Description: This paper develops a parametric model for health care insurance claims to fit parametric models to the data. Model selection is based on the ChJ-squared goodness-of-fit test and a comparison of the empirical limited expected value function to parametric limited expected value functions. A copula function was used to model the bivariate portion of the data. From Actuarial Research Clearing House 1993, VOL. 3.

Description: This paper explores the legislation of Mass 65, the intent of which was to offer health benefits to persons aged 65 and older without evidence of insurability. From TRANSACTIONS OF SOCIETY OF ACTUARIES, 1962 VOL. 14 PT. 1, NO. 40.

Description: This research material provides an evaluation and synthesis of the methodologies and data samples used on characterizing health care fraud

Description: This paper examines the details of group major-medical expense insurance, a disability coverage, also labeled as catastrophe coverage. From Transactions of Society of Actuaries 1951, Vol. 3, No. 7.

Description: The primary purpose of this paper is to present an alternative method of determining the profitability of the premium for a return of premium benefit through the use of a limited simulation program. Also discussed are necessary reserves for a return of premium benefit. From Transactions of Society of Actuaries 1973, Vol. 25, Pt. 1, No. 73.

Description: The principal objective of this paper is to remind actuaries of the rather significant misconceptions and distortions commonly encountered in the use of individual accident and health insurance loss ratios. From Transactions of Society of Actuaries 1979, Vol. 31.

Description: This paper discusses the purpose and nature of the benefit ratio [otherwise known as active life] reserve in relation to the class of health insurance contracts to which it is intended to apply. From Transactions of Society of Actuaries 1988, Vol. 40, Pt. 1.

Description: This report compares health care utilization and expenditures between individuals with Crohn’s disease who had used infliximab and those who had not. Claims data from the 1999-2003 Thomson Reuters MarketScan commercial claims and encounters databases and inpatient, outpatient, and prescription drug claims data of individuals older than 18 years of age with a diagnosis of Crohn’s were included.

Description: Discussion of accident and sickness policies, including issues with underwriting and points for improvement. Transactions of SOA Vol. 6 No. 16

Description: This paper describes a process for developing rates for a preferred provider organization [PPO]. From Transactions of Society of Actuaries 1985, Vol. 37.