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  • Pricing Issues Related to Supplemental Health Products
    _________________________________ *Copyright © 2000, Society of Actuaries Note: The charts for this ... it’s only affecting 10% more of the physicians. Table 1 was done for 1995. It’s a little dated, but it ...

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    • Authors: Floyd Martin, Dennis Hare, Darrell D Spell
    • Date: Jun 1999
    • Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>Actuarial theory in business context; Technical Skills & Analytical Problem Solving>Problem analysis and definition
    • Publication Name: Record of the Society of Actuaries
    • Topics: Health & Disability>Accident insurance; Health & Disability>Critical illness insurance; Health & Disability>Health insurance; Reinsurance>Product development - Reinsurance
  • Frequently Asked Questions about the Cost of the Future Newly Insured under the Affordable Care Act (ACA) SOA Study--And Other Things you Migh Not Know by Just Reading the Executive Summary
    (HBSM) which is a micro-simulation model of the U.S. health care system that has been used for over ... assumptions, which are included in the detailed Excel table outputs included with the report. Because many of ...

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    • Authors: David Toumala
    • Date: Oct 2013
    • Competency: Technical Skills & Analytical Problem Solving>Problem analysis and definition
    • Publication Name: Health Watch
    • Topics: Health & Disability>Health care quality; Health & Disability>Health insurance; Public Policy
  • Risk Theory Applications To Experience Rating Group Health Insurance
    Group Health Instructor: CHARLES S. FUHRER Recorder: CHARLES S. FUHRER Summary: The practicing actuary ... stop-loss insurance will be covered. Mr. Charles S. Fuhrer: If you attended Session 9 you will have ...

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    • Authors: Charles S Fuhrer
    • Date: Jun 1998
    • Competency: External Forces & Industry Knowledge>Actuarial theory in business context; Strategic Insight and Integration>Influence decisions; Technical Skills & Analytical Problem Solving>Problem analysis and definition
    • Publication Name: Record of the Society of Actuaries
    • Topics: Actuarial Profession; Health & Disability>Health insurance; Modeling & Statistical Methods>Estimation methods
  • Considerations for Surplus Determination under ACA
    There are five separate actionable outcomes (see Table 1). For a health care insurer that is between 200 ... He can be reached at richard.tash@optum. com Table 1: Risk-Based Capital authoritative action Outcomes ...

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    • Authors: Daniel Pribe, Richard Tash, David M Tuomala
    • Date: May 2014
    • Competency: External Forces & Industry Knowledge>External forces and business performance; Leadership>Thought leadership; Professional Values>Practice expertise; Strategic Insight and Integration>Strategy development; Technical Skills & Analytical Problem Solving>Problem analysis and definition
    • Publication Name: Health Watch
    • Topics: Health & Disability>Health care; Health & Disability>Health insurance; Public Policy
  • Reserving Challenges for Consumer-Directed Health Products
    involved, followed by a corridor of the consumer ’s responsibility for payment until the deductible is ... sign up today at: w w w. s o a . o r g / c c m / c m s - s e r v i c e / s t r e a m / asset/?asset_id=5179052&g11n ...

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    • Authors: Stephen J Kaczmarek
    • Date: Oct 2004
    • Competency: Technical Skills & Analytical Problem Solving>Problem analysis and definition
    • Publication Name: Health Watch
    • Topics: Health & Disability>Health insurance
  • Twenty-Four-Hour Health Coverage
    the United Kingdom. Finally, I will discuss some U.S. statistics to place the issue in perspective. CANADA ... 75% of BBG is approximately 61,000 DM or $40,000 U.S. or $48,000 Canadian. Private sector employees earningabove ...

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    • Authors: James E Drennan, Godfrey Perrott, Eric C Nordman
    • Date: Oct 1992
    • Competency: External Forces & Industry Knowledge>Actuarial theory in business context; Strategic Insight and Integration>Strategy development; Technical Skills & Analytical Problem Solving>Problem analysis and definition
    • Publication Name: Record of the Society of Actuaries
    • Topics: Economics>Health economics; Health & Disability>Disability insurance; Health & Disability>Health insurance; Public Policy; Reinsurance>Product development - Reinsurance
  • Implementing the ACA: An Actuarial Perspective
    Protection and Affordable Care Act, passed by the U.S. Congress in early 2010. Accountable Care Organization ... of the actual health care costs to the average U.S. citizen,” said Poppe. “Most employees are not ...

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    • Authors: Karin Swenson-Moore
    • Date: Dec 2013
    • Competency: Professional Values>Practice expertise; Technical Skills & Analytical Problem Solving>Problem analysis and definition
    • Publication Name: The Actuary Magazine
    • Topics: Health & Disability>Health insurance; Public Policy; Public Policy
  • The Medicare Advantage 5-Star Rating Program and Its Implications for Actuaries
    payment percentages by star rat- ing are shown in the table in Figure 1. The percentage of the savings a plan ... rebate percentages by star rating are shown in the table in Figure 2. Special rules apply to low-enrollment ...

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    • Authors: Adrian L Clark, Gabriela Dieguez, Bradley James Piper
    • Date: May 2012
    • Competency: External Forces & Industry Knowledge>External forces and business performance; Results-Oriented Solutions>Actionable recommendations; Strategic Insight and Integration>Strategy development; Technical Skills & Analytical Problem Solving>Problem analysis and definition
    • Publication Name: Health Watch
    • Topics: Health & Disability>Health insurance; Health & Disability>Payment models; Public Policy
  • Selling Health Insurance Across State Lines
    implementation of the ACA. The ACA allows the U.S. Office of Personnel Management (OPM) to oversee ... of America, the District of Colum- bia and the U.S. Territories. 2 From Kaiser Health News: State coverage ...

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    • Authors: Lawrence Mitchell
    • Date: Aug 2017
    • Competency: External Forces & Industry Knowledge>External forces and business performance; Professional Values>Public interest representation; Strategic Insight and Integration>Big picture view; Strategic Insight and Integration>Influence decisions; Technical Skills & Analytical Problem Solving>Problem analysis and definition
    • Publication Name: In The Public Interest
    • Topics: Health & Disability>Health insurance; Public Policy
  • Calibrating Risk Score Model with Partial Credibility
    Calibrating Risk Score Model with Partial Credibility This article describes a method that can be ... The specific error metrics are presented in the table below: Model Description Error Metric on Next ...

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    • Authors: Sheamus Parkes, Bradley Armstrong
    • Date: Jul 2015
    • Competency: Technical Skills & Analytical Problem Solving>Innovative solutions; Technical Skills & Analytical Problem Solving>Problem analysis and definition; Technical Skills & Analytical Problem Solving>Process and technique refinement
    • Publication Name: Predictive Analytics and Futurism Newsletter
    • Topics: Health & Disability>Health care; Health & Disability>Health insurance; Modeling & Statistical Methods>Bayesian methods; Modeling & Statistical Methods>Data mining; Modeling & Statistical Methods>Estimation methods; Modeling & Statistical Methods>Regression analysis; Predictive Analytics