Description: Health equity is taking a front row focus in many health arenas. Take a closer look at some of the efforts being used to ensure health equity. One area of interest to actuaries is value-based insurance designs (VBID). VBID can be incorporated into exchange plans. These innovations to prevent and treat disease have led to reductions in morbidity and mortality. Learn techniques to improve the quality of care and reduce barriers to high-value care in the form of high-cost sharing.

Description: This article provides an overview of critical illness insurance: history, product description, and the three primary ways to offer critical illness coverage in the United States. This article also contains an illustration of an issue age premium rate calculation, as well as product features and rating applications specific to the various types of critical illness coverage.

Description: As actuaries in health care, we spend most of our time focused on reviewing claims, enrollment and clinical data. That information is captured while patients are in health care facilities. Yet most people spend only a small fraction of their time in these facilities. This article explores what types of data are available to actuaries the provide a more holistic view of the member so that a members physical and emotional needs, the social determinants of health can be taken into consideration along with their clinical needs. Two uses cases are presented so actuaries can see how these types of analyses can be leveraged to improve clinical, operational, and financial performance of risk bearing health entities. Understanding the customer (member) not just the patient enables actuaries to provide new insights and values to our stakeholders across a wide range of business and risk applications.

Description: The evolving specialty pharmacy environment has created difficulties for actuaries pricing and forecasting pharmacy coverage. Unpredictable specialty pharmacy trends have increased insurers' earnings volatility and affected members' health care affordability. The presenters will highlight the current specialty drug development pipeline and explore specialty pharmacy drug trend management strategies. They will also provide concepts to help manage the coming wave of gene and cell therapies.

Description: This article describes some of the traditional profit measurement standards for direct marketing and then presents a more comprehensive and up-to-date foundation for insurance direct marketers and actuaries to use when reviewing individual direct marketing campaigns or total marketing programs.

Description: The presenters will discuss predictive analytics as applied to recent group life and disability experience studies and other applications.

Description: This report examines lapse experience on individual disability income insurance products by various policyholder and product factors. The study can be used for industry benchmarking as well as for background information for product development and planning purposes.

Description: This article discusses the problems in estimating the prevalence of HIV infection.

Description: This discussion at the SOA 1966 Annual Meeting is about various aspects of group life and health insurance including disclosure forms, interest rates, group life maximums, disability insurance, and Medicare.

Description: Panelists address topics such as techniques for testing data quality, the actuary’s responsibility for verifying the reasonableness of data, and considerations in modifying data sources for specific situations. Included is a discussion of ASOP No. 23. From the Record of the Society of Actuaries, Volume 27, No. 1, Session 96