Description: This paper discusses the need for actuarial judgment to be used in conjunction with statistical analysis in the calculation of incurred but not reported IBNR claim reserves.

Description: The medical scheme approach adopted by several African countries has failed to meet the needs of those in informal employment and rural communities. This is partly due to affordability amongst these individuals as well as a lack of awareness of how healthcare financing products work. Community based healthcare organisations have achieved greater levels of success in this regard by carefully incorporating the peculiarities of communities in benefit design and involving community members in the management of these healthcare solutions. There are lessons to be garnered from the countries where these have been implemented with some level of success. Even as countries aim towards universal health coverage, observing the unique needs of different communities within a country is essential to ensure resources are utilised efficiently and that healthcare needs are targeted effectively.

Description: Milliman performed an analysis of 894 uses of the checking service on individual medical health insurance applications to gain a better understanding of its protective value. From Health Watch Newsletter, September 2006, Issue No. 53.

Description: This article discusses a multiyear design for stop-loss reinsurance used by employers offering self-funded medical benefit programs.

Description: The article discusses the sustainability of the ACA individual market from a public entitlement standpoint. A key point of measuring sustainability is the reliance on market forces rather than federal budget constraints. The article explains why an actuarial viewpoint of sustainability is necessary to a greater extent than other public assistance and social insurance programs. The article challenges actuaries to be a bold, objective voice in a space that is full of opinionated but often uninformed viewpoints.

Description: Article is about a new course developed in actuarial science taught at Columbia University. Course covers traditional health actuarial projects but is expanded to cover issues for a health insurance company executive (e.g., CEO, CFO, etc.). The course also includes studying of other international healthcare systems plus healthcare reform (PPACA). Students were involved in research projects, including healthcare reform and international health systems. Students also had to teach a course as part of their final exam.

Description: Read the June 2017 issue of Health Watch, published by the Health Section. Practical information for actuaries, articles impact sections, section activities.

Description: The Behavioral Finance subgroup of the Health Section will be publishing a series of literature reviews in Health Watch. This is the first review of three in the series. The reviewed article describes an attempt to place an econometric value on consumers’ preferences between broad and narrow networks.

Description: Health Watch, Issue 79, December 2015, Health Watch