Description: This session from the 1995 SOA Vancouver Meeting reviews capitation arrangements in health insurance, the reasons for capitating providers, capitation formulas, cost reduction strategies and the role of the actuary in evaluating experience for capitation. From the Record of the Society of Actuaries, Vol. 21, No. 3a.

Description: The purpose of this paper is to demonstrate a simplified method of calculating adjusted benefit reserves for any line of life or health insurance. Specific examples are applied to individual hospital and major medical insurance. From Transactions of Society of Actuaries 1973 Vol. 25 Pt. 1 No. 73

Description: A Regulatory Perspective on Rate Review Before and After the Affordable Care Act

Description: Essential Health Benefits and Actuarial Value

Description: Medicare Advantage and ACA

Description: This paper describes in detail each of five options available to small Texas employers wanting to purchase insurance for their employees. It then describes the advantages and disadvantages to the various players: carriers, employers, employees, and agents. It points out that each player will act in its own interest.

Description: Article describes how Medicare Medical Savings Plans work and why they would be attractive option for insurance companies.

Description: Abstracts of recent articles of interest to health actuaries

Description: A new initiative, Commercial Health Care: What’s Next, will focus on education and research for health actuaries regarding issues that remain with the ACA.

Description: This is a regular column highlighting articles of interest to Health Actuaries appearing in the North American Actuarial Journal.