Description: This paper describes a new major medical policy from The Equitable. The author describes the policy and discusses anticipated claims experience and the calculation of gross premiums. From Transactions of Society of Actuaries 1955 Volume 7, Number 17.

Description: Discover the key components of value-based care (VBC) contracts and their impact on provider credibility. Learn about benchmarks, measurement period results, and the unique challenges providers face in managing insurance risk. Gain insights into reducing costs and aligning financial incentives in the US healthcare market.

Description: This is a discussion of the medical loss ratio, the confusion and debate over the calculation method under the new MLR requirement, and the opportunities it presents to consulting actuaries.

Description: Examines the question of whether health-care costs, or health insurance costs, are in crisis.

Description: Milliman performed an analysis of 894 uses of the checking service on individual medical health insurance applications to gain a better understanding of its protective value. From Health Watch Newsletter, September 2006, Issue No. 53.

Description: This article attempts to make a modest contribution to the dialogue on the potential and risks associated with novel treatments such as cell & gene therapies. With a fast-expanding roster of what are believed to be one-time treatments at ever increasing price points aimed at curing a wider swatch of the population, they are as much a source of relief for patients stuck in medical limbo, as they are a source of anxiety for payers.

Description: This article provides an in-depth discussion of how subsidies are an integral part of affordability for individual health insurance under the Affordable Care Act, and, ultimately, impact the viability of the market.

Description: A compilation of feedback from actuaries in the Health Section of the affects of the ACA.

Description: With the medical insurance market experiencing health care inflation of 10 to 13 percent and medical costs averaging above $8,000 per year per employee less for single employees and more for employees with families, employers are looking at alternative options. Politicians and regulators are as well.

Description: A discussion of the future of the Brazilian Health Market with a focus on the legislation which passed in June 1998 to regulate the private health insurance industry