Description: This article provides an overview of behavioral economic theory as it relates to health and welfare insurance plans and provides summaries of two sample applications of the theories: enrollment in health insurance exchanges created by the Patient Protection and Affordable Care Act, and product design considerations in light of vast health illiteracy.

Description: Presents a step-by-step methodology for calculating confidence intervals for IBNR estimates derived using the Averaqe PMPM method. It is a companion article to the January 2023 Health Watch article presenting the Average PMPM method for generating point estimates of IBNR with zero claims runout.

Description: This is an extension of the 8th edition of the SOA Living to 100 Symposium in the U.S. It brings new perspectives with the combination of long-term care, mortality, ElderTech, pandemic longevity and climate change response to the needs of the elderly population.

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: Learn about key actuarial and analytic tools and methodologies used by commercial health insurance to identify and quantify drivers of healthcare cost and utilization (including wasteful and low-value ones) and risks. Use case scenarios in which these tools and methodologies apply, such as underwriting, reinsurance, medical management for population health and chronic diseases, managed care contracting, insurance market reform, provider payment reform, etc., will also be covered. Experience from the U.S., China and other parts of the world will be shared.

Description: CMS provides ACOs with monthly claims data for members, including their medical visits and ACO program eligibility. This data can be divided into Membership and Claims tables through the ETL process. However, when calculating PMPY at specific levels of detail using these tables, issues arise due to unrelated dimensions, leading to inaccurate and understated results. This article presents a solution to this problem by utilizing Tableau's data blending capabilities.

Description: The article describes the factors that should determine the asset allocation of an employer's QDIA, especially Target Date Funds, and suggests that in general QDIAs have insufficient equity in retirement asset allocations.

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

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

Description: GAAP's elimination of gross profit as a basis for amortization of deferred acquisition costs enables the accounting for reinsurance of universal life contracts to better reflect the economic protection provided by reinsurance. This article takes a fresh look at the standards of accounting for universal life contracts and for reinsurance, then puts them together to find the techniques that best account for that protection.