Description: Identifying and submitting all appropriate ICD-9 diagnosis codes to CMS will result in a higher risk score for the member and increased payments to Medicare Advantage plans. Milliman's HCC prevalence study illustrates the significant variations in HCC prevalence rates by age/gender, geography, and population type and will assist plans in benchmarking the effectiveness of their own diagnosis code capture efforts.

Description: There are many factors involved with managing the financial condition of an insurance company and the factors usually fall into on of three categories: earnings management, capital management and risk management. Transfer pricing involves assigning a price for the use of funds that are transferred within the company.

Description: Summary of the Life and Health Actuarial Task Force Meeting held in September, 2003

Description: This article reports the maximum statutory valuation and nonforfeiture interest rates for calendar year 2004 issues of life insurance products and the maximum statutory valuation interest rates for calendar year 2003 issues of annuity products.

Description: Key considerations when modeling reinsurance to calculate reserves under PBR as well as a case study examining the impact of reinsurance structures on reserves.

Description: The author analyzes why LTCi is so risky, capital-intensive and unprofitable, and then makes the case that if we rethink the fundamental way a stand-alone LTCi should work, it can be transformed into a successful product.

Description: This article reviews the dynamics of surrender risk, briefly discusses current valuations in the Interest Rate option markets and presents some tailored structured hedging instruments that can be used to manage this risk.

Description: This study was sponsored by the Society of Actuaries Health Section. This paper explores the relative significance of aging as a determinant of financial cost of health care beyond age 50, with particular attention to the effect for ages 65 and older. The paper presents concepts of aging factors and aging curves, which define relative values between ages for utilization or cost of health care services. General conclusions are drawn from Medicare data that utilization and cost differ by age, but that aging factors vary across services and may be less significant at very old ages. The author then turns to the question of measuring the significance of an aging curve assumption and what accuracy is lost in the simpler alternative of a single value across an age range.

Description: This article is about Stanley B. Tulin's actuarial career and lessons he has learned regarding what leads to a successful actuarial career.