Description: To inform and educate stakeholders for health plans and insurers on novel ways to optimize reinsurance structures to meet capital related goals and boost RBC and liquidity ratios. In lieu of traditional market-based financial instruments involving equity and/or debt, a quota share transaction can be used with potentially far more attractive terms and achieving essentially the same result.

Description: Each health plan is unique, and different factors must be considered when making a decision regarding reinsurance deductibles. This overview offers considerations when selecting a medical excess deductible for commercial, Medicare and Medicaid programs. It is more applicable for large payers, such as HMOs, rather than self-funded employers because there’s usually not enough claims data to warrant such analysis on any given employer group. From Reinsurance Section News, May 2005, Issue No. 55.

Description: LEARN is an offering to regulators about reinsurance. This article summarizes a session held for Brazilian health regulators in the fall of 2022.

Description: This article talks about ASOP No. 11, The Treatment of Reinsurance Transactions Reflecting Life or Health Insurance Risks in Financial Statements. Section 3.5, Additional Liabilities.

Description: Specific and aggregate stop loss insurance reinsurance is a product that has unique characteristics. The product is a special type of policy that covers employers or their self-funded employee benefit plans for larger health claims. The product has some unique reserving challenges for the health/reinsurance actuary.

Description: Cell and Gene Therapy (CGT) are life-changing treatments where conditions such as cancer, hemophilia, spinal muscular atrophy and blindness are being cured. These are great for individuals and society, but the treatment costs are expensive which is bad for payers and reinsurers. This article explores ways for health reinsurance actuaries to participate in the space and evaluate the risk associated with these treatments

Description: This article describes the common uses , reinsurance structures , advantages , and risk- based capital repercussions of utilizing a captive to accept health care risks .

Description: This article attempts to make a modest contribution to the dialogue on the potential and risks associated with novel treatments such as cell & gene therapies. With a fast-expanding roster of what are believed to be one-time treatments at ever increasing price points aimed at curing a wider swatch of the population, they are as much a source of relief for patients stuck in medical limbo, as they are a source of anxiety for payers.

Description: This article enumerates many important considerations for a managing general underwriter(MGU) desiring to contract with an insurance carrier to issue and service provider excess of loss policies covering catastrophic medical risks assumed by accountable care organizations (ACOs).

Description: Medical stop-loss reinsurance continues to play a vital role in containing employers’ health care costs. Managing general underwriters [MGUs], who originally handled these programs, have lost market share to large direct writers. This article discusses how health care reform and highly disciplined underwriting tools offer growth opportunities to MGUs.