Description: This paper discusses the insurance plan titled, Connecticut 65 Extended Health Insurance. From Transactions of Society of Actuaries 1961, Vol. 13, No. 37.

Description: This paper presents research results from a study on health carrier insolvencies. Carriers studies include commercial insurance companies, Blue Cross/Blue Shield pland and health maintenance organizations. From Transactions of Society of Actuaries 1995, Vol. 47.

Description: This paper presents Bayesian models for analysis of claim lag data. The analysis of claim runoff patterns investigate the extraction of information on trend and seasonal patterns in incurred claims. This is investigated on the basis of individual group data, and also relative to a larger aggregation of pooled experience. The models are implemented based on Markov chain Monte Carlo methods. The models are applied to examples using simulated claim lag data. From Actuarial Research Clearing House, 2003, Vol. 1.

Description: The Health Section Research Team is pleased to make available the following research study and Excel model that provide a framework for estimating the financial impact of health plan provider network risk. The research was conducted by the Denver office of Milliman, Inc. The Excel workbook allows the user to assess cost implications of aspects of network risk under various assumptions. The assumptions in the workbook can be altered by the user and be applied to test a range of scenarios.

Description: This research report provides an evaluation and synthesis of the methodologies and data samples used on characterizing health care fraud.

Description: The primary purpose of this paper is to present an alternative method of determining the profitability of the premium for a return of premium benefit through the use of a limited simulation program. Also discussed are necessary reserves for a return of premium benefit. From Transactions of Society of Actuaries 1973, Vol. 25, Pt. 1, No. 73.

Description: This article will clarify valuation issues for the waiver of premium benefit in Accident and Health products.

Description: This paper describes a modified development method for analyzing claims experience and calculating claim reserves and liabilities on short-term health insurance benefits. It identifies many of the influences on claim development and discusses various ways to recognize them. From Transactions of Society of Actuaries 1989, Vol. 41.

Description: A mathematical framework for benefits and choices must be created, in order to model flexible benefit selection. This paper creates such a framework by defining benefit plans as reimbursement functions. These are then used with a defined choice function to calculate the cost deviation due to selection. From Actuarial Research Clearing House 1992, VOL. 1.

Description: This paper investigates the accuracy of loss reserves by comparing some reserves with the actual results five years hence. The ultimate purpose was to provide an estimate of the amount of variability which cannot be explained by listed factors. The resulting amount of variability gives an indication of the amount required for a provision for adverse deviation. From Actuarial Research Clearing House 1991, VOL. 1