Description: Presented at October 1985 Annual Meeting. Discusses 3 papers: 'Report on Reserve Standards for Individual and Group Health Insurance Contracts' by the AAA Committee on Health, 'Reserve Principles for Individual Health Insurance' by the Committee for Accident and Health, and 'Structure for Consideration of Health Coverage Valuation Standards' by an NAIC Health Subcommittee of Standing Technical Advisory Group.

Description: Intended for actuaries interested in understanding more about the Medical Loss Ratio and the impact Quality Improving Activities (QIA) and fraud reduction expenses have on the rebate calculation. This session will focus on what expenses qualifies as QIA, examples of programs from major carriers, current regulations and the differences between commercial, and Medicare, and Medicaid requirements.

Description: This article discusses many of the complexities of the new IDI valuation table and how they might impact the implementation process.

Description: Presented at September 1995 Valuation Actuary Symposium. Discusses individual disability income reserves and profit measures.

Description: Preparing an effective actuarial memorandum in support of the health actuarial opinion.

Description: Synopsis of Issue Brief prepared by Tax Work Group of the Academy-LTD Claim Reserve Assumption Basis: Use of date of incurral/date of issue of original policy.

Description: In preparing claims reserves in the annual statement, health insurers and their opining actuaries will generally include a provision for adverse deviation (PAD) in their reserved amount in order to satisfy language in both in the National Association of Insurance Commissioners (NAIC) Health Annual Statement Instructions and in Actuarial Standards of Practice. This article explores the total level of PAD (both implicit and explicit margin combined) included in the reported claims reserves by examining NAIC filing data from 2016 through 2022.

Description: Presented at April 1985 Spring Meeting. This session discussed: Definition of good and sufficient provision for unpaid and actuarial liabilities as used in the NAIC model bill, Actuary and auditor relationships in documentation, reasonableness of results, materiality, margins, and disclosure, Techniques for estimating unpaid claim liabilities, Reverse testing, Considerations regarding incurred date coding in establishing claim reserves, Reserving methodologies for alternative funding products, Reserves for catastrophic claims, Measurement, evaluation, and adjustment for claim department backlogs, changes in claim submission patterns, and environmental changes, etc.

Description: The American Academy of Actuaries task force charged with developing a risk-base capital formula for health insurers submitted its preliminary report to the NAIC Health Organizations Risk-Based Capital Working Group.