Description: From a session at a meeting of the Society of Actuaries held in San Diego, CA, June 22-23, 2000 This session covers current issues in reinsurance treaty wording including: · Claims wording · Insolvency wording of the direct company and of the reinsurer · Are the reinsurer rates guaranteed? · Does the treaty follow the NAIC model regulation?.

Description: This teaching session explores how variability in charges and costs can be measured so direct comparisons between institutions can be developed and how information can be used to develop reasonable reimbursement levels. Topics include creating & using outpatient hospital fee schedules, using relative value fee schedules to benchmark costs to aid in medical management and hospital tiering. From the Record of the Society of Actuaries, Volume 28, No. 2, Session 48

Description: Presented at April 1986 Spring Meeting. This session discussion is about what analysis is effective in measuring recent medical care experience and are the projected cost-containment savings presented to plan sponsors being realized.

Description: Presented at June 1996 Spring Meeting. This discussion looks at how a managed care plan can know whether it is doing a good job on utilization review, if there is room for further reduction in utilization, and how a plan should prevent under-utilization.

Description: Presented at October 1986 Annual Meeting. This session discussion is highlighting recent developments in the Chicago health care delivery system, the involvement of Chicago area HMOs, PPOs and insurers in the financing and delivery of health care services, and issues unique to the Chicago market as well as issues applicable to other geographical areas.

Description: Panelists provide their perspectives on current issues in the dental market, such as: · Product development · Experience trends · Competitive marketplace · Future outlook From the Record of the Society of Actuaries, Volume 27, No. 1, Session 65

Description: Presented at October 1985 Annual Meeting. This session discussion is about trends in utilization review 'UR', preadmission certification, concurrent review, discharge planning, retrospective review, considerations in the design or purchase of UR services, normative data and monitoring UR, recent experience of UR programs and future expectations.

Description: Presented at June 1996 Spring Meeting. This discussion looks at redirecting the traditional role of the actuary into new areas such as working with doctors to deal with medical management issues, dealing and negotiating with providers and how to help the company develop a provider payment strategy. Employers negotiating directly with providers is also discussed.

Description: Presented at June 1985 Spring Meeting. This session discussed factors affecting the design of flexible benefits programs: choice of benefits, cost containment, tax effectiveness of benefits.

Description: This session discussion is about the valuations applicable to health business including cash flow analysis, scenario testing, and reserving. From Record of the Society of Actuaries 1988 Vol. 14, No. 3.