Description: Panelists lead participants in a discussion of recent experiences and current issues regarding the valuation of medical and dental insurance and managed care products. Topics include ASOP 22 [asset adequacy analysis for statements of actuarial opinion] and ASOP 41 [communication]. From the Record of the Society of Actuaries, Volume 29, No. 2, Session 102

Description: Presented at June 1996 Spring Meeting. This discussion looks at redirecting the traditional role of the actuary into new areas such as working with doctors to deal with medical management issues, dealing and negotiating with providers and how to help the company develop a provider payment strategy. Employers negotiating directly with providers is also discussed.

Description: Presented at October 2000 Annual Meeting. Discusses prescription cost trends, factors behind the trends, and cost management strategies for both the commercial and Medicare markets.

Description: This discussion covers the loss experience under superimposed plans compared with comprehensive plans, controls over increasing costs and the use of Relative Value Schedules, and deductible amounts and coinsurance provisions.

Description: Discusses cost-benefit decision-making for acquiring electronic data-processing equipment and installation issues, ability of small companies to compete in pension trust arena, effectiveness of various agency compensation programs in stimulating sales and improving persistency, success of sales to substandard risks and rating methods, and pricing, reinsurance and experience with individual hospital and medical policies.

Description: Relative to group medical plans, discusses: recognition given to effect on morbidity of various demographic factors, consideration given to inflation in making rate guarantees, consideration given to group size, and underwriting transfer cases.

Description: This session discussion is about experience-rating and credibility in group health insurance. From Record of Society of Actuaries Vol. 18, No. 1B.

Description: Presented at April 1985 Spring Meeting. This session focused on recent experience of programs designed to contain health care costs.

Description: Presented at October 1985 Annual Meeting. This session discussion is about marketing opportunities, marketing techniques, product selection and design.

Description: In 2007 the International Accounting Standards Board IASB released a discussion paper proposing a new accounting model for insurance contracts, known as the current exit value model. One aspect of the proposed accounting model is that claim liabilities would need to include explicit margins satisfying certain criteria. Currently it is common for U.S. medical insurers to include explicit margins in their claim liabilities. However, we demonstrate that the margin approach most commonly used today by U.S. medical insurers does not satisfy the objectives articulated in the IASB discussion paper regarding the role of margins. We then propose a new formula for including explicit margins in U.S. medical insurance claim liabilities in a manner that is more compatible with the principles articulated in the IASB discussion paper. Finally, we illustrate our proposed claim liability formula using an example drawn from real-life data.