Description: This is a brief report that summarizes recent changes in the prevalent medical loss ratio methodologies and also looks at some of the more recent experience of health insurers that filed medical loss ratio reports.

Description: With the increase of membership in Blue Cross / Blue Shield, this paper presents the practices and experience under the plans using the United Medical Service, Inc as a model. Transactions of SOA Vol. 6, No. 14

Description: This paper examines the financial dynamics resulting from the currency exchange rate for medical insurance products that are denominated in a currency different from that in which covered medical expenses are incurred. From Transactions of Society of Actuaries 1995, Vol. 47.

Description: This paper presents Bayesian models for analysis of claim lag data. The analysis of claim runoff patterns investigate the extraction of information on trend and seasonal patterns in incurred claims. This is investigated on the basis of individual group data, and also relative to a larger aggregation of pooled experience. The models are implemented based on Markov chain Monte Carlo methods. The models are applied to examples using simulated claim lag data. From Actuarial Research Clearing House, 2003, Vol. 1.

Description: 1973 SOA Annual Meeting. This paper provided summaries of several concurrent sessions from the referenced meeting including: 1. NEW DEVELOPMENTS IN GROUP LIFE AND HEALTH PROGRAMS. 2. MARKETING INDIVIDUAL ORDINARY INSURANCE. 3. ACTUARIAL LITERATURE. 4. INDIVIDUAL DISABILITY INCOME INSURANCE. 5. GROUP SURVIVOR INCOME BENEFITS. 6. GROUP LIFE AND HEALTH - EXTERNAL DEVELOPMENTS. 7. PENSION PLAN FINANCIAL REPORTING.

Description: The birthday rule is used to determine whether the father's or the mother's insurer is liable for a child's medical bills, where the liability rests with the insurer of the parent whose birthday falls in the first half of the year. It is assumed that the odds are even that the liable insurer will be the mother's, vs. the father's. This paper demonstrates how the key determinant of whether this assumption is valid is the distribution of the difference in spouses' ages.

Description: This paper proposes a hypothesis that the negative public policy implications of durational rating strategies in the medical insurance market are caused by lack of prefunding of durational deterioration of experience and constitute a failure to maintain an important part of the original insuring promise. To solve the problem, a practical and simple reserving basis is proposed as a regulatory standard. Discussions of this paper are included.

Description: 1959 SOA Regional Meetings in Atlanta and San Francisco. These panel discussions reviewed procedures, techniques and vehicles used to provide benefits to retired employees. The panels also discussed Group Insurance Dividends and Major Medical issues.

Description: The actuarial committee that authored this report developed a model to estimate the revenue the tax would generate. The results point out key considerations for an excise tax on high cost health plans, including the wide range of results generated by sensitivity to certain assumptions.

Description: This is a discussion about long-range plans being used as management tools in the life insurance business. Also discussed are the implications that Medicaid will have on the private health insurance business. From Transactions of Society of Actuaries 1966, Vol. 18 Pt. 2, No. 51.