Description: The Actuary Vol. 22, No. 6. The author provides commentary regarding an interview with Paul Barnhart reported on in The Actuary March 1988 concerning the controversy over health insurance reserves. Specifically the elements of the “Benefit Ratio Reserve” method were analyzed.

Description: This section presents book reviews and summaries of recent publications on a variety of topics.

Description: There are early indications of a six year cycle in ACA markets reminiscent of the traditional underwriting cycle.

Description: Discuss various analytics and use cases using payer published reimbursement contract data under federal mandate of Transparency in Coverage. These contract rates are publicly available in machine readable format (MRF) starting July 1, 2022, and refreshed monthly. By attending the session, you will have a better understanding of the state-of-art development and analytics using MRF data, including the technologies used to extract and analyze huge MRF files, validation and limitations of published rates, and their use cases.

Description: This 1978 session dealt with Group ASO and Minimum Premium Plans. Topics covered: 1. Reasons for using Administrative Services Only plans. 2. Problems with ASO plans 3. Questions to address when considering ASO plans 4. Legal issues

Description: 2021 Life Meeting - Session 5F: Premium Leakage - How Outdated Claims Systems are Losing You Money 8.31.21 Recording

Description: The object of this paper is to present a theoretical basis for the mathematical graduation of continuance data for both elementary and combined benefits, and to demonstrate the methods of utilizing the theory to derive claim costs for a wide variety of benefits. From Transactions of Society of Actuaries 1959, Vol. 11, No. 31.

Description: Cover a variety of topics centered around the unsupervised learning technique called 'clustering'. The presenters will take you through a wide array of topics that range from 'What is Clustering?' to 'How can I use this technique to solve problems I didn't even know existed?' In the health care industry, everyone is looking for an edge in reducing total spend-cluster analysis finds the unambiguous in an ambiguous framework of results.

Description: A panel of actuaries and clinical consultants at this session of the SOA 2003 Vancouver Spring Meeting provides an assessment of current and future applications of predictive modeling techniques in the health arena. A practical example of risk adjustment, discussion of the clinical use of this technique, and applications in underwriting are discussed.