Description: An economic analysis of bariatric surgery and health care costs supports the case for health plans to cover these procedures.

Description: In this interview Dr. Reinhardt shares his thoughts on the role he believes actuaries should take in the health care system reforms.

Description: This article makes organizations entering the MA market aware of the star rating climate, as well as short- and long-term star rating & revenue considerations.

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

Description: In this paper we propose a model that can be used to analyze correlated claims data. In the process we introduce a class of multivariate generalized Poisson distributions. Then we present posterior distributions of its parameters. These distributions are difficult to manipulate, so we employ Markov chain Monte Carlo methods to draw random numbers from posteriors and predictive distributions. We present a collection of EXCEL VBA functions and subroutines to perform the simulations.

Description: Recap of Q&A sessions held to discuss the findings and methodology of a SOA study on the cost of the newly insured under the ACA.

Description: The PPACA imposed a market share-based health insurance provider fee, known as the "Section 9010 Fee", "Health Insurer Fee", or simply the "HIF", on each “covered entity” with net premiums written in excess of $25 million that is engaged in the business of providing health insurance coverage for U.S. health risks. This article provides background information to help unpack the language behind the Section 9010 Fee and highlights a few areas of special interest including merger and acquisition-related issues, application of the Section 9010 fee to expatriate plans, and considerations regarding fee administration.

Description: Panelists discuss major reforms of health care financing and delivery systems around the world. From the Record of the Society of Actuaries, Vol. 24, No. 2.

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.