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.

Description: What No One Ever Told Me About the Rate Filing Process: how to deal the unspoken rules and politics. From Health Section News, December 2000, Issue No. 39.

Description: This article compares the Prescription Drug Plan (PDP) market to the commercial individual market exchanges included in the Affordable Care Act. PDP carrier actions to date could help predict certain aspects of the exchange market.

Description: A review of strategies for non-ACA products for small employers including level-funded plans, association health plans (AHPs), and multiple employer welfare arrangements (MEWAs). Discussion will focus on market trends, strategy, pricing, and block management. Session will include some audience participation via polling so audience can crowd source information and identify industry trends.

Description: Charts for Session Maui II 78PD Hot Topics in Individual Disability Income. From the Record of the Society of Actuaries, Vol. 24, No. 2.

Description: Discussion about career events for an actuary working on health care reform

Description: This session is targeted for new ASAs/FSAs or actuaries who are new to reserving. The session will be delivered in two parts. The first part is intended to deliver a basic understanding of IBNR reserving and different reserving methods and assumptions. We will go through examples of constructing claims triangles and developing completion factors, while exploring concepts such as seasonality, trend and outlier claims. During the second part of the session, we will apply the material from the first part to look at various example from different products such as inpatient, outpatient, RX, Medicare Supplement, dental, critical illness, etc.

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 discussion looks at the approach companies are taking in developing dividend scales for participating accident and health policies as well as arguments for and against grading accident and sickness premiums. From Transactions of Society of Actuaries 1959, Vol. 11, No. 31.

Description: After the bid process, desk review, rebate reallocation, an “enjoyable” audit, and open enrollment; the Medicare plan year starts. Throughout the year, organizations find it pertinent to get an accurate picture of their Part D liability as reinsurance, LICS (Low Income Cost-Sharing) subsidy, and risk corridors are accrued. Attendees will learn about the basics of Part D accruals, how future accrual amounts are estimated based on patterns in the data, and how bid assumptions versus actual results impact plan sponsor profitability. We will also discuss financial statement treatment of these items. Real-life examples from bids to outcomes will be provided to enhance the discussion. Ultimately, attendees will come away with a deeper understanding how their bid assumptions play out, and how they can use Part D accruals to plan for future bid development.