Description: 1997 Valuation Actuary Symposium, Session 5 explores health cash-flow testing.

Description: This paper provides an outline of the pricing methodology used by Blue Cross and Blue Shield of Virginia which incorporates trend analysis by trend component. From Actuarial Research Clearing House 1993, VOL. 3.

Description: In this paper the authors analyze data from group medical expense insurance claims and show that many insurance loss distributions have very 'heavy tails' because large losses represent a disproportionate fraction of the total cost. They also present a simple model to reproduce and explain the large loss behavior. From Actuarial Research Clearing House 1990, VOL. 2

Description: This is the abstract for the paper entitled 'Pricing Long Term Insurance Contracts.' This paper considers several models describing the changes in the needs of the insured for care over time. From Actuarial Research Clearing House 1994, VOL. 1.

Description: This tool created graphs of Google's mobility Data. This version of the tool contains global, country-level data through July 31, 2020

Description: This is an Excel workbook that can be used as a tool for health insurance companies to model their potential risk exposure from an influenza pandemic. It is based on a model developed for a Society of Actuaries study examining the potential implications of a pandemic on the U.S. health insurance industry. The spreadsheet is saved with many of the same assumptions used in this research and reproduces the results of the exhibits contained in the June 2010 report, 'Potential Impact of Pandemic Influenza on the U.S. Health Insurance Industry.'

Description: Employers, health plans, stop-loss insurers and reinsurers are all affected by the high cost of treating cancer. In recent years, cutting-edge pharmaceuticals, bone marrow transplants and CAR-T cell therapies have driven very high cost trends for cancer, with more emerging therapies on the horizon. In this session, we will review these new treatments, showcase models that aid in understanding the range of likely financial effects of the current, expanded, and likely-to-be approved indications for cell therapies that will treat certain patients affected by lymphoma, leukemia, and multiple myeloma. This session will explain important considerations for modeling Medicare, Medicaid versus commercial populations, key risk concerns caused by the size of enrollee pools, and important differences between the various therapies that affect modeling. We will also discuss averted cost, health outcomes, pricing levels, and risks caused by provider billing practices.

Description: Chapter 1 presents the background to the current study, followed by the methodology used, and a summary of the findings of the study. From Group Medical Insurance Large Claims Database Collection and Analysis, M-HB97-1.

Description: The MACRA/QPP Payer Revenue Model is designed to provide Health Plans an estimate of the expected claim cost increase/decrease due to MACRA.

Description: Watch as presenters highlight the SOA's work on an updated Medicaid underwriting margin model. This research project includes the model along with a set of instructions and a paper describing the key components of underwriting margin, including cost of capital and risk margin. The model was created as a tool for Medicaid actuaries representing both MCO and state principals to determine appropriate underwriting margin components within Medicaid managed care rates. In addition, explore a brief description of the motivation for an underlying theory behind the model. Walk through different model inputs and run through some realistic scenarios that Medicaid actuaries may encounter in states where they operate.