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 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: In this article, the author, reflecting upon his own experiences, discusses why meaningful individual health insurance, unlike other lines of individual coverage, is generally not offered by insurers to individuals with long-term needs.

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.

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

Description: This is a brief report that summarizes recent changes in the prevalent medical loss ratio methodologies and also looks at some of the more recent experience of health insurers that filed medical loss ratio reports.

Description: Discusses variability in per capita health-care costs by health-care provider.