Description: This paper is being produced in conjunction with eight companion pieces reflecting a variety of stakeholder experiences with the development of the risk pool.

Description: This SOA report describes the components of margin for calculating capitation rates in a Medicaid context along with practical issues that MCOs may face.

Description: This paper was prepared to facilitate discussions with the New York State Insurance Department concerning price regulation and the application of minimum loss ratio standards for individual health insurance. From Transactions of Society of Actuaries 1982, Vol. 34.

Description: This paper presents the findings of the Society of Actuaries' Committee on Individual Accident and Health Valuation Principles concerning statutory reserve standards for policy and claim reserves. From Transactions of Society of Actuaries 1985, Vol. 37.

Description: This paper presents a surplus-ratio goal that is appropriate for group accident and health insurance and discusses growth, the sources of gains and losses, ways to improve operating gain and tracking results against expectations. A discussion of the paper follows. From Transactions of Society of Actuaries 1977, Vol. 29.

Description: This paper presents population hospital utilization data concerning the proportion of total hospital days that is due to injury and the proportion of total hospital days that is spent in intensive care units for use in obtaining reserve factors. The paper also presents continuation data for hospitalizations. From Transactions of Society of Actuaries 1979, Vol. 31.

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.

Description: 1959 SOA Regional Meetings in Atlanta and San Francisco. These panel discussions reviewed procedures, techniques and vehicles used to provide benefits to retired employees. The panels also discussed Group Insurance Dividends and Major Medical issues.

Description: One of the first projects undertaken by Claim Analytics was to create a model to predict return to work for group insurance claimants with long term disabilities. This report, sponsored in part by the Society of Actuaries Health Section , is a case study on creating such a model.

Description: A review of literature regarding care management program outcomes - either financial or utilization-related which are indicative of financial improvement or from which financial conclusions may be drawn. Includes a discussion on utilization & concurrent review, case & demand & population & disease management . Paper 3 of an 8 paper series on 'An Introduction to Care Management Interventions and Their Implications for Actuaries'.