Description: Essential Health Benefits and Actuarial Value

Description: Panelists at this session of the SOA 1997 Palm Desert Spring Meeting discuss how clinicians and actuaries work together in a managed care environment and how they can serve as a resource to each other. Views are presented from both a clinician and an actuary.

Description: This session discusses what will happen to supplemental coverages under health care reform. Topics include traditional group ancillary benefits, health care reform supplements, and traditional individual/group niche products? From Record of Society of Actuaries Vol. 20, No. 3A.

Description: Affordable Care Act and Payment Reform

Description: This discussion focused on possiblities related to controlling health care costs in the private sector using the HMO structure. From Record of Society of Actuaries, Vol. 6, No. 3, SOA's 1980 June Meeting

Description: This report compares health care utilization and expenditures between individuals with Crohn’s disease who had used infliximab and those who had not. Claims data from the 1999-2003 Thomson Reuters MarketScan commercial claims and encounters databases and inpatient, outpatient, and prescription drug claims data of individuals older than 18 years of age with a diagnosis of Crohn’s were included.

Description: A call for essays issued by the SOA Health and Long Term Care Sections on the visions for the future of the U.S. health care system.

Description: This is a highly interactive role-playing session detailing the actual product development process for a hypothetical health care product. From Record of Society of Actuaries, Vol. 30, No. 3, Session 19

Description: The SOA’s research objective is to provide guidance to state exchange officials and administrators, federal officials and administrators, and actuaries assisting states and health plans. The goal of the project is to estimate the morbidity and/or cost for newly insured individuals in the individual market (and to some degree, the small group exchange) relative to the morbidity and/or cost for the current commercially insured population. This analysis will primarily focus on the individual, non-group market. In order to plan for the impact that these currently uninsured individuals will have on the health insurance markets, it will be important to understand their costs relative to the costs for people already enrolled, for whom many health insurers have experience and data.

Description: Panelists discuss various managed care strategies and their experiences with how well these strategies have been implemented in the individual and small group market. From the Record of the Society of Actuaries, Vol. 25, No. 2.