Description: The purpose of this document is to inform the user of the 2021 Health Care Cost Model about the sources of data, other reports, and assumptions which were used to populate this report and drive some of the key considerations.

Description: Risk Adjustment continues to be a hot topic in Health Insurance since its emergence. This mechanism came into being as a means of reducing the risk of selection, particularly in marketplaces where underwriting is not allowed, and rating factors are significantly restricted. Risk adjustment serves to adjust premiums to reflect the risk of individual members or overall members as a whole within a particular cohort of a health plan. Risk adjustment is not perfect, as it does not perfectly predict future costs or perfectly adjust for the differences in expected costs. Different marketplaces have different challenges with risk adjustment.

Description: In an age of accelerating transformation—technological, financial, and regulatory —reinsurance continues to be an important component of capital management strategy across the insurance industry. This is true in spite of, and sometimes because of, the evolving ecosystems of ceding companies and reinsurers. Direct writers and reinsurance carriers are coping with a number of critical challenges that are undermining growth potential and threatening profitability. Waning demand and increased capacity for traditional products have, in some instances, led companies to struggle to achieve traditional profit targets. An increase in commoditized pricing, internal expenses related to increased regulation, inefficiencies in internal infrastructure, and the sustained low interest rate environment are additional factors impacting the top and bottom lines of reinsurers and primary carriers alike. In this session we will explore these critical challenges and highlight prevailing practices that organizations are using to deal with the changing landscape.

Description: The Society of Actuaries Long Term Care Insurance and Health Sections are seeking researchers to author a primer on long-term care insurance wellness programs. The underlying motivation for this effort is to educate actuaries on these programs and provide a useful resource for understanding their benefits, structure and limitations.

Description: In the face of declining response rates from direct mail campaigns, the author suggests use of the internet to generate leads will be much more efficient and successful.

Description: 1993 SOA Annual Meeting in New York. This session is about core benefit plans from a state and from a national level. Core benefit plan is used interchangeably in this session with standard benefit plan, basic benefit plan, and minimum benefit plan. Topics included: 1. A summary of the legislative process. 2. A summary of options available within the national health-care debate, with a primary focus on the Clinton proposal. 3. The role of core benefit-plans in health-care reform.

Description: Panelists at this session of the SOA 1998 Maui II Spring Meeting discuss the impact point-of-service [POS] plans have had on both HMOs and on indemnity carriers. Different types of POS plans and the problems presented by primary care gatekeepers are discussed.

Description: Medical stop-loss reinsurance continues to play a vital role in containing employers’ health care costs. Managing general underwriters [MGUs], who originally handled these programs, have lost market share to large direct writers. This article discusses how health care reform and highly disciplined underwriting tools offer growth opportunities to MGUs.

Description: An examination of past Flaspohler Survey data to identify drivers of direct writer satisfaction with reinsurers.