Description: Before the proliferation of HMOs, multiple options and flexible benefit programs, there were fairly standard underwriting rules regarding participation and benefit design. These rules no longer can be applied. This session discusses the underwriting effects of HMO penetration, high/low options, working spouses, new dependent coverage rules, and renewals. It includes a discussion on cost containment, AIDS, cost shifting and mental health / substance abuse. From Record of the Society of Actuaries 1988 Vol. 14, No. 1.