Description: This 1991 panel discussion is about medical claims management and keeping up with changes in technology. The panelists discuss the use of artificial intelligence in claims processing, 'intelligent' coverage cards, and code gaming problems. From the Record of the Society of Actuaries Vol. 17, No. 4B.

Description: This session will discuss the role of actuaries under national health insurance, role of the Canadian health actuaries under that national program and how actuaries can shape the health-care environment in the U.S.. From Record of Society of Actuaries Vol. 18, No. 4B.

Description: This presentation from Session 71PD of the SOA 1996 Colorado Springs Meeting discusses demutalization, mergers of health maintenance organizations [HMOs], and conversion from nonprofit to for-profit. It also addresses the question: How does an actuary value HMOs? From the Record of the Society of Actuaries, Vol. 22, No. 2.

Description: This panel discussion focuses on design and cost considerations of group health insurance including pricing, credibility formulas, cost containment, trends in morbidity experience, and improving cost effectiveness to the policyholder. From Record of Society of Actuaries 1980, Vol. 6, No. 4.

Description: This session discussion is about what factors affect the small employer's choice of programs, how may the small employer capitalize on recent developments in managed health care, what problems do insurance companies have in marketing and communicating their plans to small employers, are partially self-insured benefits a threat or an opportunity for carriers in this market. From Record of the Society of Actuaries Vol. 12, No. 1.

Description: An update on HMO market trends and reinsurance products, and services supporting them.

Description: This is a discussion of the paper, Surgical and Medical Insurance by a Blue Shield Plan by Arthur Hunter and James F. Coleman. From Transactions of Society of Actuaries 1954, Vol. 6, No. 16.

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.

Description: This article is from the Digest of Informal Discussion, Transactions of Society of Actuaries 1956 Volume 8, Number 20. The article identifies the participants and summarizes each person’s comments. The participants discuss recent developments in expanding major medical expense coverage under individual policies and group policies, and progress made in providing hospital, surgical and medical expense coverage beyond age 65. Guaranteed renewability and substandard issues are discussed.

Description: This discussion at a 1959 Regional Meeting looks at issues related to health insurance coverage at older ages including levels of coverage, underwriting issues, expense levels, and renewability provisions.