Description: This session discussion is about methods of managing care, what methods have been most effective, experience to date under managed care products, are savings being generated, employer acceptance of managed care products, provider acceptance of managed care products, what will future managed care programs look like. Includes a discussion on utilization review and management, From Record of the Society of Actuaries 1988 Vol. 14, No. 1.

Description: Discussion of various group life and health insurance topics, including: A. Amount of group dental insurance being written and benefit provisions currently being offered and financial experiences of the coverages to date. B. Problems of professional association groups? C. Current level of interest in group paid-up or group permanent.

Description: This session discussion is about state risk pools, Massachusetts programs, federal catastrophic coverage and mandated minimum health benefit coverage. From Record of the Society of Actuaries 1987 Vol. 13, No. 4B.

Description: Panelists at this session of the SOA 1998 Maui II Spring Meeting discuss prescription drug issues including the drivers or cost, employer response to increasing costs, and how this issue is addressed in mergers and acquisitions of pharmaceutical companies.

Description: From session 30OF at a meeting of the Society of Actuaries held in Las Vegas, NV May 22-24, 2000 This session introduces a popular new model, the Quality Compass Model, which seeks to balance concerns regarding consumer satisfaction, clinical outcomes, cost, and utilization.

Description: This session provides an overview of industry approaches to valuing the liabilities of nontraditional health products such as specific and employer stop loss, provider excess and critical illness. From the Record of the Society of Actuaries, Volume 29, No. 2, Session 117

Description: 2004 SOA Spring Meeting, Anaheim, CA. In this session panelists presented an overview of underwriting processes for a variety of product lines. They also discuss related topics such as identifying keys to underwriting decisions, the cost of underwriting and protective value, and ensuring consistency with pricing assumptions. Some of the underwriting tools discussed were use of RX history, credit checks, DMV history, and fraud data bases.

Description: This paper, first published in 1982 in the Transactions of Society of Actuaries, Vol. 34, discusses the phenomenon of durational antiselection, a commonly observed steady and seemingly irreversible increase in loss ratios on mature blocks of individual health insurance policies. The author, William F. Bluhm, constructs a model to explain the deterioration of loss ratios over time, and to quantify the cumulative antiselection effect. This paper was awarded the 1980-82 Triennial Prize. The paper includes written discussion and the author’s review of discussion.

Description: Healthcare costs have been rising faster than general inflation for many years. Early models that predicted this past pattern projected healthcare expenditure growth that continued to outpace total expenditure growth leading to the fallacious position that the whole of the US economy would ultimately be consumed by healthcare. The Society of Actuaries' Pension Section and Health Section Research teams commissioned Professor Thomas E. Getzen of Temple University to construct a resource model for the projection of long term healthcare cost trends that includes capacity constraints to ensure the long-term projection is rational. The motivation for creation of the model was driven by its potential usage as a resource for the estimation of reportable liabilities for retiree healthcare benefits as specified under FAS 106 and GASB 45 accounting statements. This is a zip file containing the following: 1. A background paper on the creation of the health trend model, 2. The model, programmed in Microsoft Excel [xls format], that projects per-person expenditures and growth rates through 2099 using baseline assumptions, but also permits the flexibility for user–inputted alternative assumptions, and 3. Technical documentation providing transparency and support for the ultimate results.

Description: This discussion is about problems of smaller companies entering the individual health insurance field. From Transactions of Society of Actuaries 1962 Vol. 14 Pt. 2