Description: Presented at October 1985 Annual Meeting. This session is about actuarial implications of individual choice, antiselection problems for medical coverages, plan design considerations, flexible benefits program experience, impact of alternative delivery systems on insured plan.

Description: The question of sex discrimination in employee pension plans in life insurance programs is only part of the more general issue of risk classification. Challenges to the old ways of classifying risks are not limited to pensions or to life insurance. It also impacts auto insurance, health insurance, and all other areas. However, for this discussion we will concentrate on sex discrimination in pension and retirement plans. From Record of the Society of Actuaries 1979, Volume 5, No. 1.

Description: This session discussion is about the effect of solvency concerns on health insurers: NAIC proposed risk-based capital formulas, typical return on equity for health business, rating agency formulas and volatility measures for loss ratios. From Record of Society of Actuaries Vol. 18, No. 1B.

Description: The Health Section Research Team is pleased to make available the following research study and Excel model that provide a framework for estimating the financial impact of health plan provider network risk. The research was conducted by the Denver office of Milliman, Inc. The Excel workbook allows the user to assess cost implications of aspects of network risk under various assumptions. The assumptions in the workbook can be altered by the user and be applied to test a range of scenarios.

Description: This 1993 paper examined the premium rate changes that could have resulted from the passage of The Health Insurance Reform and Cost Control Act of 1991. From Actuarial Research Clearing House 1993, VOL. 3.

Description: Discover the key components of value-based care (VBC) contracts and their impact on provider credibility. Learn about benchmarks, measurement period results, and the unique challenges providers face in managing insurance risk. Gain insights into reducing costs and aligning financial incentives in the US healthcare market.

Description: Panelists report on the status of activities by national associations in regard to risk-based capital requirements for health insurers. From the Record of the Society of Actuaries, Vol. 24, No. 2.

Description: The Health Section Research Team is pleased to make available the following research study and Excel model that provide a framework for estimating the financial impact of health plan provider network risk. The research was conducted by the Denver office of Milliman, Inc. The Excel workbook allows the user to assess cost implications of aspects of network risk under various assumptions. The assumptions in the workbook can be altered by the user and be applied to test a range of scenarios.

Description: After the bid process, desk review, rebate reallocation, an “enjoyable” audit, and open enrollment; the Medicare plan year starts. Throughout the year, organizations find it pertinent to get an accurate picture of their Part D liability as reinsurance, LICS (Low Income Cost-Sharing) subsidy, and risk corridors are accrued. Attendees will learn about the basics of Part D accruals, how future accrual amounts are estimated based on patterns in the data, and how bid assumptions versus actual results impact plan sponsor profitability. We will also discuss financial statement treatment of these items. Real-life examples from bids to outcomes will be provided to enhance the discussion. Ultimately, attendees will come away with a deeper understanding how their bid assumptions play out, and how they can use Part D accruals to plan for future bid development.

Description: This article compares three potential approaches to determining new coefficients for health-based risk scoring models: full recalibration, p-value credibility weighting, and penalized ridge regression.