Description: This session addressed the following regarding benefit plan design to control claim costs: What has been tried? What works? and What else can be tried?

Description: This is an internal letter from an actuary to an associate regarding a claims study that established, in the mind of the writer, the adequacy and conclusiveness of a small sample size in certain situations. Actuarial Research Clearing House ARCH 1988, Vol. 3

Description: This session is about NAIC health rate regulations regarding loss ratios, new business/closed-block issues, experience data for reporting, and trend. Topics include alternatives to durational rating, prefunding, and rate spread, From Record of Society of Actuaries Vol. 19, No. 1A.

Description: Presented at October 2001 Annual Meeting. Panelists provide insight into the factors driving the cost increase of prescription drugs and how these factors are being addressed. Strategies include drug utilization review, manufacturer contracting, benefit design, formularies, pharmaceutical pricing, therapeutic substitution, physical education, and introduction of new pharmaceuticals. Also discussed are pharmacoeconomic benefit considerations when studying integrated medical and pharmacy expenses.

Description: Panelists discuss the contractual relationships between health-care providers and health-care insurers [payers], and how they can be improved. Discussed are managed care, HMO, and PPO types of negotiated contracts in the private arena. Recent trends in types of provider arrangements, and expectations for the future, are also discussed. From the 2002 Record of Society of Actuaries, Volume 28, No. 3. Session 97PD of the Boston Annual Meeting.

Description: This session from the 1994 Valuation Actuary Symposium covers long term care and health related issues for valuation, an update from the Risk-Based Capital Task Force of the Academy on developing a risk-based capital formula for health coverages, an overview of the health practice notes.

Description: This session is about appointed actuary issues for the health actuary including cash-flow testing, asset valuation and risk-based capital. From Record of Society of Actuary Vol. 19, No. 4B.

Description: Panelists at this session of the SOA 1997 Palm Desert Spring Meeting present various physician incentive programs, including withholds, bonuses, capitation, and other risk-sharing concepts. Implications and effectiveness of each type of program and appropriate situations for applying each program are discussed.

Description: The American Academy of Actuaries is engaged in several projects that proactively examine the future status of the Medicare Program. This session presents the findings that have resulted from these efforts. From the Record of the Society of Actuaries, Vol. 24, No. 2.

Description: In this paper, a model is proposed as a potential explanation for the steady deterioration in loss ratios often observed on blocks of individual health insurance policies. This model, which incorporates assumptions of anti-selective lapses, can be used for morbidity projections and projections of the effects of rate increases. Discussions of this paper are included.