Description: 2021 Life Meeting - Session 5C: Assumption Setting in an Uncertain World 8.31.21 Recording

Description: This paper describes the development of the net annual claim costs, net premiums, and reserve factors that comprise the 1974 Medical Expense Tables. From Transactions of Society of Actuaries 1978, Vol. 30.

Description: Realizing the impact of medical errors on the U.S. health care system, the Health Section commissioned a research project to measure the annual frequency of medical errors and their total measurable direct and indirect cost to the economy.

Description: A preview of the contents of the latest issue, including essays & interviews related to health care reform, provider reimbursements, rate filing review, and medical errors.

Description: Data science, predictive analytics and AI are certainly the buzzwords these days. They are heavily used and developed in underwriting and marketing but for most actuaries, they might/may as well be science fiction. The presenters will demonstrate how a normal actuary can utilize data science techniques in their daily job function without forming an official data science team within a company. It can be done in a gradual fashion so that normal business is not disrupted and improvements are made over time. The usage of data science techniques will include demonstrations of the following areas: - Regression analysis - Economic scenario generator - Experience study - Data quality checks - Inforce compression for explicit hedging

Description: The SOA, with SCOR as the researcher, completed an experience study of post-level term (PLT) lapse and mortality. In the first part of this session, the presenters will cover the key findings of the traditional analysis regarding the shock lapse, the PLT lapse and mortality experience. The remainder of the session will focus on the results of the predictive modeling, which will provide further insights into policyholder behavior in the post-level term period.

Description: The Experience Study Rate Errors paper discusses, in depth, the errors that arise from the use of two partial rate years, such as policy years or years of age, to cover one calendar year.

Description: The purpose of this paper is to outline certain questions involved in the analysis of the experience emerging from the operation of Major Medical Expense insurance plans. From Transactions of Society of Actuaries 1958, Vol. 10, No. 28.

Description: The supplemental health market is changing. Carriers are looking to simplify claims processes, proactively identify missed claim opportunities, and reduce barriers to claim payment. As a result, more and more companies are looking at ways to use data from medical diagnostic and treatment codes. Take an introductory look at the most used medical codes—ICD (9 and 10), CPT, and HCPCS. Discuss the history and purpose of each code system and decipher the structure. Dive into how medical codes can be used in the supplemental health market (automatic claims adjudication, fraud identification, pricing), as well as common pitfalls encountered when using medical coding. By attending this session, you will have a basic understanding of the different types of medical codes, their actuarial applications, and common pitfalls.

Description: CPT, NCCI, ICD, CCI, DRG, APC, PTP – understanding healthcare claims involve a dizzying array of code sets and payment methodologies, and yet the claim form is the intersection of health plan affordability, provider payment, and data analysis. This webcast will cover: • The code sets used in medical coding • Types of correct coding policies implemented by CMS and commercial payers • Payment integrity strategies to drive health plan affordability • Data analytics approaches leveraging medical coding knowledge