Description: Diabetes mellitus type 2 is an excellent model for assessing the setup of medical coverage in the U.S. health care system. It is a chronic disease that has genetic, behavioral and other medical causes, and causes many complications over the long term. From Financing Chronic Care Monograph, M-HB05-1.

Description: Results of an SOA survey regarding the expectation for 2015 accruals for 3Rs and cost sharing reduction payments

Description: Pricing Small Group Medical Coverage Renewal Pricing regression to the mean, blending of experience and manual rates, small group reform laws. Issue No. 40.

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: Changes introduced by various Medicare Alternative Payment Models and the Medicare Access and CHIP Reauthorization Act (MACRA) have accelerated an existing market trend of shifting some of what has traditionally been considered “insurance risk” to providers. The Provider Risk Sharing Boot Camp will give attendees deeper insights into methods, current thinking, and alternative solutions that actuaries can use to help providers understand and manage the financial and actuarial risks that they are taking, many for the first time.

Description: This is the twenty-seventh annual report on the continuing study of the morbidity experience of Group Weekly Indemnity insurance. The report contains experience for the years 1969, 1970, 1971, 1972, and 1973.

Description: 1998 Valuation Actuary Symposium. The speakers presented a case study on long-term-care gross premium valuations, GPV from an individual disability income perspective, and a case study for a medical GPV.

Description: This is the 1979 report on the continuing study of the morbidity experience of Group Weekly Indemnity insurance.

Description: In Medicaid rate development, actuaries have not historically shared models that developed the margin (i.e., underwriting gain) assumption. This is unfortunate, given the margin assumption is one of the most critical components of the rate development in ensuring financial solvency of the Medicaid managed care organizations (MCOs). In this session, we will discuss the primary components of the this assumption and will share working models that help actuaries quantify these components—including the cost of capital and risk (or contingency) margin. We expect a lively discussion as we “open the black box” and discuss these actuarial assumptions in the public for the first time.

Description: 1993 SOA Spring Meeting, San Diego. This session is about heath insurance issues affecting the 25-250 life group market including marketing, rating, reinsurance, and products.