Description: As actuaries in health care, we spend most of our time focused on reviewing claims, enrollment and clinical data. That information is captured while patients are in health care facilities. Yet most people spend only a small fraction of their time in these facilities. This article explores what types of data are available to actuaries the provide a more holistic view of the member so that a members physical and emotional needs, the social determinants of health can be taken into consideration along with their clinical needs. Two uses cases are presented so actuaries can see how these types of analyses can be leveraged to improve clinical, operational, and financial performance of risk bearing health entities. Understanding the customer (member) not just the patient enables actuaries to provide new insights and values to our stakeholders across a wide range of business and risk applications.

Description: This article provides an overview of behavioral economic theory as it relates to health and welfare insurance plans and provides summaries of two sample applications of the theories: enrollment in health insurance exchanges created by the Patient Protection and Affordable Care Act, and product design considerations in light of vast health illiteracy.

Description: This article describes Medicare Supplement and short-term care products in more detail, and we compare their risk profiles. We explore the concept that these two products—when offered together—may provide a complementary hedge of certain policyholder behavior risks.

Description: As China’s population officially ages, the government has now escalated reform of China's social security system to a national strategic level. The report of the 19th National Congress further mentioned construction of an old-age security system and social environment, painting a bright future for development of the pension industry. At the moment, development of China's pension industry is beginning a new journey. Learn about the current status and future development of pillar 2 pension, which is core to China's pension system; framework and operation management overview of Enterprise Annuity and Occupational Annuity; possible evolution paths in contribution payment methods’ investment operation models, and development of professional pension managers.

Description: Meet the authors of and learn about the contributors to the newly published e-book "Design Your Future with the Competency Framework." Presenters will share their personal reflections, stories and words of wisdom to bring to life the eight professional and personal competencies in the SOA Competency Framework.

Description: The Society of Actuaries (“SOA”) Research Institute is the research arm of the SOA, providing objective, data-driven research that brings together tried and true practices and future-focused approaches to address societal challenges and business needs. The Institute provides trusted knowledge, extensive experience and new technologies to help effectively identify, predict and manage risks.

Description: A news release announcing the winners of the 2024 Student Research Case Study Challenge.

Description: Risk Adjustment continues to be a hot topic in Health Insurance since its emergence. This mechanism came into being as a means of reducing the risk of selection, particularly in marketplaces where underwriting is not allowed, and rating factors are significantly restricted. Risk adjustment serves to adjust premiums to reflect the risk of individual members or overall members as a whole within a particular cohort of a health plan. Risk adjustment is not perfect, as it does not perfectly predict future costs or perfectly adjust for the differences in expected costs. Different marketplaces have different challenges with risk adjustment.

Description: There are practical and conceptual aspects underlying (re)insurability. Practically, something or someone is insurable if an insurer is willing provide insurance coverage at a price the applicant is willing to pay. In contrast, a conceptual view of (re)insurabiity incorporates a range of more complex factors usually considered in the insurance process. This article discusses these two approaches.

Description: The article provides a summary of key issues presented at the 2023 U.S. Living to 100 Symposium focused on the interests of retirement professionals and retirees. It provides an overview of the subjects covered. The discussion focused on the well-being of retirees and the development of the retirement system. It is focused on late-in-life issues and having the best life possible during that period. It balances technical and lifestyle issues, with an emphasis on mortality and longevity trends and influences. Some of the topics discussed include the impact of COVID, climate, housing, and age-friendly communities. The Elder Tech Symposium was merged into Living to 100 and includes discussion of a variety of technology approaches to improve lives and simplify support. The symposium recognized that the decisions needed and concerns during retirement are different later in life, particularly as people decline.