Description: The Society of Actuaries (SOA) retained Milliman, Inc. (Milliman) to conduct a research project related to product innovation. This report explores key risks and considerations for product innovation using the long-term care insurance (LTC, LTCI) industry as a case study. We identify how actuaries of all backgrounds can apply the lessons learned, and challenges overcome, by the LTCI industry to improve future innovation, product development and risk management.

Description: This report describes two methods, an observation-based analysis and an actual to model analysis, to analyze long-term care insurance experience to determine if calendar year trends exist.

Description: The "Think Tank on Steroids" group at the DI and LTC Insurers’ Forum brainstormed about what the United States should do in order to deal with the impending Long-Term Care problem in the United States. The group’s ideal plan for dealing with Long Term Care can be thought of as a three-legged stool. The legs are private savings and assets (including tax-advantaged LTC savings accounts), Long-Term Care Insurance (including smaller, more affordable products), and support from the family. The Medicaid system ought to be reformed so that it is only available to people who have exhausted all other options. The ongoing Think Tank will continue this conversation and publish a white paper detailing the Think Tank’s solution to the problem.

Description: The objectives of this paper include an assessment of the basis of volatility of experience and financial results, considering the risks and uncertainties associated with long-term policies, especially LTCi. In so doing, it is observed that a properly determined provision for risk and uncertainty is needed in premiums and reserves. It then describes the approaches that can be taken to quantify such a provision in new and re-rated LTCi. The paper discusses possible mitigation approaches that have and should be taken, especially but not limited to the use of policy design features to enhance the alignment of interests of the LTC insurer and its policyholders. It also explores the relationship between historical and expected future risks and uncertainties specific to LTCi. It concludes by pointing out the pervasiveness of the uncertainties involved, the earlier underestimation of the uncertainties involved, although the actual degree of uncertainty may have decreased over time as relevant experience has been obtained. Effective management of LTCi demands incorporation of mitigation approaches in its product design and continuous monitoring of relevant experience.

Description: This article discusses the details of being classified as cognitively impaired, particularly the relationship between being classified as cognitively impaired and subsequent mortality experience and the effect of cognitive impairment on mortality rates.

Description: This survey is intended to share insurance company risk management practices and perspectives, so that these stakeholders may have a common understanding when discussing fraud, waste and abuse in LTC insurance claims.

Description: This report estimates sex-specific trends in HIPAA ADL disability between 1984 and 2004 using the National Long Term Care Survey (NLTCS); estimates age-standardized 20-year changes in ADL and cognitive impairment (CI) among the U.S. elderly using the HIPAA CI trigger; estimates the joint distribution of cognitive impairment (CI) and ADL disability among aged Medicare enrollees using the HIPAA disability triggers.

Description: Research report describing an analysis of experience transition rates between Long Term Care insurance claim settings over the course of a claim. Examples of such transitions are from an assisted care facility to home health care or from home health care to a nursing home.

Description: This is the sixth Intercompany Study of Long–Term Care Insurance. This report combines and analyzes data received from 35 insurers. Available data was collected on policies issued between January 1, 1984 and December 31, 2007. Claims incurred on policies during this same timeframe were followed from claim inception through the earlier of claim termination or June 30, 2008.

Description: This paper introduces continuing care retirement communities and outlines the major recent developments in financing procedures and regulatory requirements aimed at keeping these entities solvent. In particular, it describes the Actuarially Based Financial Management System created by the AAA and the accounting Statement of Position 90-8 promulgated by the AICPA. From Transactions of Society of Actuaries 1995 Vol. 47