Description: Presented at April 1986 Spring Meeting. This session discusses how employers are trying to limit their risks under medical care plans and the implications of such strategies for carriers. This session considered the differences in the economic and random fluctuation risks, and the effectiveness of programs in controlling each.

Description: Presented at April 1985 Spring Meeting. This session discussed: Selective underwriting standards, Renewable options, Producer controls, Compliance with state laws and regulations, Control and profitability.

Description: Measurement and benchmarking of surplus levels provide health plans with valuable insights regarding their financial strength and performance. This session discusses target surplus and reserves for health plans. From Record of the Society of Actuaries, Volume 30, No. 1, Session 50

Description: This session discusses various techniques for evaluating the success of an existing network as defined by profitability, risk exposure and long-term viability. Topics include network design, provider changes and quality measurement. From the Record of the Society of Actuaries, Volume 28, No. 2, Session 92

Description: This session discussion is about experience-rating and credibility in group health insurance. From Record of Society of Actuaries Vol. 18, No. 1B.

Description: Panelists lead participants in a discussion of recent experiences and current issues regarding the valuation of medical and dental insurance and managed care products. Topics include ASOP 22 [asset adequacy analysis for statements of actuarial opinion] and ASOP 41 [communication]. From the Record of the Society of Actuaries, Volume 29, No. 2, Session 102

Description: This session discussion is about pros and cons of the NAIC recommended rate filing guidelines, pros and cons of renewal rating practices of MET and individual major medical business. From Record of Society of Actuaries Vol. 16, No. 1.

Description: Presented at October 2001 Annual Meeting. Panelists provide insight into the factors driving the cost increase of prescription drugs and how these factors are being addressed. Strategies include drug utilization review, manufacturer contracting, benefit design, formularies, pharmaceutical pricing, therapeutic substitution, physical education, and introduction of new pharmaceuticals. Also discussed are pharmacoeconomic benefit considerations when studying integrated medical and pharmacy expenses.

Description: Presented at June 1996 Spring Meeting. This discussion looks at redirecting the traditional role of the actuary into new areas such as working with doctors to deal with medical management issues, dealing and negotiating with providers and how to help the company develop a provider payment strategy. Employers negotiating directly with providers is also discussed.

Description: Presented at April 1985 Spring Meeting. This session discussed: Definition of good and sufficient provision for unpaid and actuarial liabilities as used in the NAIC model bill, Actuary and auditor relationships in documentation, reasonableness of results, materiality, margins, and disclosure, Techniques for estimating unpaid claim liabilities, Reverse testing, Considerations regarding incurred date coding in establishing claim reserves, Reserving methodologies for alternative funding products, Reserves for catastrophic claims, Measurement, evaluation, and adjustment for claim department backlogs, changes in claim submission patterns, and environmental changes, etc.