Description: This paper focuses on credibility when used in the underwriting and pricing of group medical insurance. In this report, group medical refers to broad comprehensive major medical coverage that reimburses the insured for practically all necessary health-related services, subject only to a very high payment limit and modest member cost-sharing in the form of copays, deductibles, and coinsurance. Readers are expected to have some familiarity with this coverage.

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: A mathematical framework for benefits and choices must be created, in order to model flexible benefit selection. This paper creates such a framework by defining benefit plans as reimbursement functions. These are then used with a defined choice function to calculate the cost deviation due to selection. From Actuarial Research Clearing House 1992, VOL. 1.

Description: This paper describes a modified development method for analyzing claims experience and calculating claim reserves and liabilities on short-term health insurance benefits. It identifies many of the influences on claim development and discusses various ways to recognize them. From Transactions of Society of Actuaries 1989, Vol. 41.

Description: A mathematical framework for benefits and choices must be created to model benefit selection. This paper creates such a framework by defining benefit plans as reimbursement functions. These are then used with a defined choice function to calculate the cost deviation due to selection. Finally, utility functions can be applied to this framework to predict choice.

Description: This paper presents a model of the progression of the Acquired Immunodeficiency Syndrome [AIDS] epidemic in the United States. From Transactions of Society of Actuaries 1989, Vol. 41.

Description: This paper summarizes the salient techniques for evaluating and pricing the risks in group disability income coverages. This paper contains examples of how to evaluate short-term and long-term disability experience for developing manual rates. A discussion of the paper follows. From Transactions of Society of Actuaries 1990, Vol. 42.

Description: Presented at June 2002 Spring Meeting. This session discusses how credibility varies by size of groups for various health coverages, when a block of business can be considered fully credible, how credibility can factor into a rate filling, and to what extent current experience can be considered more credible than past experience.

Description: This session discussion is about dimensions of AIDS and health insurance products. From Record of the Society of Actuaries1988 Vol. 14, No. 4B.

Description: This session takes a fresh look at the issues related to acute care focus and the challenges of providing coordinated care for chronic conditions in the United States. From the Record of the Society of Actuaries Vol. 31 No. 2, Session 80