Description: This paper examines the factors affecting claims in a group health insurance plan.

Description: Discussion of the following topics pertaining to disability income and other health insurance: 1. What portions of the loss of income and of the expenses incurred are properly insurable? 2. What special problems are encountered in providing suitable coverage for the following: a Employees and dependents eligible under Group plans b Individuals employed or not employed and their dependents ineligible under Group plans c Aged persons. 3. Methods for companies to meet the problems of overinsurance arising from duplication of coverage or from other causes?

Description: From a session at the Health/Pension Spring Meeting held in New Orleans, Louisiana June 15-17, 2005 Panelists discussed some of the research behind understanding decision-making and how this type of research can be used to enhance the modeling of consumer choice. Discussion of the field of behavioral economics and its potential application in improving assumptions for modeling health care purchasing.

Description: Panelists discuss pricing issues regarding supplemental products, which for this purpose, are defined as cancer, specified disease, student accident, and other special risk accident and health coverages. From the Record of the Society of Actuaries, Vol. 25, No. 2.

Description: This article summarizes 2012 AAA activities relating to the Affordable Care Act implementation, including work on the Amicus Brief for the Supreme Court Decision, MLR regulations, Actuarial Value, Rate Review, Essential Health Benefits and work with the NAIC.

Description: This work investigates the use of a statistical approach to calculate the incurred but not reported IBNR reserve directly. This allows for the reserve to be estimated in one step, without completion factors, and it provides a confidence interval around the estimate of IBNR as well.

Description: This paper describes in detail each of five options available to small Texas employers wanting to purchase insurance for their employees. It then describes the advantages and disadvantages to the various players: carriers, employers, employees, and agents. It points out that each player will act in its own interest.

Description: Abstracts of recent articles of interest to health actuaries

Description: Explanation of Medicare Advantage STAR rating program as it relates to payment rates for MA bids. Also describes important features of the program from an actuarial perspective, how the components of the STAR rating are calculated and implications and considerations for actuaries.