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

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.

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: This paper derives exact expressions for the ultimate ruin probability and establishes the effect of correlation on ruin probability using the Wiener-Hopf factorization.

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 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: Discussion of how to mature value-based contracts between health insurers and provider organizations to improve population health and financial sustainability. Centers around contract parameter consistency, revenue predictability and risk assessment. Intended audience are health plan and ACO actuaries and leaders. Authors are writing from the provider perspective in value-based contracts.