Description: This session of the 1990 Valuation Actuary Symposium discusses health liabilities and reserves.

Description: This discussion from the 1983 SOA Vancouver Meeting reviews the movement to small group health plans, group insurance underwriting, the plan design of non-traditional benefit programs such as cafeteria plans, HMO's and PPO's and new financial processes. From Record of Society of Actuaries, Vol. 9, No. 3.

Description: This session from the 1984 SOA Atlanta Meeting covers the issues in the individual medical insurance market - escalating costs, utilization rates and anti-select lapsation, the potential solutions and the challenges facing the actuary.

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: This session from the 1984 SOA Atlanta Meeting covers cost containment in health care costs, cost sharing and cost containment features, underwriting, the use of deductibles or co-payments, different delivery systems and utilization.

Description: Learn about key actuarial and analytic tools and methodologies used by commercial health insurance to identify and quantify drivers of healthcare cost and utilization (including wasteful and low-value ones) and risks. Use case scenarios in which these tools and methodologies apply, such as underwriting, reinsurance, medical management for population health and chronic diseases, managed care contracting, insurance market reform, provider payment reform, etc., will also be covered. Experience from the U.S., China and other parts of the world will be shared.

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: Panelists at this session of the SOA 1998 Maui II Spring Meeting offer several approaches to creative provider reimbursement where a single capitation and fee schedule was not the best solution.

Description: In this session 152 PD of the New York Annual Meeting panelists discuss some of the continuing challenges facing credit disability insurance, and some promising recent trends. From the Record of the Society of Actuaries, Vol. 24, No. 3.