Description: This paper reviews the applications of operations research methods in the insurance industry. From Transactions of Society of Actuaries 1995, Vol. 47.

Description: This session challenges participants to consider the insurance landscape over the next five to ten years and how existing business models need to evolve. From the Record of the Society of Actuaries, Volume 27, No. 2, Session 19PD of the Toronto Spring Meeting.

Description: The attached report presents the results of a survey whose purpose was to explore the various uses of technology by life insurance companies. The survey was conducted by the Technology Survey Subcommittee of the Society of Actuaries Life Insurance Mortality and Underwriting Survey Committee. The primary focus of this survey was the impact of technology on mortality studies and underwriting.

Description: Using Johns Hopkins data around the COVID-19 pandemic, this article explores the interaction between selecting a metric and the different ways of visualizing it.

Description: Book review of 'Being Geek: The Software Developer's Career Handbook'

Description: CMS provides ACOs with monthly claims data for members, including their medical visits and ACO program eligibility. This data can be divided into Membership and Claims tables through the ETL process. However, when calculating PMPY at specific levels of detail using these tables, issues arise due to unrelated dimensions, leading to inaccurate and understated results. This article presents a solution to this problem by utilizing Tableau's data blending capabilities.

Description: This presentation is a panel discussion, session 90PD, from the 2000 Annual Meeting of the Society of Actuaries, held October 15-18 in Chicago. The panelists, including a chief technology officer and a Microsoft employee, introduce actuaries to XML, discussing the origins of XML and its relation to HTML. They discuss how to model with XML to achieve independence between platforms and systems. The speakers present XML applications, including online insurance, employee benefits and mathematics. Discussion from participants is included. From the Record of Society of Actuaries, Volume 26, No. 3.

Description: Risk adjustment in government regulated health plans has been around for over two decades. Yet the strategies for promoting risk score accuracy haven't varied much during that time. Most health plans, physician groups, and vendors promote chart reviews and/or in-home assessments as the primary vehicle for collecting data not perceived to be present in the routine claims submission and adjudication stream. We know that most organizations trying to coalesce encounter data from multiple sources often fail to ensure that all relevant data is ultimately submitted to CMS or a state Medicaid agency. Crucial data, often with significant financial value, frequently gets lost in the data pipeline, somewhere between the provider's billing system and the health plan and/or its vendors. Because 837-formatted data is difficult to read, it complicates payers and vendor’s abilities to track encounter data so that every service delivered to patients is credited to the applicable risk adjustment formula. It is incumbent upon successful risk-adjusted entities to be able to track encounter data, identify processes and/or vendors which may be mangling or losing data, in order to ensure that risk scores are sufficiently accurate to be compliant with plan sponsor requirements and to ensure appropriate revenue to the health plan or provider group.

Description: Predictive modeling continues to gain traction in the life insurance industry with the rapid growth of available data and maturity of open source tools. New methods and technology in predictive analytics have enabled the evaluation of extremely large data more quickly and allow us to incorporate features previously not considered. The presenters will provide background on predictive modeling tools and algorithms utilized by actuaries and data scientists for life insurance, highlighting applications from marketing to underwriting.

Description: To expand our understanding of the theory of behavioral economics and its application to life and health insurance policyholder and annuitant behavior, the Society of Actuaries' Committee on Knowledge Extension Research, Committee on Life Insurance Research and the Financial Reporting Section issued a call for papers, inviting actuaries, academics, economists, psychologists, sociologists, researchers and other professionals to explore this topic from a variety of perspectives.