Description: This article highlights a trend among companies to integrate the management of the various medical programs including health, workers compensation and disability. This concept of total health management allows greater focus on the health and wellness of employees resulting in improved productivity.

Description: Managed care networks are important to control rising health care costs . these need to be priced appropriately to produce the right results for all stakeholders . This includes analysis of utilization and costs for both in and out of network claims . A variety of risk and administrative service options exist for entities assuming such risk .

Description: The impact of Medicare on retiree medical. Issue No. 44.

Description: This paper is a primer for actuaries with limited experience in accessing and using public data sets. From Small Talk Newsletter, November 2005, Issue No. 25.

Description: This a book review of 'Synthetic State Estimates of Disability Derived from the National Health Survey' by the National Center for Health Statistics. This paper arose in response to the increasing demand for health statistics on the state level.

Description: The article provides insights about the need for revolutionary actuaries in Saudi Arabia due to the reform that is happening across the kingdom under all sectors. Then I talk briefly about the health sector and the transformation that is happing in the sector, and how qualified health actuaries can contribute to this health reform.

Description: Cell and Gene Therapy (CGT) are life-changing treatments where conditions such as cancer, hemophilia, spinal muscular atrophy and blindness are being cured. These are great for individuals and society, but the treatment costs are expensive which is bad for payers and reinsurers. This article explores ways for health reinsurance actuaries to participate in the space and evaluate the risk associated with these treatments

Description: The big event of 2023 is the launch of multiple Humira biosimilars, which began in January with the arrival of Amgen’s Amjevita on the market. The launch of Amjevita kicks off the process of changing the specialty drug marketplace in the United States. The expectation of the full impact of this big event is very hopeful, but there is still uncertainty several months after its beginning. Humira is the highest-selling drug in the world and has been since 2013 (Figure 1)—except for when COVID-19 projects temporarily surpassed it. The world is eagerly awaiting the launch of multiple biosimilar drugs to compete with Humira and hopefully bring more competitive pricing to the benefit of payers and patients everywhere.

Description: The article describes changes to the computation of discounted unpaid losses (claim reserves) as a result of the 2017 tax legislation.

Description: This article is about our dependence on prescription drugs, their cost and the desire for insurance coverage of drugs.