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: This is the 1977 report on the continuing study of the morbidity experience of Group Weekly indemnity insurance. The report contains experience for the years 1972, 1973, 1974, 1975, and 1976.

Description: This report provides morbidity experience under individual medical expense policies in force during the 1975 and 1976 calendar years.

Description: This provides the experience under Individual Loss-of-time policies for calendar years 1976-77.

Description: The panel at this session of the SOA 1997 Palm Desert Spring Meeting addresses possible strategies to identify and control factors causing medical inflation.

Description: Panelists define the various provider-centered managed-health-care entities and discuss the differences among them. From the 1997 Record of Society of Actuaries, Vol. 23, No. 3.

Description: Panelists at this session of the SOA 1998 Maui II Spring Meeting discuss the impact point-of-service [POS] plans have had on both HMOs and on indemnity carriers. Different types of POS plans and the problems presented by primary care gatekeepers are discussed.

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

Description: Panelists at this session of the SOA 1998 Maui II Spring Meeting discuss the strategies various insurers have taken in response to the Health Insurance Portability and Accountability Act [HIPAA] requirement to use guaranteed issue for small group and certain individual health plans to qualified individuals.

Description: This panel at the SOA 1998 New York Annual Meeting discusses the history of HMOs with respect to actuarial support and looks at how actuaries can and should be involved in supporting HMOs.