Description: Stuart Klugman provides a preliminary education update as it pertains to Exams P/1, FM/2, and MLC.

Description: The presenters give a history lesson on the origin of CMS Medicare star ratings, including why this demonstration was originally created and how the program has worked over the years. The discussion will cover both the evolution of the underlying measures and the financial impact to Medicare Advantage stakeholders. By attending the session, you will have a stronger understanding of how member experience and outcome-based measures can be factored into the funding within a health care system to better align incentives among various stakeholders.

Description: Hear about some applications using quantile regression-derived individual and group claim distributions and how they may be used in various traditional health care modeling situations. The session will not focus on the technical use of quantile regression to obtain estimates of claim distributions, but more so is intended to focus on the uses of the distributions in actuarial modeling and the additive framework in assessing claims distributions. Presenters will show how actuaries can better assess risks by focusing on the individual- and group-specific claims distributions as opposed to traditional point-estimate-centric models.

Description: This presentation on the subject of Defined-Contribution Health Plans, covers reasons to move to a DC health plan, advantages and disadvantages, comparison to DC retirement plans, plan designs, pricing, risk considerations, and the regulatory and tax environment. 2001 SOA Annual Meeting, New Orleans.

Description: The April/May 2013 edition of The Actuary magazine—the Society of Actuaries’ flagship publication.

Description: As the insurance industry continues to evolve due to a pandemic and rapidly changing economic and regulatory conditions, the role of data scientists and actuaries has become increasingly important. In an interview with the Atidot data science and actuarial team, we discuss what it is like to work at an InsurTech, how data scientists and actuaries can collaborate, and look at some concrete technical examples of where the innovation is having an impact. This article explores what collaboration can look like and how the role of data science and actuary may evolve in the InsurTech industry in the future.

Description: Facilitators lead a discussion of recent experiences and current issues regarding the valuation of medical and dental insurance and managed care products. Includes a discussion of deficiency reserves, HMO reserving, liquidity tests, cashflow testing and codification of regulations. From the Record of the Society of Actuaries, Volume 28, No. 2, Session 132

Description: This study produces annual claim costs for Group Weekly Indemnity Insurance and Group Employee & Dependents Hospital & Surgical Expense Insurance and exhibits the trend in these claims costs. This report is based on a study by the Committee on Group Accident and Sickness Experience designed to satisfy that need to update previous studies due to the shift in emphasis by plan of benefit, the increase in level of hospital expenses and the change in pattern of these expenses. From Transactions of Society of Actuaries 1960, Vol. 12, No. 34.

Description: The evolving specialty pharmacy environment has created difficulties for actuaries pricing and forecasting pharmacy coverage. Unpredictable specialty pharmacy trends have increased insurers' earnings volatility and affected members' health care affordability. The presenters will highlight the current specialty drug development pipeline and explore specialty pharmacy drug trend management strategies. They will also provide concepts to help manage the coming wave of gene and cell therapies.

Description: In this session on the topic of health insurance valuation issues, the topics covered included Sarbanes-Oxley considerations, internal replacement Standards of Practice, self-funded plans, and long-term-care insurance developments. From a session at the Health/Pension Spring Meeting held in New Orleans, Louisiana June 15-17, 2005.