Description: Learn about key actuarial and analytic tools and methodologies used by commercial health insurance to identify and quantify drivers of healthcare cost and utilization (including wasteful and low-value ones) and risks. Use case scenarios in which these tools and methodologies apply, such as underwriting, reinsurance, medical management for population health and chronic diseases, managed care contracting, insurance market reform, provider payment reform, etc., will also be covered. Experience from the U.S., China and other parts of the world will be shared.

Description: This article gives an overview of the CFO Forum diversification paper. The key points that the CFO Forum made are: 1. The lack of sufficient diversifying strategies for risk management needs to be addressed. Therefore they provided a policy framework that promotes sound risk measurement and management practices in a way that can be implemented and supervised with confidence. 2. The lack of sufficient regulatory over-site needs to be addressed, so they presented a set of core principles to form the basis of European insurance regulation. These core principle incorporate diversification in a consistent manner.

Description: Overview about the information covered in the Predictive Analytics Certificate and how that is useful for actuaries.

Description: There will be inflection points in the value of an instrument when interest rates change. These inflection points could materially impact the approximation of value change using ALM metrics. In this part of the seven-part series, I will highlight: • How to identify the inflection points; • the range of rate changes where ALM metrics may be relied upon i.e., the “validity” range, outside of which recalculation of the ALM metrics is required and the potential that one needs to rebalance the portfolio; • a technique to improve on the approximation of value change beyond the validity range; and • a technique to convert non-linear change on the yield curve to be used with duration and convexity.

Description: 2011 Enterprise Risk Management Symposium, Chicago. This study investigates whether simulation-based models can be used to predict liquidity risk for banks, which must comply with Basel III by January 2015. The paper looks at the process of developing a measurement framework using Black-Scholes and Merton’s asset-based models to measure liquidity risk.

Description: CMS provides ACOs with monthly claims data for members, including their medical visits and ACO program eligibility. This data can be divided into Membership and Claims tables through the ETL process. However, when calculating PMPY at specific levels of detail using these tables, issues arise due to unrelated dimensions, leading to inaccurate and understated results. This article presents a solution to this problem by utilizing Tableau's data blending capabilities.

Description: Discover the impact of COVID-19 on member costs post diagnosis and the future of mortality in this Emerging Long Term COVID-19 Trends webcast. This webcast will be split up into Health and Life portions. During the Health portion of this webcasts, you will learn more about the impact on risk scores due to recent findings. Enjoy this discussion and further dive into the emerging COVID-19 trends that may affect how you conduct business practices. At the Life portion, the SOA Research Institute assembled a panel of mortality experts who will express opinions on the effects of the U.S. mortality rate for general, insured and pension populations in the short-term.

Description: The method described in this paper is to allocate surplus to each category of business and reserves in proportion to its estimated effect on an insurer's surplus variation. Risk load for each category of business is then selected so that the return on allocated surplus for each category is equal to the overall return on surplus. From Actuarial Research Clearing House 1993, VOL. 3.

Description: As a follow-up to a previous five-part series on accounting for ceded reinsurance under LDTI, this article focuses on one issue that has, until now, been left without a general solution—how to measure the reinsured portion of a direct loss from capping a net premium ratio or flooring a liability. After acknowledging limited guidance on the issue, the article describes the various events that can lead to a loss, how reinsurance protects against loss, and how that is translated into formulas for measuring the reinsured portion of a loss.

Description: The momentum in value-based care has produced an opportunity for actuaries to become pioneers in health care