Description: This panel discussion was presented at the SOA's May 1976 Meeting in Houston. The topics covered included: experience rating problems, group life problems, Long Term Disability issues, Association Group, and utilization of HMOs. From Record of the Society of Actuaries 1976, Volume 2, No. 2.

Description: Health Care in Ireland public care, private insurance, risk adjustment Issue No. 39.

Description: Health Watch, Issue 79, December 2015, Health Watch

Description: Under the Affordable Care Act (ACA), groups with 50 or less full time employee equivalents will eventually be subject to the ACA’s modified community rating rules. While some groups will see lower premiums than they would have without the ACA, others will see significant premium increases. Many of the latter type opted for transitional relief beginning in 2014 to avoid the ACA as long as possible. With the end of transitional relief approaching in 2018, what will these groups do? One option will be to self-insure using a product generically termed Level Funding.

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 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.