Description: Presented at May 1985 Spring Meeting. Discusses current financial reporting topics related to both group and individual health insurance, including: Standards of practice for health actuaries, Deficit Reduction Act of 1984 DEFRA, Qualifications for health certification, Internal management reporting needs, New state reporting requirements.

Description: Presented at October 1985 Annual Meeting. This session is about actuarial implications of individual choice, antiselection problems for medical coverages, plan design considerations, flexible benefits program experience, impact of alternative delivery systems on insured plan.

Description: After the bid process, desk review, rebate reallocation, an “enjoyable” audit, and open enrollment; the Medicare plan year starts. Throughout the year, organizations find it pertinent to get an accurate picture of their Part D liability as reinsurance, LICS (Low Income Cost-Sharing) subsidy, and risk corridors are accrued. Attendees will learn about the basics of Part D accruals, how future accrual amounts are estimated based on patterns in the data, and how bid assumptions versus actual results impact plan sponsor profitability. We will also discuss financial statement treatment of these items. Real-life examples from bids to outcomes will be provided to enhance the discussion. Ultimately, attendees will come away with a deeper understanding how their bid assumptions play out, and how they can use Part D accruals to plan for future bid development.

Description: More and more providers are desiring risk-based contracts instead of traditional FFS-based contracts. This session is intended to outline some of the actuarial best practices in risk-based contracting related to the many flavors of the CMS ACO programs, as well as Commercial risk-based contracts.

Description: Presented at June 2002 Spring Meeting. This session discusses how credibility varies by size of groups for various health coverages, when a block of business can be considered fully credible, how credibility can factor into a rate filling, and to what extent current experience can be considered more credible than past experience.

Description: This discussion about group Life and group Accident and Health insurance covered over insurance, medical catastrophe coverage, conversion privilege, and the regulatory environment. From TRANSACTIONS OF SOCIETY OF ACTUARIES, 1953 VOL. 5 NO. 11.

Description: This discussion is about the actuarial considerations that should surround proposals in Congress for reinsurance of health plans. From Transactions of Society of Actuaries 1954, Vol. 6, No. 14.

Description: This is a panel discussion session on the developments in the group insurance market in the 1980s including designing benefit plans with the employee as the focus, the cost to the corporate employer, and the group insurance underwriter's outlook.

Description: This is a panel discussion session on the purpose, rationale and conclusions of the Committee for Accident and Health Valuation Principles. Discussion also covers the comments received and any modifications to their original draft report.

Description: Experts discuss new strategies related to provider contracting and network management. Topics include various reimbursement approaches and risk-sharing arrangements, unique risk arrangements for certain provider specialties, unique risk managements for specific diseases, and the role of care management/care coordinators. From the 2002 Record of Society of Actuaries, Volume 28, No. 2. Session 59PD of the San Francisco Spring Meeting.