Description: This session from the 2003 SOA Orlando Meeting addresses long-term care reinsurance, annuity reinsurance - dealing with the shift from variable to fixed, the global life and life reinsurance market, personal accident reinsurance and the catastrophe market. From the Record of the Society of Actuaries, Volume 29, No. 3.

Description: Recently researchers, practitioners, and regulators had intense debates about how to treat the data collection threshold in operational risk modeling. There are several approaches under consideration—the empirical approach, the “naive” approach, the shifted approach, and the truncated approach—for fitting the loss severity distribution. Since each approach is based on a different set of assumptions, different probability models emerge. Thus, model uncertainty arises. When possible we investigate such model uncertainty analytically, otherwise we use Monte Carlo simulations. For specific parametric examples we consider exponential and Lomax distributions which are special cases of the generalized Pareto family. Our primary goal is to quantify the effect of model uncertainty on risk measurements. This is accomplished by evaluating the probability of each approach producing conservative capital allocations based on the value-at-risk measure. These explorations are further illustrated using a real data set for legal losses in a business unit (Cruz, 2002).

Description: Medicare-Advantage Organizations (MAOs) are often under intense pressure to increase revenue. The ACA dramatically changed the incentives by which MAOs achieve financial success. With benchmark rates growing only as fast as FFS Medicare rates, many MAOs rely on risk scores and quality bonuses as their primary source of additional revenue.There are a not insignificant number of MAOs that are either under scrutiny by federal investigators, exposed to whistleblower lawsuits, and some even paying large penalties to resolve False Claims Act liability for providing inaccurate risk adjustment information (e.g., $270 million paid by Healthcare Partners/DaVita Medical Holdings in October 2018).Is it possible to operate a risk adjustment program that is both compliant with applicable federal regulations and sub-regulatory guidance yet still generate the revenue to ensure that Medicare-Advantage plans are financially viable in the marketplace? The presenters believe that not only is true compliance (as opposed to the mere appearance of a compliance program) a requirement for success, it is a necessary pre-condition for both MAO profitability and to ensure that risk scores are an accurate representation of member morbidity.

Description: Impaired annuities - a niche product marketed to people at the “at-need” edge of long-term care and has the potential to instruct in bridging the gap for the products now being marketed to people “pre-need.” From Long-Term Care, Dec 2003, Issue No. 10

Description: In this session, the presenters will discuss implementation challenges with US GAAP Long Duration Targeted Improvements (LDTI) for life and annuity products, and methods and changes to actuarial models their organizations use to overcome the challenges. Presenters will specifically discuss the following topics: The current GAAP reporting framework can create challenges with transparency for annuity insurers. Many annuity insurers report on adjusted earning measures in addition to US GAAP, believing the adjusted measures more accurately reflect earnings. Using a variable annuity framework, presenters will discuss key differences between GAAP and adjusted earnings measures, key challenges and their solutions for LDTI implementation, and the potential for LDTI to reduce the need for adjusted earnings measures and increase transparency. For FAS 60 based life products, insurers need to update and modernize the assumption setting process. Presenters will cover methods and the decision process whether to use existing data or new experience studies to review product experience and set assumptions. There is a lack of clarity and guidance for development and implementation of LDTI in a reinsurance framework. For reinsured life products, LDTI guidance is clear on the direct side of the financial statements, but the guidance is less clear on reinsurance ceded values. Presenters will discuss methods and changes to actuarial financial models that are needed in order to ensure the direct and ceded values are consistent.

Description: A discussion of the efforts to implement straight through processing and standardization of the HIPAA form for long term care claims data.

Description: A brief description of current events and techniques that may impact trend models.

Description: Interview discusses developing forecasting models to predict the financial impact of disruptive events and new medical technologies. Issue No. 60