Description: This session discussion is about surplus requirements, unique health insurance surplus needs, and the impact of A.M. Best and other rating agencies. From Record of the Society of Actuaries Vol. 15, No. 1

Description: This article examines two general approaches to pricing The Forecast Approach and the Rebuilding Approach. The author then supplies the reader with the best approach. From Health Watch Newsletter, March 2005, Issue No. 49.

Description: Discusses how a small health insurance company may be able to create and successfully maintain its wealth through careful actuarial model considerations used in calculating reserves. A traditional and a conservative approach to calculating the reserves are compared. The conservative approach was found particularly useful when estimating reserves for an individual health insurance company with numerous product lines each relatively small in volume.

Description: The process of setting initial and renewal premium rates for small group medical block of business using risk characteristics. Presents three pricing schemes and compares profitability Following the Curve, Lowest Best Rate and Highest Worst Rate.

Description: Presented at June 1985 Spring Meeting. This session discussed factors affecting the design of flexible benefits programs: choice of benefits, cost containment, tax effectiveness of benefits.

Description: Presented at June 1996 Spring Meeting. This discussion looks at redirecting the traditional role of the actuary into new areas such as working with doctors to deal with medical management issues, dealing and negotiating with providers and how to help the company develop a provider payment strategy. Employers negotiating directly with providers is also discussed.

Description: Presented at October 2001 Annual Meeting. Topics covered in this session include Internet-based health plan exchanges, defined-contribution health plans, self-directed health plans, personal spending accounts, and episodic based reimbursement to insureds.

Description: Presented at September 1995 Valuation Actuary Symposium. Discusses the Health Organization Risk-Based Capital formula.

Description: This session discussion is about the valuations applicable to health business including cash flow analysis, scenario testing, and reserving. From Record of the Society of Actuaries 1988 Vol. 14, No. 3.

Description: This article describes methodologies for detection and deterrence of Medicare fraud. It also describes the validation of PRIDIT for fraud detection in Medicare.