Description: This paper presents research results from a study on health carrier insolvencies. Carriers studies include commercial insurance companies, Blue Cross/Blue Shield pland and health maintenance organizations. From Transactions of Society of Actuaries 1995, Vol. 47.

Description: The PPACA imposed a market share-based health insurance provider fee, known as the "Section 9010 Fee", "Health Insurer Fee", or simply the "HIF", on each “covered entity” with net premiums written in excess of $25 million that is engaged in the business of providing health insurance coverage for U.S. health risks. This article provides background information to help unpack the language behind the Section 9010 Fee and highlights a few areas of special interest including merger and acquisition-related issues, application of the Section 9010 fee to expatriate plans, and considerations regarding fee administration.

Description: This paper examines the factors affecting claims in a group health insurance plan.

Description: The principal objective of this paper is to remind actuaries of the rather significant misconceptions and distortions commonly encountered in the use of individual accident and health insurance loss ratios. From Transactions of Society of Actuaries 1979, Vol. 31.

Description: CDHP reserve levels claim, policy and premium reserves. New reserve technique for ASO plan sponsor reserves. Issue No. 48.

Description: This is a highly interactive role-playing session detailing the actual product development process for a hypothetical health care product. From Record of Society of Actuaries, Vol. 30, No. 3, Session 19

Description: Interviews with several actuaries who are subject matter experts in the health field to get their perspectives on implementing the Affordable Care Act (ACA).

Description: This article describes a method that can be useful when re-fitting a risk score model to a population of only moderate size. Learn how to use concepts like ridge regression to train a model with partial credibility.

Description: Presentation on estimating rates of early-onset Alzheimer's Disease. This document contains incident rates, critical illnese insurance information, adverse selection, and more.

Description: This article describes methodologies for detection and deterrence of Medicare fraud. It also describes the validation of PRIDIT for fraud detection in Medicare.