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: 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: 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: 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: Article discussing how the pursuit of value-based care as a consequence of health care reform laws such as the Affordable Care Act (ACA) and the Medicare Modernization Act has accelerated the use of risk adjustment and what it means to actuaries.

Description: During the past few years, performance, cost, and risk trends for Medigap products have undergone substantial changes. Some of these trends could ease cost pressures on Medigap insurers, while others might increase them. Part 1 of this Issue Brief article discusses current changing trends and considerations around about how they are impacting Medigap.

Description: NAIC Health Update by Rowen B. Bell from Health Section News, June 2002, Issue No. 46.

Description: This article discusses the court cases dealing with the severability of the individual mandate from the Affordable Care Act. Severability is related to essentiality, and actuarial input was relied upon to determine essentiality. The article concludes with lessons that actuaries should learn from the legal proceedings.

Description: Updates on the efforts of the Academy’s health practice council. its work groups and task forces, to educate health care policymakers on issues including health care reform, Medicare, loss ratios, premium review, reinsurance, benefit and eligibility changes, exchanges, and risk based capital.

Description: Key aspects of credibility formulas & modeling, experience data requirements Issue No. 37.