Description: Panelists at this session of the SOA 1995 Vancouver Spring Meeting discuss the financial implications of managed care for health insurance profitability. Factors that affect profitability for managed care companies and health insurance companies are discussed.

Description: As actuaries in health care, we spend most of our time focused on reviewing claims, enrollment and clinical data. That information is captured while patients are in health care facilities. Yet most people spend only a small fraction of their time in these facilities. This article explores what types of data are available to actuaries the provide a more holistic view of the member so that a members physical and emotional needs, the social determinants of health can be taken into consideration along with their clinical needs. Two uses cases are presented so actuaries can see how these types of analyses can be leveraged to improve clinical, operational, and financial performance of risk bearing health entities. Understanding the customer (member) not just the patient enables actuaries to provide new insights and values to our stakeholders across a wide range of business and risk applications.

Description: Panelists discuss potential effects on the health insurance system and implications of future developments in genetic technology. From the Record of the Society of Actuaries, Volume 28, No. 3, Session 53.

Description: This paper explores how change in societal forces can affect the systems for providing security including private pensions, social security, life insurance and health insurance. The societal forces examined are changes in family, role of women, inflation and the age composition of population. From Transactions of Society of Actuaries 1978, Vol. 30.

Description: This report has been assembled by the Task Force as a comprehensive guide to practicing actuaries in evaluating the impact of AIDS on the solvency of life and health insurance companies in the US and Canada. From Transactions of Society of Actuaries 1988, Vol. 40, Pt. 2.

Description: Describes a process to develop a good forecast. Also provides an example.

Description: Presentation at October 1985 Annual Meeting. This session will discuss trends in medical technology as they affect health care benefits programs, including: life extension, organ transplants, high-cost procedures, and plan design.

Description: This article discusses the potential characteristics of health care reform and the associated impact on small insurance companies.

Description: Intended for actuaries interested in understanding more about the Medical Loss Ratio and the impact Quality Improving Activities (QIA) and fraud reduction expenses have on the rebate calculation. This session will focus on what expenses qualifies as QIA, examples of programs from major carriers, current regulations and the differences between commercial, and Medicare, and Medicaid requirements.

Description: This article exams societal trends that may influence retirement patterns and presented retirement scenarios. From The Actuary Vol. 24, No. 12