Description: This is a discussion of the paper, Gross Premiums for Individual and Family Major Medical Expense Insurance by Morton D. Miller. From Transactions of Society of Actuaries 1955, Vol. 7, No. 19.

Description: Under the Affordable Care Act (ACA), groups with 50 or less full time employee equivalents will eventually be subject to the ACA’s modified community rating rules. While some groups will see lower premiums than they would have without the ACA, others will see significant premium increases. Many of the latter type opted for transitional relief beginning in 2014 to avoid the ACA as long as possible. With the end of transitional relief approaching in 2018, what will these groups do? One option will be to self-insure using a product generically termed Level Funding.

Description: Article from The Actuary September 1989 – Volume 23, No. 8 that discusses how increasingly keen competition for small-group medical business has caused many carriers to drastically alter their approaches to renewal rating of all-group business.

Description: This article discusses Medical Savings Accounts MSA as proposed in federal legislation and the problems that actuaries will face in predicting their use.

Description: This article summarizes a report in the June 13, 1974 issue of the New England Journal of Medicine, Policy Options and The Impact of National Health Insurance which estimates the dollar and time price of various features common to many national health insurance proposals and the resulting effect on demand.

Description: This article provides a brief summary of the health insurance bill introduced in the New York legislature on February 22, 1967 which proposes mandatory heath insurance.

Description: This article exams societal trends that may influence retirement patterns and presented retirement scenarios. From The Actuary Vol. 24, No. 12

Description: The big event of 2023 is the launch of multiple Humira biosimilars, which began in January with the arrival of Amgen’s Amjevita on the market. The launch of Amjevita kicks off the process of changing the specialty drug marketplace in the United States. The expectation of the full impact of this big event is very hopeful, but there is still uncertainty several months after its beginning. Humira is the highest-selling drug in the world and has been since 2013 (Figure 1)—except for when COVID-19 projects temporarily surpassed it. The world is eagerly awaiting the launch of multiple biosimilar drugs to compete with Humira and hopefully bring more competitive pricing to the benefit of payers and patients everywhere.

Description: With the medical insurance market experiencing health care inflation of 10 to 13 percent and medical costs averaging above $8,000 per year per employee less for single employees and more for employees with families, employers are looking at alternative options. Politicians and regulators are as well.

Description: This paper describes a new major medical policy from The Equitable. The author describes the policy and discusses anticipated claims experience and the calculation of gross premiums. From Transactions of Society of Actuaries 1955 Volume 7, Number 17.