Description: This 1991 panel discussion is about the NAIC and HIAA models, as well as state regulations proposed or adopted to regulate small group underwriting and rate guidelines. From the Record of the Society of Actuaries Vol. 17, No. 3A.

Description: This 1991 open forum discussion is about the resource-based relative value scale [RBRVS] and its impact on physician fee trends [Medicare and non-Medicare], physician specialization, utilization, Medicare supplement plans, employer plans [active and retired], HMOs, and physicians and senior citizens. From the Record of the Society of Actuaries Vol. 17, No. 3A.

Description: This 1991 panel discussion is about medical claims management and keeping up with changes in technology. The panelists discuss the use of artificial intelligence in claims processing, 'intelligent' coverage cards, and code gaming problems. From the Record of the Society of Actuaries Vol. 17, No. 4B.

Description: This 1991 panel discussion is about mid-size and large group medical issues, including: 1. Managing the underwriting cycle, 2. Effectively managing the risk, 3. Controlling medical costs, 4. Financial arrangements offered to control or shift risk [i.e., Administrative Services Only [ASO] and minimum premium contracts], and 5. The effect of the Resource-Based Relative Value Schedule [RBRVS] on provider fees and plan costs. From the Record of the Society of Actuaries Vol. 17, No. 4A.

Description: At this presentation, the panelists address the following questions: 1. How is health insurance risk measured? 2. How and why do surplus requirements differ between health insurance and life insurance? 3. How and why do surplus requirements differ among health insurers [e.g., Commercial, Blue Cross, HMO] and among health insurance products? 3. What are some of the current techniques being used by health insurers for determining target or required surplus and for managing surplus? 4. How do the rating agencies view surplus requirements for health insurers? From the Record of the Society of Actuaries Vol. 17, No. 3A.

Description: This 1991 panel discussion about individual health rate filings asks the following seven questions and answers each pro and con: 1. Should individual accident and health be guaranteed renewable? 2. Should there be rate increase caps? 3. Should duration rating be permitted? 4. Should optional pre-filing be permitted? 5. Should loss ratios be increased? 6. Should the pending small-group regulation laws apply to the individual policy area? 7. Should the loss ratio be the only determinant in the approval of a rate change? From the Record of the Society of Actuaries Vol. 17, No. 4B.

Description: Panelists discuss the tools available for coping with increases in rates for managed-care health insurance, such as: improved information on specific providers [relative costs, charges, and efficiency], analysis of the value of managed-care administrative fees, The Leapfrog Group, other data-quality initiatives, and plan-design changes. From the 2002 Record of Society of Actuaries, Volume 28, No. 3. Session 149OF of the Boston Annual Meeting.

Description: In this session at the SOA 1997 Palm Desert Spring Meeting, panelists discuss how managed care dental programs work, the actuarial issues, quality issues, and the perspective of the dentist.

Description: This session from the 1984 SOA Toronto Meeting discusses an overview of the underwriting methods and techniques used with individually issued accident and health insurance including elimination periods, underwriting limits and claims costs. From Record of the Society of Actuaries Vol. 10, No. 4

Description: On January 1, 1999, the National Association of Insurance Commissioners adopted a new model regulation addressing risk-based capital for managed care organizations. This presentation from Session 16OF of the SOA 1999 San Francisco Annual Meeting discusses the features of this regulation and what has been learned in the months since its adoption. From the Record of the Society of Actuaries, Vol. 25, No. 3.