Description: Accurate forecasts of future health care expenditures for cohorts of elderly individuals can be especially difficult. Current techniques use average per capita costs, based on local experience, adjusted for the cohort's age, sex, institutionalization, and welfare status distribution. This paper presents a method to adjust such per capita cost estimates to reflect more accurately the likely health status of a particular cohort. The adjustment uses the cause-of-mortality profile in the local population, which is a readily available tabulation known to be highly correlated with a major proportion of total medical care expenditures for people beyond age 65. From Transactions of Society of Actuaries 1984, Vol. 36.

Description: This report estimates sex-specific trends in HIPAA ADL disability between 1984 and 2004 using the National Long Term Care Survey (NLTCS); estimates age-standardized 20-year changes in ADL and cognitive impairment (CI) among the U.S. elderly using the HIPAA CI trigger; estimates the joint distribution of cognitive impairment (CI) and ADL disability among aged Medicare enrollees using the HIPAA disability triggers.

Description: Relative to group medical plans, discusses: recognition given to effect on morbidity of various demographic factors, consideration given to inflation in making rate guarantees, consideration given to group size, and underwriting transfer cases.

Description: This final report is a SOA Task Force response to a NAIC request to develop valuation recommendations for long-term care insurance. Two basic sets of tables are provided: one for institutional benefits [nursing home] and one for noninstitutional benefits [home health care]. From Transactions of Society of Actuaries 1995, Vol. 47.

Description: The objectives of this paper include an assessment of the basis of volatility of experience and financial results, considering the risks and uncertainties associated with long-term policies, especially LTCi. In so doing, it is observed that a properly determined provision for risk and uncertainty is needed in premiums and reserves. It then describes the approaches that can be taken to quantify such a provision in new and re-rated LTCi. The paper discusses possible mitigation approaches that have and should be taken, especially but not limited to the use of policy design features to enhance the alignment of interests of the LTC insurer and its policyholders. It also explores the relationship between historical and expected future risks and uncertainties specific to LTCi. It concludes by pointing out the pervasiveness of the uncertainties involved, the earlier underestimation of the uncertainties involved, although the actual degree of uncertainty may have decreased over time as relevant experience has been obtained. Effective management of LTCi demands incorporation of mitigation approaches in its product design and continuous monitoring of relevant experience.

Description: This paper sets forth hospital utilization data from 1978 by age and sex for both prepaid hospital contracts and contracts supplementing medicare. In addition, hospital continuation data from 1977 is provided from regular contracts. From Transactions of Society of Actuaries 1983, Vol. 35.

Description: The Canadian public health care delivery system continues to experience growing needs for increased funding. The total health care delivery system today costs Canadians $98 billion a year or about 9.7 percent of GDP. Of that total cost, 71 percent is paid by the government, which means the taxpayers. While that may pale in comparison to the costs in the U.S., it does make the Canadian system one of the five most expensive health care delivery systems in the world. While today’s cost pressures are of major concern, of even more concern are the costs being projected by many participants in the current health care debate for the period when the Baby Boom makes higher demands on the Canadian health care delivery system. Traditional projection methods, however, do not differentiate between the elderly who survive the year versus those who die as to their use of health care systems. This paper first looks at the impact that this differentiation could have on projected costs. Second, the paper looks at the impact that the wide use of Advance Directives [also called Living Wills] might have on future health care costs and some of the issues surrounding their use. From Actuarial Research Clearing House 2004, Vol. 1.

Description: Report on the SOA's 1st Annual LTC Operations and Technology Benchmark Survey. Its goals were to provide data to support the development of time and cost benchmarks for LTC operations, identify the most pressing operations and technology issues, and gain insights into the technologies that are being used to administer Long Term Care business.

Description: This document provides key findings from the 2007 Risks and Process of Retirement Survey related to health and long-term care risks in retirement.

Description: This report presents results for industry long-term care insurance persistency.