Description: Panelists at this session of the SOA 1998 Maui II Spring Meeting discuss the impact point-of-service [POS] plans have had on both HMOs and on indemnity carriers. Different types of POS plans and the problems presented by primary care gatekeepers are discussed.

Description: Panelists at this session of the SOA 1998 Maui II Spring Meeting discuss the strategies various insurers have taken in response to the Health Insurance Portability and Accountability Act [HIPAA] requirement to use guaranteed issue for small group and certain individual health plans to qualified individuals.

Description: This panel at the SOA 1998 New York Annual Meeting discusses the history of HMOs with respect to actuarial support and looks at how actuaries can and should be involved in supporting HMOs.

Description: This session from the 1992 Valuation Actuary Symposium reviews the appointed actuary concept, the actuarial opinion and asset adequacy analysis as they apply to health insurance and expresses the views of one regulator on the subject and one actuary in terms of the actuarial standards of practice.

Description: In order to encourage health insurance issuers to offer health insurance coverage on the Exchange and on the individual and small group markets, while ameliorating the potential impact on any particular health insurance issuer of providing coverage without pricing for pre-existing conditions or the gender of the insured, the Affordable Care Act includes three risk-sharing programs: the Transitional Reinsurance program, the Risk Corridor program and the Risk Adjustment program (collectively referred to as the “3Rs”). The financial and tax reporting of each health insurance issuer is affected by the implementation of these risk-sharing programs because each health insurance issuer is required to pay for the programs’ costs, and some issuers are or will be eligible for benefits under them.

Description: Editor letter detailing article and encouraging authorship.

Description: This paper explores the legislation of New York 65, the intent of which was to offer health benefits to persons age 65 and over without health examination or other evidence of insurability. From TRANSACTIONS OF SOCIETY OF ACTUARIES, 1962 VOL. 14, PT. 1 NO. 40.

Description: This discussion focuses on sickness insurance and associated issues. From Transactions of Society of Actuaries 1950, Vol. 2, No. 2.

Description: This discussion looks at the changing needs for individual accident and sickness insurance, including coverage for older people [ages 65 and over]. The discussion seeks to answer: What changes in the scope of and market for individual accident and sickness insurance have taken place in recent years, and what revisions of policies and marketing procedures have been made or are indicated to meet changing needs? From Transactions of Society of Actuaries 1959, Vol. 11, No. 31.

Description: This discussion looks at the approach companies are taking in developing dividend scales for participating accident and health policies as well as arguments for and against grading accident and sickness premiums. From Transactions of Society of Actuaries 1959, Vol. 11, No. 31.