Description: Panelists define the various provider-centered managed-health-care entities and discuss the differences among them. From the 1997 Record of Society of Actuaries, Vol. 23, No. 3.

Description: This paper will develop an aggregate claim reserve methodology for health claims. The theoretical nature of the unpaid claim process is outlined and discussed. This is then used to develop a paradigm shift, which views the claim reserve estimation as a projection of claims from one period to another, rather than as a matter of estimating residual unpaid claims from observed paid claims.

Description: This paper presents a method for analyzing the experience of a stop-loss underwriter to develop a claim continuance table. This method is designed to deal with the limitations presented from certain limited information so as to get the most out of the available information. To the extent this approach is succesful, the credibility of the experience analysis will be maximized, thus minimizing the reliance on external data. From Actuarial Research Clearing House 1993, VOL. 3.