Description: A discussion of insurance claims processing and payment systems, and how to achieve the minimum possible number of errors.

Description: SOA’s recently completed research project related to long term projects of health care cost trends for use in post retirement medical valuations.

Description: In order to encourage health insurance issuers to offer health insurance coverage on the Exchange and on the individual and small group markets, while ameliorating the potential impact on any particular health insurance issuer of providing coverage without pricing for pre-existing conditions or the gender of the insured, the Affordable Care Act includes three risk-sharing programs: the Transitional Reinsurance program, the Risk Corridor program and the Risk Adjustment program (collectively referred to as the “3Rs”). The financial and tax reporting of each health insurance issuer is affected by the implementation of these risk-sharing programs because each health insurance issuer is required to pay for the programs’ costs, and some issuers are or will be eligible for benefits under them.

Description: Panelists discuss the methods HMOs employ to measure their providers' quality of care, outcomes, compliance with best practice guidelines, and cost control. From the Record of the Society of Actuaries, Vol. 25, No. 2.

Description: Panelists discuss different aspects of self-selection among Medicare options. From the Record of the Society of Actuaries, Vol. 24, No. 2.

Description: Presenter describes many of the desirable characteristics of a health care financing system, and alternative health care financing systems as they are found in other parts of the world. The advantages and disadvantages of each alternative system are also discussed. From the Record of the Society of Actuaries, Vol. 24, No. 2.

Description: This article discusses the new Kassebaum-Kennedy bill a.k.a. HIPPA and looks at future of individual health insurance plans, which will be determined at the state level.

Description: The author takes exception to criticism from the AMA about hospital discharge guidelines as being set by actuaries when, in fact, they are set by physicians based on actual practice.

Description: Discusses new valuation standards for credit disability insurance looking to be adopted by the NAIC.

Description: This article addresses the growing need for critical illness insurance in the U.S. and the opportunities for insurance companies in this market. The article discusses product design both as stand-alone health insurance and accelerated benefits on life insurance policies, managing the risk through contract wording, and underwriting.