Description: Chronic Kidney Disease (CKD) affects many lives and has a large impact on health systems around the world. To better understand and predict costs for insurance plan members with CKD in the United States, we built a new model of their individual costs. Our model is the first to explicitly model both the CKD stage transition process and the distribution of costs given those stages.

Description: This article provides an overview of critical illness insurance: history, product description, and the three primary ways to offer critical illness coverage in the United States. This article also contains an illustration of an issue age premium rate calculation, as well as product features and rating applications specific to the various types of critical illness coverage.

Description: Follow up to the study 2014 GLTD Termination Table study. Reporting on recent experience and relative to the parameters underlying that table examined.

Description: In 2018, the Financial Accounting Standards Board (FASB) adopted significant revisions to the U.S. GAAP insurance accounting literature, via Accounting Standards Update (ASU) 2018-12. The title of ASU 2018-12 is “Targeted Improvements to the Accounting for Long-Duration Contracts,” and as a result a common acronym for ASU 2018-12 is LDTI (long-duration targeted improvements).

Description: The report looks at the different outcomes for the 50 states from the ACA, in terms of cost and availability of health insurance coverage. It identifies 11 key observations since the passage of the ACA.

Description: Predicting mortality (or longevity) and measuring the associated risk are the keys to the success of insurance business. Underwriting has been used for years for this purpose and approved effective. Currently, underwriting has been focusing on human physical conditions such as BMI, blood sample, medical history, and others, as well as severe mental diseases; occasionally, there are mental health assessments such as mental illness or cognitive testing that have been used in underwriting Life or Long-Term Care (LTC) business.

Description: Presents a step-by-step methodology for calculating confidence intervals for IBNR estimates derived using the Averaqe PMPM method. It is a companion article to the January 2023 Health Watch article presenting the Average PMPM method for generating point estimates of IBNR with zero claims runout.

Description: This session from the 1992 Valuation Actuary Symposium covers recoverability and loss recognition including using cash flow testing to determine loss recognition or recoverability, actuarial standard of practice 14, and valuation work by line of business or issue-year groups.

Description: In preparing claims reserves in the annual statement, health insurers and their opining actuaries will generally include a provision for adverse deviation (PAD) in their reserved amount in order to satisfy language in both in the National Association of Insurance Commissioners (NAIC) Health Annual Statement Instructions and in Actuarial Standards of Practice. This article explores the total level of PAD (both implicit and explicit margin combined) included in the reported claims reserves by examining NAIC filing data from 2016 through 2022.

Description: This 1990 Valuation Actuary Symposium session is an open forum on short-term and intermediate risks in health insurance today. This forum will also discuss HMOs and the valuation actuary.