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: This paper presents a method for analyzing the experience of a stop-loss underwriter to develop a claim continuance table. This method is designed to deal with the limitations presented from certain limited information so as to get the most out of the available information. To the extent this approach is succesful, the credibility of the experience analysis will be maximized, thus minimizing the reliance on external data. From Actuarial Research Clearing House 1993, VOL. 3.

Description: Since detailed claim information is not readily available to the Committee on Group Mortality and Morbidity on an annual basis, a special investigation of group hospital expense experience has been conducted. That investigation is summarized in this paper, and covers plan descriptions, morbidity and cost data, and continuation tables.

Description: This paper presents a procedure for calculating aggregate stop-loss premiums that takes parameter uncertainty into account. From Actuarial Research Clearing House ARCH 1988, Vol. 3

Description: There has been a proliferation of proposals to expand access to public health insurance plans, either to strengthen insurance markets under the Affordable Care Act (ACA) or to replace the ACA marketplaces or other health insurance programs altogether. These proposals range from creating a public plan that would operate alongside private plans in the ACA marketplaces, to allowing individuals to buy into Medicare or Medicaid, to expanding Medicare to all. The terms used to describe these various options are often used interchangeably but they would be structured differently and have different impacts depending on the implementation details. Panelists at this session will discuss the general approaches for expanding access to public plans and their potential implications.

Description: The article explores how deeply the Affordable Care Act reduced the Medicare Advantage benchmark payment rates and quantifies how much of that reduction Medicare Advantage Organizations earned back through quality bonuses.

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

Description: Joe Wurzburger, Staff Fellow at the SOA, shares his views and insights about the health care industry in general and the Health Section's role in particular.

Description: This article summarizes 2012 AAA activities relating to the Affordable Care Act implementation, including work on the Amicus Brief for the Supreme Court Decision, MLR regulations, Actuarial Value, Rate Review, Essential Health Benefits and work with the NAIC.

Description: This is a presentation From 38th Annual Actuarial Research Conference 8/9/2003, University of Michigan, Ann Arbor, Michigan. Pricing health insurance presents numerous statistical problems. This paper develops a non-parametric method for handling these problems. This method involves kernel density estimation of the charge level distribution and also kernel smoothing between the reimbursement function derivatives. It derives some properties of the estimates so obtained. It illustrates the method with some dental data and compares the results to some other simpler estimation techniques.