Description: This session's discussion is about maintenance of effort provisions, benefit demands of employers, unbundling of services, new funding techniques and multiple options versus adverse selection. From Record of the Society of Actuaries Vol. 15, No. 1.

Description: This session at a SOA 1990 Spring Meeting is about open ended managed care plans from various perspectives including structure, marketing and actuarial issues.

Description: September’s Actuary contained an excellent summary by Drew Davidoff of renewal rating for small group medical business. Among the techniques he describes are age, sex, and area rating, experience rating using credibility, experience rating using tiers, examination of the diagnoses in the claim file, and initial and reentry medical underwriting.

Description: At this presentation, the panelists address the following questions: 1. How is health insurance risk measured? 2. How and why do surplus requirements differ between health insurance and life insurance? 3. How and why do surplus requirements differ among health insurers [e.g., Commercial, Blue Cross, HMO] and among health insurance products? 3. What are some of the current techniques being used by health insurers for determining target or required surplus and for managing surplus? 4. How do the rating agencies view surplus requirements for health insurers? From the Record of the Society of Actuaries Vol. 17, No. 3A.

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: Attempts to explain the need for premium increases on level-premium, guaranteed-renewable health-insurance policies. It presents a perspective on loss ratios for such policies that may be helpful to an insurer in reflecting a regulator's or consumer's viewpoint.

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: The presenters will provide updates on research being conducted under SOA sponsorship. This includes projects on the topics of Direct Primary Care and Patient Centered Medical Homes.