Description: This paper develops a parametric model for health care insurance claims to fit parametric models to the data. Model selection is based on the ChJ-squared goodness-of-fit test and a comparison of the empirical limited expected value function to parametric limited expected value functions. A copula function was used to model the bivariate portion of the data. From Actuarial Research Clearing House 1993, VOL. 3.

Description: This paper develops a parametric model for health care insurance claims using currently available software to fit parametric models to the data. Model selection is based on the Chi-squared goodness-of-fit test and a comparison of the empirical limited expected value function to parametric limited expected value functions. From Actuarial Research Clearing House 1993, VOL. 3.

Description: This Fellowship credit research paper describes the use of fuzzy sets applications to the selection of group health risks. In general, fuzzy set theory is implemented to describe collections of objects whose boundaries are not precisely defined, as in the judgment of what constitutes a good risk group. First, single-plan underwriting is considered, then the work is extended to multiple-option plans.

Description: In this paper the authors analyze data from group medical expense insurance claims and show that many insurance loss distributions have very 'heavy tails' because large losses represent a disproportionate fraction of the total cost. They also present a simple model to reproduce and explain the large loss behavior. From Actuarial Research Clearing House 1990, VOL. 2

Description: The birthday rule is used to determine whether the father's or the mother's insurer is liable for a child's medical bills, where the liability rests with the insurer of the parent whose birthday falls in the first half of the year. It is assumed that the odds are even that the liable insurer will be the mother's, vs. the father's. This paper demonstrates how the key determinant of whether this assumption is valid is the distribution of the difference in spouses' ages.

Description: 1973 SOA Regional Meetings, Saint Paul and San Francisco. This paper provided a summary of several concurrent sessions from the referenced meetings including: 1. PRICE DISCLOSURE AND COST COMPARISON. 2. INDIVIDUAL LIFE AND HEALTH UNDERWRITING. 3. TIME SERIES ANALYSIS AND FORECASTING. 4. INDIVIDUAL HEALTH INSURANCE - PROBLEMS AND PRODUCT TRENDS. 3. VARIABLE LIFE INSURANCE. 6. POLLUTION, POPULATION, AND THE QUALITY OF LIFE. 7. HEALTH MAINTENANCE ORGANIZATIONS.

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 provides an outline of the pricing methodology used by Blue Cross and Blue Shield of Virginia which incorporates trend analysis by trend component. From Actuarial Research Clearing House 1993, VOL. 3.