Description: The Society of Actuaries has developed and released a health care forecast model to illustrate the potential impact of the COVID-19 outbreak on insurance plan health care costs in the United States. Users of the model may include insurance company actuaries seeking an additional reference point for 2021 cost development, regulatory actuaries seeking additional insights and validation of costs as part of rating submissions for 2021, and insurance purchasers seeking a deeper understanding of the forces driving 2021 health care costs and premiums. The model is not intended as a replacement for existing modeling tools developed by insurers or regulators. Rather, the model’s primary purpose is to illustrate the key outbreak-related forces that are affecting the trajectory of health care costs. In addition the model can provide a common reference point to facilitate dialogue with respect to the regulatory review of 2021 health insurance rate filings.

Description: One of the many resources that the SOA offers for download are research projects and reports that focus on health.

Description: This paper helps the audience understand the actuary’s role in estimating the financial impact of primary care programs. In addition, the paper can be used by actuaries to think about key issues when estimating the financial impact of their employers’ and clients’ own primary care programs.

Description: The implications of the new long-term care law for individuals, employers, insurers and providers, and the federal government.

Description: This research report examines the potential implications of the risk mitigation programs – risk adjustment, reinsurance, and risk corridors – established under The Patient Protection and Affordable Care Act.

Description: Chronic Kidney Disease (CKD) affects many lives and has a large impact on health systems around the world. To better understand and predict costs for insurance plan members with CKD in the United States, we built a new model of their individual costs. Our model is the first to explicitly model both the CKD stage transition process and the distribution of costs given those stages.

Description: This research report is sponsored by The Society of Actuaries and the Canadian Institute of Actuaries on the Canadian health care system. Performed by Stéphane Levert, FSA, FCIA, the study (available in French and English) estimated the future costs of the Canadian health care system, assessed the sustainability of the system over a 25-year horizon, and analyzed the implications of the changes to the Canada Health Transfer proposed on Dec. 19, 2011 by the federal government. The report summarizing the findings indicates that, without significant government intervention, the Canadian health care system in its current form is not sustainable.

Description: This paper describes an actuarial methodology [adjusted average per capita cost - AAPCC] developed to meet the requirements of the risk contract that the medicare program makes available to certain health maintenance organizations. From Transactions of Society of Actuaries 1981, Vol. 33.

Description: This research paper investigates health care costs in the last year of life. This paper looks specifically at the issues of measurement of retiree health care costs when the baseline healthcare costs are measured in terms of the last year of life costs and maintenance costs.

Description: The purpose of this paper is to sketch the mathematical functions which are needed in valuing the benefits of a self-insured plan, and to study certain problems that arise in connection with the valuation of these plans. From Transactions of Society of Actuaries 1950, Vol. 2, No. 2.