Description: This article will consider several issues arising from ACO budgeting and pricing of stoploss coverage, including: 1) attribution of members; 2) claim carve outs; 3) ambiguous stoploss terms; 4) providers gaming the system and 5) credibility of data.

Description: Three papers use sophisticated actuarial methods to develop a straightforward retirement income strategy that can be implemented in virtually any IRA or 401(k).

Description: CDHP reserve levels claim, policy and premium reserves. New reserve technique for ASO plan sponsor reserves. Issue No. 48.

Description: Does disease management DM positively influence health care costs? According to three prestigious sources, the answer is no. From Financing Chronic Care Monograph, M-HB05-1.

Description: The well-known examples of predictive modeling “successes” are numerous. Perhaps less widely recognized is the myriad of ways in which a predictive model can fail to perform as expected, often due to misconceptions or misrepresentations on the part of the analyst. This article, which is intended for a general actuarial audience, focuses on three such pitfalls. By understanding these three common pitfalls, readers may guard against them within their own work, teams, and organizations.

Description: Discussion of a New York Times article dealing with the arbitraging of policy loan proceeds by investing them in money market instruments whose yields were well above the policy loan interest rate.

Description: The editorial explores the reasons for the current low interest rates and introduces the February/March 2016 issue of The Actuary in which experts offer strategies on how to cope with the complex issues facing insurance companies and investment actuaries.

Description: Four appendices are attached to the monograph: a letter requesting information, two letters requesting participation, and a set of general database specifications. From Group Medical Insurance Large Claims Database Collections and Analysis, M-HB97-1.

Description: The five words for ERM are transparency, discipline, alignment, adaptability and resilience. This article focuses on transparency, discipline and resilience.

Description: An introduction of predictive modeling techniques that are applicable to insurance industry, including generalized linear model (GLM) and classification and regression tree model(CART). Other models such as data clustering, neural network, and support vector machine (SVM), are also briefly discussed.