Description: Presented at April 1986 Spring Meeting. This session discusses how employers are trying to limit their risks under medical care plans and the implications of such strategies for carriers. This session considered the differences in the economic and random fluctuation risks, and the effectiveness of programs in controlling each.

Description: This teaching session explores how variability in charges and costs can be measured so direct comparisons between institutions can be developed and how information can be used to develop reasonable reimbursement levels. Topics include creating & using outpatient hospital fee schedules, using relative value fee schedules to benchmark costs to aid in medical management and hospital tiering. From the Record of the Society of Actuaries, Volume 28, No. 2, Session 48

Description: This session presents a summary of actuarial and potential uses of stochastic modeling for health actuaries. Three case studies are presented: rating health plan reimbursement provisions, developing claim liabilities, and defining appropriate reinsurance levels. From the Record of the Society of Actuaries, Volume 30, No. 1, Session 18

Description: Presented at June 1996 Spring Meeting. This discussion looks at how a managed care plan can know whether it is doing a good job on utilization review, if there is room for further reduction in utilization, and how a plan should prevent under-utilization.

Description: Affordability is a primary consideration in the design and marketing of disability products for both group and individual insurers. In this session, the panelists explore the need for affordable coverage from both the insurer's and the customer's perspectives. From the Record of the Society of Actuaries, Vol. 31, No. 2, Session 37

Description: Presented at April 1985 Spring Meeting. This session discussed: Definition of good and sufficient provision for unpaid and actuarial liabilities as used in the NAIC model bill, Actuary and auditor relationships in documentation, reasonableness of results, materiality, margins, and disclosure, Techniques for estimating unpaid claim liabilities, Reverse testing, Considerations regarding incurred date coding in establishing claim reserves, Reserving methodologies for alternative funding products, Reserves for catastrophic claims, Measurement, evaluation, and adjustment for claim department backlogs, changes in claim submission patterns, and environmental changes, etc.

Description: This discussion looks at recent claim experience in group accident and health, experience rating criteria, the advantages and disadvantages of providing medical coverage with a schedule of benefits, and the extent to which total and permanent disability income clauses are being offered in new group life policies.

Description: Presented at June 1985 Spring Meeting. This session discussed factors affecting the design of flexible benefits programs: choice of benefits, cost containment, tax effectiveness of benefits.

Description: Presented at October 2001 Annual Meeting. Topics covered in this session include Internet-based health plan exchanges, defined-contribution health plans, self-directed health plans, personal spending accounts, and episodic based reimbursement to insureds.