Description: This is a panel discussion session examining the future of individual comprehensive medical expense insurance including trends, state regulation, plan design, and financial experience. From Record Of The Society Of Actuaries Volume 8, Number 4

Description: 1993 SOA Spring Meeting, San Diego. This session discussed credibility theory. Areas addressed included defining credibility and the complexities of measuring it with an emphasis on group medical insurance.

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: More and more providers are desiring risk-based contracts instead of traditional FFS-based contracts. This session is intended to outline some of the actuarial best practices in risk-based contracting related to the many flavors of the CMS ACO programs, as well as Commercial risk-based contracts.

Description: This session discussion is about outside actuarial profession's perspective on health care cost, insurer's role in medical care management, relationships between treatment decisions, available coverage, appropriate use of underwriting and paying for uncompensated care. From Record of Society of Actuaries Vol. 18, No. 1A.

Description: 1993 SOA Spring Meeting, San Diego. This session is about heath insurance issues affecting the 25-250 life group market including marketing, rating, reinsurance, and products.

Description: This 1992 discussion is about the resource-based relative value scale [RBRVS]- where it is and where it's going, and its impact on trends, Medicare supplemental coverage, indemnity plans, and health cost projections. From the Record of the Society of Actuaries Vol. 18, No. 1A.

Description: This paper presents a method involving re-sampling 'with replacement but without random numbers', numerical convolutions for sums and quotients, and estimation of confidence intervals for trend in average size claim. In this paper, this method is applied to major medical claims.

Description: This report provides morbidity experience under Individual Loss-of-Time policies, 1974-1975.

Description: This presentation from Session 4PD of the SOA 1996 Orlando Annual Meeting provides an update on the issues addressed and findings reached by the American Academy of Actuaries [AAA] work group responsible for Medical Savings Accounts [MSAs]. From the Record of the Society of Actuaries, Vol. 22, No. 3.