Description: This paper proposes a hypothesis that the negative public policy implications of durational rating strategies in the medical insurance market are caused by lack of prefunding of durational deterioration of experience and constitute a failure to maintain an important part of the original insuring promise. To solve the problem, a practical and simple reserving basis is proposed as a regulatory standard. Discussions of this paper are included.

Description: With the increase of membership in Blue Cross / Blue Shield, this paper presents the practices and experience under the plans using the United Medical Service, Inc as a model. Transactions of SOA Vol. 6, No. 14

Description: At the end of 1963 health insurance claim reserves and liabilities held by companies on this continent totaled well over one billion dollars. This paper seeks to study the problems involved in calculating these reserves and liabilities and to describe the methods in use. From Transactions of Society of Actuaries 1964, Vol. 16, Pt. 1, No. 44 AB.

Description: 1959 SOA Regional Meeting in Atlanta. This discussion covered the advantages and disadvantages of entering the pension field through Ordinary policies or Group Annuities. The panel also discussed considerations in entering the Accident and Sickness field.

Description: This paper describes a process for developing rates for a preferred provider organization [PPO]. From Transactions of Society of Actuaries 1985, Vol. 37.

Description: This paper describes a modified development method for analyzing claims experience and calculating claim reserves and liabilities on short-term health insurance benefits. It identifies many of the influences on claim development and discusses various ways to recognize them. From Transactions of Society of Actuaries 1989, Vol. 41.

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.

Description: This paper examines five alternative valuation methods - prospective, retrospective, global, intermediate, and static - for the proper application of GAAP to Medicare supplement insurance. The focus of this paper is on the changes to expected future claim costs due to changes in the Medicare deductibles.

Description: This paper describes the construction of the 1965 Supplementary Major Medical Tabular used to measure expect4ed claims. The paper also comments on the relationship of the intercompany 1963-65 experience to it. From Transactions of Society of Actuaries 1968, Vol. 20, Pt. 1, No. 56 AB.

Description: This paper discusses the purpose and nature of the benefit ratio [otherwise known as active life] reserve in relation to the class of health insurance contracts to which it is intended to apply. From Transactions of Society of Actuaries 1988, Vol. 40, Pt. 1.