Description: This research material provides an evaluation and synthesis of the methodologies and data samples used on characterizing health care fraud

Description: On average, contracts receiving their first star rating receive 3.20 stars, compared to existing or established contracts receiving 3.90 stars on average. This 0.70 disparity in quality ratings creates significant hardship on new contracts when this lower star rating decreases their payments in the following calendar year. This article explores the disparity in Medicare Advantage Star Ratings between contracts receiving their first star ratings (“New” contracts) and existing contracts, including: 1. Understanding what happens to Medicare Advantage Payments when contracts receive lower star ratings? – What is the Star Rating cliff and why does it matter to new contracts? 2. Explaining when a contract receives their first star rating and how much enrollment this requires – When does the Star Rating cliff occur? 3. Noting which specific star measures “New” contracts struggle with, including those contracts under large parent organizations, contracts with rapid growth, and all other new contracts. – How can my contract avoid the Star Rating cliff?

Description: What is the difference between a Single-Payer and Universal Health Care System, and how could the U.S. implement a system that would reduce the growth of medical costs while increasing quality.

Description: This paper will examine why CSR defunding produces pricing uncertainty and how regulators can alleviate these risks when insurers price 2020 premiums.

Description: This discussion examines miscellaneous topics. Topics include actuarial training, final salary pension plans and hospitalization and surgical insurance. From Transactions of Society of Actuaries 1960, Vol. 12, No. 34.

Description: Discusses the rapidly growing AIDS epidemic and its impact on traditional underwriting principles for life insurance and health insurance.

Description: Panelists discuss the NAIC new loss ratio requirements for limited benefit [supplemental] health plans and companies' responses to these requirements. From the Record of the Society of Actuaries, Vol. 25, No. 2.

Description: 1994 SOA Meeting, San Antonio. This session explored some of the general issues applicable to the appointed actuary, particularly from a health insurance perspective: 1. What it means. 2. How it developed. 3. What are the duties? 4. To whom is the appointed actuary responsible? 5. What kind of product the appointed actuary has to produce?

Description: Panelists at this session of the SOA 2000 Las Vegas Spring Meeting discuss Congressional proposals for changing Medicare and the Academy's Medicare Reform Task Force report with respect to financial soundness, competition and potential prescription drug benefits.

Description: Rating agencies, investment bankers and insurance regulators discuss their views on how recent events, such as the economic climate, the war on terrorism, regulatory actions and initiatives and litigation affect health insurers and reinsurers. From the Record of the Society of Actuaries, Volume 28, No. 2, Session 115