Description: This article describes methodologies for detection and deterrence of Medicare fraud. It also describes the validation of PRIDIT for fraud detection in Medicare.

Description: Key findings from a market research study which the SOA undertook as part of their strategic initiative: Untapped Opportunities for Actuaries in Health.

Description: Research project that reviewed and inventoried the range of quality and efficiency measures that demonstrate the performance of hospitals and physicians. Besides outlining key areas of consideration for quality and efficiency measurement, this report also describes future opportunities for actuaries and other health professionals interested in this evolving area. The inventory part of this report is in a separate document.

Description: Fiduciaries play a vital role in the financial health of a pension plan. How they carry out their duties is a question of increasing interest to beneficiaries, regulators, shareholders and taxpayers. Having a clear, logical and well-documented risk management process in place can make a big difference.

Description: This paper is intended to acquaint actuaries with a simple and practical application of the ruin function technique in the determination of the C-2 mortality risk reserve needed for individual life insurance business. Followed by 2 discussion papers submitted

Description: This article talks about the challenges facing the FDA, especially those arising from the globalization of the pharmaceutical supply chain.

Description: Ways of closing the mortality protection gap, by leveraging some of the new technology, data and analytics to reduce the friction in the buying process.

Description: People naturally observe risk in the form of the range of experienced gains and losses which is usually represented in statistical terms by standard deviation. In most cases, there are not enough observed values to reliably discern the true amount of losses that are possible in extreme situations. Statistical techniques that have long been applied to insurance company risks are being used to extrapolate from observed risk to extreme tails of the distribution of gains and losses. These processes are essentially an extrapolation from the “known” risk of volatility near the mean to “unknown” risk of extreme losses. “Fat tails” is a term often applied to risks where the likely losses in rare situations significantly exceeds the predictions of a Gaussian (“thin tailed”) distribution. This paper will look at the relationship between the observed risk and the extreme risk in statistical insurance r isk models and discuss how we might create a discussion among model users about the appropriateness of that relationship for specific types of risks.

Description: Article is a detailed discussion of the Risk Management and Own Risk and Solvency Assessment (RMORSA) Model Act that was recently approved by the NAIC and is being adopted by legislatures across the country.

Description: Response to Life Insurance 2020 Foresight – A Call for Essays. An essay stating the author’s vision for the future of the life insurance sector.