Description: A proposal to address provider payment issues by gradually moving to accountable care organizations. Capitations would be risk-adjusted, non-capitated costs would be covered by hospitalization fund and stoploss, incentives for quality & effective preventive care would be tied to the amount remaining in the fund, and government involvement would be through incentives rather than mandate.

Description: An essay suggesting a health care financing system.

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: Panel discussion of prospects for cost containment of, and alternatives to, fee-for-service health care, and management of health care under national health insurance. Discussion points include cost containment devices, HMOs, economic impact, cost escalation, self-insurance, stop-loss, claims administration, loss of state premium taxes, and Phase 3 tax problems under NH1.

Description: A comparison of fully insured medical insurance to two self- funding alternatives , specific and aggregate and level funding .

Description: 1993 SOA Spring Meeting, San Diego. This session is about stop loss insurance and some of the issues associated with it. Product issues discussed included: 1. Issuance of stop-loss policies with internal limits that don't match up with the underlying plan document. 2. The use of 12/12 renewals under which the stop-loss policy only covers claims incurred and paid in the twelve-month contract period. 3. Offering two-year rate guarantees. 4. Offering of lifetime limits in excess of $1 million.

Description: Presentation at May 1996 Spring Meeting. This session takes a hard look at Lloyd’s of London, examines how it has reached its current state of affairs, the role of Equitas, the impact of corporate capital and the firm's outlook.

Description: This session from the 2003 SOA Spring Meeting discusses how the employer stop-loss market has experienced turbulence in recent years. Panelists discuss their views on this market, including market size and growth, whether or not pricing is softening, claim cost trends and underwriting. Session 3PD.

Description: Feature article discussing the American Academy of Actuaries Academy review of the various risk-based capital RBC formulas for health insurance products.

Description: First dollar carriers, stop loss carriers, and reinsurers play a different role in reimbursing healthcare claims. This article explores the reinsurer's role in reimbursing COVID-19 related claims.