Description: A preview of the contents of the latest issue, including essays & interviews related to health care reform, provider reimbursements, rate filing review, and medical errors.

Description: After years of discussion and debate, PrinciplesBased Reserving (PBR) is finally a reality. Small insurance companies have a unique opportunity to decide between electing for the company-wide exemption or adopting the PBR methods. This article discusses the benefits and challenges of the options available to small insurers under VM-20 as well as best practices that have been found along the way.

Description: The Actuary Vol. 22, No. 3. This editorial discusses the impact of the AIDS epidemic on financial security programs and what to do about it.

Description: Future mortality improvement has been a common assumption in life insurance and annuity pricing and forecasting for many years. However, experience over the last decade suggests this might be an assumption that merits reconsideration in the United States. This article will take a closer look at factors that impact mortality improvement trends and discuss why insurers may want to reevaluate product designs to better manage the associated mortality risk. We then introduce a product idea with this in mind, where premiums are based on a life expectancy index and insurers share the risk (and opportunity) or mortality improvement with policyholders.

Description: CMS provides ACOs with monthly claims data for members, including their medical visits and ACO program eligibility. This data can be divided into Membership and Claims tables through the ETL process. However, when calculating PMPY at specific levels of detail using these tables, issues arise due to unrelated dimensions, leading to inaccurate and understated results. This article presents a solution to this problem by utilizing Tableau's data blending capabilities.

Description: The South African life insurance industry contains the largest life insurance market in Africa, it is highly sophisticated and highly regulated. In the years 2020 and2021, the industry suffered significant mortality losses due toCovid-19. What can we learn from this experience in South Africa?

Description: Summary of the 1974 report of the HIAA Prevailing Health Care Charges System which contains data from about 900,000 charges for up to 1,600 different surgical procedures, summarized for 250 geographical areas. From The Actuary Vol. 9, No. 7

Description: This article provides a description of the development process for the 2003 GRET factors. The results were also presented and discussed.

Description: ACA risk adjustment is intended to "bridge the gap" between allowed rates and actuarial rates. If risk adjustment methodology is not bridging that gap & becomes an additional input to pricing formulae, it is not serving its intended purpose.

Description: Updates on the efforts of the Academy’s health practice council. its work groups and task forces, to educate and influence health care policymakers on issues including principles for health care reform, Medicare, wellness programs, and solvency.