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

Description: Medical stop-loss reinsurance continues to play a vital role in containing employers’ health care costs. Managing general underwriters [MGUs], who originally handled these programs, have lost market share to large direct writers. This article discusses how health care reform and highly disciplined underwriting tools offer growth opportunities to MGUs.

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

Description: This year’s Survey, its sixth year, further reflects the impact of health care reform and the resulting prevalence of unlimited lifetime maximums on stop loss coverage. Of surveyed plans, 88% report such coverage –a steep increase from 13% in 2010. About half pair an unlimited lifetime with an interim annual maximum of $5 million or less. Premiums continue to rise (to no surprise)and are 60% to 70% higher than levels reported in our initial Survey in 2007. The primary focus of the Survey, current premium rates, is shown in the following graphs and tables.

Description: Gathering information and assess risks of Managed Care Networks. Looking at cost and service areas. Issue No. 44.

Description: Panelists at this session of the SOA 1997 Palm Desert Spring Meeting discuss medical excess coverage which is provided to hospitals and/or physician groups to reimburse such groups for benefits in excess of a deductible. This coverage typically involves situations where providers are taking capitation.

Description: Medical insurance today is more like pre-paid medical payments. Medical insurance should be bought for protection, but rarely used, like auto insurance.

Description: The discussion will review major elements of the reinsurance market as health care reform replaces traditional markets. From Record of Society of Actuaries Vol. 20, No. 3A.

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: At this presentation from Session 81PD of the SOA 1996 Colorado Springs Meeting, the panelists examine current issues involving small-employer health reinsurance programs from viewpoints of both the direct writer and the reinsurer. From the Record of the Society of Actuaries, Vol. 22, No. 2.