Description: Presented at the Living to 100 Symposium, January 2011. This paper examines the relationship between the earliest stages of dementia—mild cognitive impairment—and mortality. Using data from long-term care insurance applicants, and linking this to the Social Security Master Death File, the authors focus on the classification results of two cognitive screens used at various times in the underwriting process. Applying the Cox Proportional Hazards Model as well as relative mortality ratio analysis, the authors show that the proportion of individuals classified as cognitively impaired have significantly higher relative mortality compared to those classified as cognitively intact.

Description: This discussion is on the availability of utilization and cost experience data for group medical care insurance coverages. Specifically, it highlights the role of the Society of Actuaries in intercompany data collection, employer demands for sophisticated utilization data for comparison by industry and geographic location, sources of industry-wide data, data resource potential of health claims processing by the National Electronic Information Corporation, and antitrust implications. From Record of the Society of Actuaries 1981, Volume 7, No. 4.

Description: The presenters will provide insights into fraud and abuse risk in the health insurance industry, including an examination of traditional and predictive modeling techniques for both prevention and detection. Emphasis will be placed on current and emerging risks. Canadian examples and perspectives will be offered, but the applications for attendees to use in practice are non-nation specific.

Description: Actuaries historically modeled new launches in pharmaceuticals by anticipating the expected change to the market basket. This became more complicated with the recent launches of gene and cell therapies as they address rare diseases. Rare conditions have low total member volume to study and some do not currently have a diagnosis code to identify them within claims data. Addressing this modeling challenge has been growing more important in the recent years with the number of therapies launching. What has the health care industry, and more specifically health care, done to enhance modeling and how should this be altered for the future? Additionally, historic modeling has sometimes incorporated a level of direct medical treatment cost offsets where studies have shown lower treatment costs are achievable. Can gene and cell financial modeling include cost offsets as well? And if so, what are suggested precautions or limitations to this effort?

Description: This article discusses the problems facing long-term care insurance. These include slowing sales, large premium increases and carriers exiting the market. The author suggests that the public needs to be better educated and that insurers need to find innovative ways to design products that are sustainable, yet sufficiently affordable to be attractive to a wide variety of buyers.

Description: The primary focus of this 1997 presentation from the 32nd Actuarial Research Conference is the adaptation of the representative scenario method such that the distribution of the primary rates used for product pricing, are consistent, regardless of the initial random number seed. A preliminary question is how many stochastically generated scenarios are required for consistency. This presentation looks at the implications of: the use of antithetic random normal deviates upon the scenario process, ways of modifying the candidate list, and the choice function within the representative scenario process.

Description: SOA’s recently completed research project related to long term projects of health care cost trends for use in post retirement medical valuations.

Description: This paper presents population hospital utilization data concerning the proportion of total hospital days that is due to injury and the proportion of total hospital days that is spent in intensive care units for use in obtaining reserve factors. The paper also presents continuation data for hospitalizations. From Transactions of Society of Actuaries 1979, Vol. 31.

Description: In this paper several probability models for the random amounts of needed long-term care are explained, and one model is used to provide an alternate premium calculation method for certain long-term care coverages. From Actuarial Research Clearing House 1990, VOL. 2.

Description: New products should address having acceptable carrier risks and at the same time enhance the product’s value to consumers to pave the way for broader acceptance.