Description: This paper develops a parametric model for health care insurance claims to fit parametric models to the data. Model selection is based on the ChJ-squared goodness-of-fit test and a comparison of the empirical limited expected value function to parametric limited expected value functions. A copula function was used to model the bivariate portion of the data. From Actuarial Research Clearing House 1993, VOL. 3.

Description: This is the sixth Intercompany Study of Long–Term Care Insurance. This report combines and analyzes data received from 35 insurers. Available data was collected on policies issued between January 1, 1984 and December 31, 2007. Claims incurred on policies during this same timeframe were followed from claim inception through the earlier of claim termination or June 30, 2008.

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 report explores two LTC insurance product concepts. The concepts were developed as part of an effort to create innovative new LTC insurance products.

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

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: This is a finalist submission for the 2018 Student Case Study Challenge.