Description: This paper presents a surplus-ratio goal that is appropriate for group accident and health insurance and discusses growth, the sources of gains and losses, ways to improve operating gain and tracking results against expectations. A discussion of the paper follows. From Transactions of Society of Actuaries 1977, Vol. 29.

Description: Essay stating accessibility, affordability and efficiency are the key to success in the future of healthcare.

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: This session dealt with Regulatory Considerations in Group Insurance. Topics included: 1. National health insurance. 2. Federal hospital cost control programs. 3. Non-discrimination legislation and regulation. 4. Multiple- employer trusts. 5. Impact of recent OASDI financing changes. 6. Changes in mandatory retirement age on group insurance.

Description: At this presentation, the panelists address the following questions: 1. How is health insurance risk measured? 2. How and why do surplus requirements differ between health insurance and life insurance? 3. How and why do surplus requirements differ among health insurers [e.g., Commercial, Blue Cross, HMO] and among health insurance products? 3. What are some of the current techniques being used by health insurers for determining target or required surplus and for managing surplus? 4. How do the rating agencies view surplus requirements for health insurers? From the Record of the Society of Actuaries Vol. 17, No. 3A.

Description: This 1991 panel discussion is about medical claims management and keeping up with changes in technology. The panelists discuss the use of artificial intelligence in claims processing, 'intelligent' coverage cards, and code gaming problems. From the Record of the Society of Actuaries Vol. 17, No. 4B.

Description: This session will discuss the role of actuaries under national health insurance, role of the Canadian health actuaries under that national program and how actuaries can shape the health-care environment in the U.S.. From Record of Society of Actuaries Vol. 18, No. 4B.

Description: This presentation from Session 71PD of the SOA 1996 Colorado Springs Meeting discusses demutalization, mergers of health maintenance organizations [HMOs], and conversion from nonprofit to for-profit. It also addresses the question: How does an actuary value HMOs? From the Record of the Society of Actuaries, Vol. 22, No. 2.

Description: September’s Actuary contained an excellent summary by Drew Davidoff of renewal rating for small group medical business. Among the techniques he describes are age, sex, and area rating, experience rating using credibility, experience rating using tiers, examination of the diagnoses in the claim file, and initial and reentry medical underwriting.

Description: This session discussion is about what factors affect the small employer's choice of programs, how may the small employer capitalize on recent developments in managed health care, what problems do insurance companies have in marketing and communicating their plans to small employers, are partially self-insured benefits a threat or an opportunity for carriers in this market. From Record of the Society of Actuaries Vol. 12, No. 1.