Description: This paper was prepared to facilitate discussions with the New York State Insurance Department concerning price regulation and the application of minimum loss ratio standards for individual health insurance. From Transactions of Society of Actuaries 1982, Vol. 34.

Description: This paper proposes a hypothesis that the negative public policy implications of durational rating strategies in the medical insurance market are caused by lack of prefunding of durational deterioration of experience and constitute a failure to maintain an important part of the original insuring promise. To solve the problem, a practical and simple reserving basis is proposed as a regulatory standard. Discussions of this paper are included.

Description: This report compares health care utilization and expenditures between individuals with Crohn’s disease who had used infliximab and those who had not. Claims data from the 1999-2003 Thomson Reuters MarketScan commercial claims and encounters databases and inpatient, outpatient, and prescription drug claims data of individuals older than 18 years of age with a diagnosis of Crohn’s were included.

Description: This is an internal letter from an actuary to an associate regarding a claims study that established, in the mind of the writer, the adequacy and conclusiveness of a small sample size in certain situations. Actuarial Research Clearing House ARCH 1988, Vol. 3

Description: In this paper, a model is proposed as a potential explanation for the steady deterioration in loss ratios often observed on blocks of individual health insurance policies. This model, which incorporates assumptions of anti-selective lapses, can be used for morbidity projections and projections of the effects of rate increases. Discussions of this paper are included.

Description: This report has been assembled by the Task Force as a comprehensive guide to practicing actuaries in evaluating the impact of AIDS on the solvency of life and health insurance companies in the US and Canada. From Transactions of Society of Actuaries 1988, Vol. 40, Pt. 2.