Description: This article discusses the advantages, logistical concerns, and pricing formulas of implementing a TNHP, in which members pay less for treatment from providers who meet higher quality and cost-effectiveness standards.

Description: This article contains a condensed summary and excerpts from a recent white paper regarding the Individual Mandate.

Description: Using the Internet as a Pricing Tool clinical background information, defining the change in coverage, collecting data, data quality and data limitations. Issue No. 39.

Description: Incorporating Pended Claims in Medical IBNR Estimates. Issue No. 45.

Description: Discussion of methods to estimate unpaid claim liability UCL for health plans. Includes traditional IBNR lag method and a lag method based on claims reported but not paid RBNP. Issue No. 45

Description: Recognizing an opportunity to help serve its members in this age of increased financial oversight, the Health Section of the Society of Actuaries commissioned a series of guides on the use of statistical techniques specifically geared for the work of health actuaries. From Health Watch Newsletter, January 2008, Issue No. 57.

Description: Article builds on similar article in January 2002 issue and presents brief discussion on extra stop-loss risk. Health Section News, June 2002, Issue 46

Description: Analysis of diagnosis and pharmacy-based methods of health risk assessment. Issue No. 44.

Description: Applying Diagnosis-Based Predictive Models that use medical and pharmacy claims to measure expected costs for Group Underwriting. Issue No. 46.

Description: ASOP No. 6 Exposure Draft Provisions Relating to Community- Rated HMO Contracts. Discusses determination of initial per capita health care rates, effect on valuation results, accounting standards, potential conflicts with FAS 106 and source of problems. Issue No. 42.