Description: This review summarizes the key features of a stochastic model that works with non-life insurance claim incurral, accrual and reporting. More specifically it provides an overview of the claim model components, classical parameter estimators, test statistics, and forecast point estimates and error variances. From Actuarial Research Clearing House 1991, VOL. 1.

Description: This article takes a comparative review on Medicare and Private Health Insurance and examines the cost of administration. From Health Watch Newsletter, May 2006, Issue No. 52.

Description: This paper develops a parametric model for health care insurance claims using currently available software to fit parametric models to the data. Model selection is based on the Chi-squared goodness-of-fit test and a comparison of the empirical limited expected value function to parametric limited expected value functions. From Actuarial Research Clearing House 1993, VOL. 3.

Description: This paper presents a procedure for calculating aggregate stop-loss premiums that takes parameter uncertainty into account. From Actuarial Research Clearing House ARCH 1988, Vol. 3

Description: Facilitators lead a discussion of recent experiences and current issues regarding the valuation of medical and dental insurance and managed care products. Includes a discussion of deficiency reserves, HMO reserving, liquidity tests, cashflow testing and codification of regulations. From the Record of the Society of Actuaries, Volume 28, No. 2, Session 132

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: In Medicaid rate development, actuaries have not historically shared models that developed the margin (i.e., underwriting gain) assumption. This is unfortunate, given the margin assumption is one of the most critical components of the rate development in ensuring financial solvency of the Medicaid managed care organizations (MCOs). In this session, we will discuss the primary components of the this assumption and will share working models that help actuaries quantify these components—including the cost of capital and risk (or contingency) margin. We expect a lively discussion as we “open the black box” and discuss these actuarial assumptions in the public for the first time.

Description: In this paper, fuzzy sets - collections of objects whose boundaries are not precisely defined - are used to model the selection process in group health insurance. Both single and multiple options plans are discussed. Discussions of this paper are included.

Description: This Fellowship credit research paper describes the use of fuzzy sets applications to the selection of group health risks. In general, fuzzy set theory is implemented to describe collections of objects whose boundaries are not precisely defined, as in the judgment of what constitutes a good risk group. First, single-plan underwriting is considered, then the work is extended to multiple-option plans.

Description: Presented at June 2002 Spring Meeting. This session discusses how credibility varies by size of groups for various health coverages, when a block of business can be considered fully credible, how credibility can factor into a rate filling, and to what extent current experience can be considered more credible than past experience.