Description: This research material provides an evaluation and synthesis of the methodologies and data samples used on characterizing health care fraud

Description: A research report describing aspects of provider network performance in health care settings with particular focus on experiences with Exchanges.

Description: This report describes the results of a survey on reflecting risk in pricing. The survey expands on one conducted in 2003 and was expanded to include life, health, P&C, and non-North American insurance companies.

Description: This discussion on major medical expense insurance examines the trends in the types of plans sold, popularity of the comprehensive type of medical expense insurance plan, special problems, and dependent coverage. From Transactions of Society of Actuaries 1959, Vol. 11, No. 29 AB.

Description: This paper develops net claim costs for each major type of dental service, using experience data under group dental contracts covering 250,000 persons from 1974-1977. From Transactions of Society of Actuaries 1979, Vol. 31.

Description: This paper explores the legislation of Mass 65, the intent of which was to offer health benefits to persons aged 65 and older without evidence of insurability. From TRANSACTIONS OF SOCIETY OF ACTUARIES, 1962 VOL. 14 PT. 1, NO. 40.

Description: With the increase of membership in Blue Cross / Blue Shield, this paper presents the practices and experience under the plans using the United Medical Service, Inc as a model. Transactions of SOA Vol. 6, No. 14

Description: This paper describes the construction of the 1965 Supplementary Major Medical Tabular used to measure expect4ed claims. The paper also comments on the relationship of the intercompany 1963-65 experience to it. From Transactions of Society of Actuaries 1968, Vol. 20, Pt. 1, No. 56 AB.

Description: This paper suggests that many problems in health insurance pricing can be solved by requiring a minimum mandatory paid-up period [i.e., premium period shorter than insurance period], and by encouraging insureds to persist by providing them adequate pricing information. This will generate significant investment income for insuring programs and reduce the cost of insurance.

Description: This paper explores the legislation of New York 65, the intent of which was to offer health benefits to persons age 65 and over without health examination or other evidence of insurability. From TRANSACTIONS OF SOCIETY OF ACTUARIES, 1962 VOL. 14, PT. 1 NO. 40.