Description: The purpose of this paper is to demonstrate a simplified method of calculating adjusted benefit reserves for any line of life or health insurance. Specific examples are applied to individual hospital and major medical insurance. From Transactions of Society of Actuaries 1973 Vol. 25 Pt. 1 No. 73

Description: A call for papers on health insurance topics to enhance the program for a 1979 special topic meeting of the Society of Actuaries.

Description: The actuarial committee that authored this report developed a model to estimate the revenue the tax would generate. The results point out key considerations for an excise tax on high cost health plans, including the wide range of results generated by sensitivity to certain assumptions.

Description: Since detailed claim information is not readily available to the Committee on Group Mortality and Morbidity on an annual basis, a special investigation of group hospital expense experience has been conducted. That investigation is summarized in this paper, and covers plan descriptions, morbidity and cost data, and continuation tables.

Description: It is the purpose of this paper to provide data derived from actual claim experience on lives age 65 and over in a form that will facilitate actuarial calculations involving modification of durations of hospital stay and variations in the allowances provided for miscellaneous services billed by the hospital. From Transactions of Society of Actuaries 1963, Vol. 15, pt. 1, No. 43.

Description: This is a discussion of the paper, Special Investigation of Group Hospital Expense Insurance Experience by Stanley W. Ginger. From Transactions of Society of Actuaries 1952, Vol. 4, No. 10.

Description: This article overviews the results of the 2008 survey of Third Party Administrators of Employer Stop Loss business.

Description: Health care is a complex market with a wide variety of stakeholders. These stakeholders have diverse business needs, requiring complicated data-driven decisions. The analytics and research supporting these decisions are often dependent on the availability of real-world data (RWD), which includes a wide variety of data capture technology and data reflecting treatment, clinical outcomes, and costs of health care in real treatment settings (e.g.,, outside of controlled clinical trials). The goal of this panel discussion is to explore how existing and emerging sources of RWD can enhance benefit design, improve risk assessment, influence treatment decisions, and advance the measurement of clinical, humanistic, and financial outcomes. The diverse speaker panel includes actuarial and non-actuarial perspectives, representing the pharmaceutical industry, a health-care services business, and academia. The panel will describe the decision-making that drives their individual needs to use RWD, identify current and developing RWD sources, provide examples of analyses using RWD, and discuss how emerging RWD may influence actuarial analytics and potentiate the development of new interdisciplinary methods and value drivers.

Description: Risk adjustment is used to adjust the revenue stream to health insurers that sell ACA eligible plans and Medicare Advantage plans. This article compares and contrasts these risk adjustment programs.

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