Description: Feature article discussing the impact of health care reform on the direct insurance market and the reinsurance market.

Description: An update on HMO market trends and reinsurance products, and services supporting them.

Description: Panelists discuss the following managed care topics: · Design issues/pros and cons e.g., self-directed health-care model · Provider reimbursement methodologies · Consumer and regulatory issues · Insurance and reinsurance pricing and underwriting issues · Catastrophic claims · Risk-based capital repercussions · Defined contribution health plans From the Record of the Society of Actuaries, Volume 27, No. 1, Session 61

Description: this article provides an overview of coverage and claim trends for managed care medical excess of loss insurance and reinsurance programs. it addresses features such as deductible, maximum benefit, inside limits , comprehensive versus non- comprehensive , and claims by diagnosis for commercial , Medicare and Medicaid risk. It also reviews cost containment support programs for catastrophic claims .

Description: This session 62 PD of the Las Vegas Spring Meeting focuses on provider excess reinsurance, which is an excess of loss coverage for providers assuming risk under various forms of managed care arrangements, such as HMOs, PPOs, and Medicare/Medicaid. From Record of Society of Actuaries, Volume 26, No. 3.

Description: Feature article focuses on the regulators who determine risk-based capital or RBC standards applicable to health plans.

Description: This article addresses issues of importance to HMO excess reinsurance purchasers when negotiating a reinsurance treaty.

Description: Employer stop loss is an insurance coverage offered to employers who self-fund their employee benefits program pursuant to an ERISA plan document. From Reinsurance Section News, November 2007, Issue No. 61.

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.