Description: Panelists at this session of the SOA 1997 Palm Desert Spring Meeting discuss medical excess coverage which is provided to hospitals and/or physician groups to reimburse such groups for benefits in excess of a deductible. This coverage typically involves situations where providers are taking capitation.

Description: This session 62 PD of the Las Vegas Spring Meeting focuses on provider excess reinsurance, which is an excess of loss coverage for providers assuming risk under various forms of managed care arrangements, such as HMOs, PPOs, and Medicare/Medicaid. From Record of Society of Actuaries, Volume 26, No. 3.

Description: Panelists discuss the following managed care topics: · Design issues/pros and cons e.g., self-directed health-care model · Provider reimbursement methodologies · Consumer and regulatory issues · Insurance and reinsurance pricing and underwriting issues · Catastrophic claims · Risk-based capital repercussions · Defined contribution health plans From the Record of the Society of Actuaries, Volume 27, No. 1, Session 61