting gain. The model was developed by researching existing financial literature and performing a statistical analysis of industry data to build out a framework that can be leveraged to estimate underwriting gain.