Description: This Fellowship credit research paper describes the use of fuzzy sets applications to the selection of group health risks. In general, fuzzy set theory is implemented to describe collections of objects whose boundaries are not precisely defined, as in the judgment of what constitutes a good risk group. First, single-plan underwriting is considered, then the work is extended to multiple-option plans.

Description: 1973 SOA Regional Meetings, Saint Paul and San Francisco. This paper provided a summary of several concurrent sessions from the referenced meetings including: 1. PRICE DISCLOSURE AND COST COMPARISON. 2. INDIVIDUAL LIFE AND HEALTH UNDERWRITING. 3. TIME SERIES ANALYSIS AND FORECASTING. 4. INDIVIDUAL HEALTH INSURANCE - PROBLEMS AND PRODUCT TRENDS. 3. VARIABLE LIFE INSURANCE. 6. POLLUTION, POPULATION, AND THE QUALITY OF LIFE. 7. HEALTH MAINTENANCE ORGANIZATIONS.

Description: This paper suggests that using the entire runoff triangle to keep a tail on the runoff curve was not necessary, and that doing so was actually a disadvantage if group medical and dental claim payment patterns changed over the period being used. An alternative was presented. From Actuarial Research Clearing House 1993, VOL. 3.

Description: This session from the 1983 SOA Hollywood, Florida Meeting discusses the practical application of risk analysis technique In Health Insurance. This includes using company claim information and multinomial distributions for predictive purposes and using this information to price health insurance. From Record of Society of Actuaries Vol. 9, No. 4

Description: 1994 SOA Spring Meeting, Orlando. In this session the panel consider the question of uncertainty in loss reserves including discussion of sources and measurement. The panelists analyzed the same data set from different perspectives and discussed the strengths and weaknesses of the approaches.

Description: This article will clarify valuation issues for the waiver of premium benefit in Accident and Health products.

Description: This paper develops a parametric model for health care insurance claims to fit parametric models to the data. Model selection is based on the ChJ-squared goodness-of-fit test and a comparison of the empirical limited expected value function to parametric limited expected value functions. A copula function was used to model the bivariate portion of the data. From Actuarial Research Clearing House 1993, VOL. 3.

Description: This is an internal letter from an actuary to an associate regarding a claims study that established, in the mind of the writer, the adequacy and conclusiveness of a small sample size in certain situations. Actuarial Research Clearing House ARCH 1988, Vol. 3

Description: The birthday rule is used to determine whether the father's or the mother's insurer is liable for a child's medical bills, where the liability rests with the insurer of the parent whose birthday falls in the first half of the year. It is assumed that the odds are even that the liable insurer will be the mother's, vs. the father's. This paper demonstrates how the key determinant of whether this assumption is valid is the distribution of the difference in spouses' ages.

Description: This session presents a summary of actuarial and potential uses of stochastic modeling for health actuaries. Three case studies are presented: rating health plan reimbursement provisions, developing claim liabilities, and defining appropriate reinsurance levels. From the Record of the Society of Actuaries, Volume 30, No. 1, Session 18