Description: Court cases demonstrating how ERISA Preemption Clause makes it difficult for members to sue Managed Care Organizations MCOs. Issue No. 41.

Description: Panelists provide an overview of the current long-term-care [LTC] market and trends. They cover recent hot topics such as pricing, rate stabilization, administration, marketing, and hybrid/combo products. From the Record of the Society of Actuaries, Vol. 31, No. 2, Session 16

Description: This session will discuss the continuing evolution of the managed health care process. Topics include precertification, utilization review, retrospective review, case management, appropriateness review, benchmarking, recredentialing, provider contracting, and integrated medical systems. From Record of Society of Actuaries Vol. 20, No. 3A.

Description: This session discusses continuing care retirement communities. What opportunities exist? What role does the actuary play? From Record of Society of Actuaries, Volume 26, No. 1.

Description: Presented at May 2000 Spring Meeting. This teaching session presents techniques and tools for valuing long-term-care insurance for mergers and acquisitions, drivers behind M&A activity in this market, the appraisal process. Specific situations are discussed.

Description: Panelists discuss current and future developments in health insurance on the Internet and the Health Insurance Portability and Accountability Act from the perspective of providers, insurers, employers and customers. From the Record of the Society of Actuaries, Volume 28, No. 2, Session 131

Description: Discussion of state medicaid expansion due to provisions of the Affordable Care Act.

Description: Accurate forecasts of future health care expenditures for cohorts of elderly individuals can be especially difficult. Current techniques use average per capita costs, based on local experience, adjusted for the cohort's age, sex, institutionalization, and welfare status distribution. This paper presents a method to adjust such per capita cost estimates to reflect more accurately the likely health status of a particular cohort. The adjustment uses the cause-of-mortality profile in the local population, which is a readily available tabulation known to be highly correlated with a major proportion of total medical care expenditures for people beyond age 65. From Transactions of Society of Actuaries 1984, Vol. 36.

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 is an abstract article about social sercurity and medical care by Andrew Lang. ARCH 2008, Issue 1.