Description: This session discussion is about outside actuarial profession's perspective on health care cost, insurer's role in medical care management, relationships between treatment decisions, available coverage, appropriate use of underwriting and paying for uncompensated care. From Record of Society of Actuaries Vol. 18, No. 1A.

Description: This analysis provides an overview of the functional components of the managed care system. It discusses the market forces underlying the United States’ system for health care financing and delivery and suggests how market forces impact the health care industry. The analysis focuses on societal goals for health care delivery and on managed care’s effectiveness in enabling achievement of those goals. The analysis develops and uses an innovative model developed to summarize the complex interplay among the many stakeholders, or participants, in the health care system. The model provides a framework for analysis of the many relationships among stakeholders. The analysis also highlights current issues in managed care, particularly the barriers that impede collaboration among stakeholders.

Description: SMI Trust Fund: Estimates under Alternative II Assumption for Aged and Disabled Excluding End-Stage Renal Disease Enrollees from Pension Section News, October 2000, Issue No. 44.

Description: This article describes the pre-HIPAA small group market and identify some of the key changes to this market resulting from HIPAA particularly guaranteed issue and renewal and restriction of pre-existing conditions and.

Description: This article talks about the challenges facing the FDA, especially those arising from the globalization of the pharmaceutical supply chain.

Description: This article is a brief overview of what the Health Actuarial Research Initiative, HARI, is and what the participants in HARI will be doing. HARI is a project formed by the Society of Actuaries that will develop actuarial research studying changes in health care systems.

Description: This article discusses HIPAA, Health Insurance Portability and Accountability Act of 1997 and the many NAIC model laws affecting health insurance and paricularly how Arkansas is facing the post-HIPAA complexities.

Description: There is a wide range of literature on aging and health care. We sample this literature and find it fits into the subcategories of theoretical aging, medical significance of aging, treatment of the elderly, and resource allocation to the elderly. Themes are that financial arrangements can cause inefficient and ineffective care and that care guidelines need to developed specifically for the elderly rather than extrapolating guidelines for younger patients.

Description: This is Part 2 of 2 on changes affecting Medigap insurers. It focuses on marketing and regulatory differences between Medigap and Medicare Advantage that affect the competitiveness of Medigap plans.

Description: Discussion of recent developments in the taxation of noncoordinated benefits such as fixed indemnity, hospital indemnity, and specified disease insurance policies. Developments include a recent Chief Counsel Advice Memorandum and proposed triagency rulemaking that would impact non coordinated benefits.