Description: Presented at June 1996 Spring Meeting. This discussion looks at how a managed care plan can know whether it is doing a good job on utilization review, if there is room for further reduction in utilization, and how a plan should prevent under-utilization.

Description: This session presents a summary of actuarial and potential uses of stochastic modeling for health actuaries. Three case studies are presented: rating health plan reimbursement provisions, developing claim liabilities, and defining appropriate reinsurance levels. From the Record of the Society of Actuaries, Volume 30, No. 1, Session 18

Description: Presented at April 1985 Spring Meeting. This session discussed: Definition of good and sufficient provision for unpaid and actuarial liabilities as used in the NAIC model bill, Actuary and auditor relationships in documentation, reasonableness of results, materiality, margins, and disclosure, Techniques for estimating unpaid claim liabilities, Reverse testing, Considerations regarding incurred date coding in establishing claim reserves, Reserving methodologies for alternative funding products, Reserves for catastrophic claims, Measurement, evaluation, and adjustment for claim department backlogs, changes in claim submission patterns, and environmental changes, etc.

Description: Presented at October 2001 Annual Meeting. Topics covered in this session include Internet-based health plan exchanges, defined-contribution health plans, self-directed health plans, personal spending accounts, and episodic based reimbursement to insureds.

Description: Presented at June 1985 Spring Meeting. This session discussed factors affecting the design of flexible benefits programs: choice of benefits, cost containment, tax effectiveness of benefits.