Description: In Medicaid rate development, actuaries have not historically shared models that developed the margin (i.e., underwriting gain) assumption. This is unfortunate, given the margin assumption is one of the most critical components of the rate development in ensuring financial solvency of the Medicaid managed care organizations (MCOs). In this session, we will discuss the primary components of the this assumption and will share working models that help actuaries quantify these components—including the cost of capital and risk (or contingency) margin. We expect a lively discussion as we “open the black box” and discuss these actuarial assumptions in the public for the first time.

Description: This session 99PD of the New Orleans Annual Meeting summary: Insurers today are looking for new ways to use currently available experience data to better predict future costs. Both the federal and state governments are looking at the possibility of using prescription drug data because it is more available and often of higher quality than other experience data. From the Record of the Society of Actuaries, Volume 27, No. 3, Session 99PD.

Description: This session will explore the various methods of determining the credibility levels that are given to various size employer groups and Medicare plans. The background and theory of the methods that have commonly been used will be explained and then some new data-driven research in the area and possible alternatives will be discussed.

Description: This session from the 1983 SOA Hollywood, Florida Meeting discusses the practical application of risk analysis technique In Health Insurance. This includes using company claim information and multinomial distributions for predictive purposes and using this information to price health insurance. From Record of Society of Actuaries Vol. 9, No. 4

Description: 1994 SOA Spring Meeting, Orlando. In this session the panel consider the question of uncertainty in loss reserves including discussion of sources and measurement. The panelists analyzed the same data set from different perspectives and discussed the strengths and weaknesses of the approaches.

Description: This session presents a summary of actuarial and potential uses of stochastic modeling for health actuaries. Three case studies are presented: rating health plan reimbursement provisions, developing claim liabilities, and defining appropriate reinsurance levels. From the Record of the Society of Actuaries, Volume 30, No. 1, Session 18

Description: Provides a how-to session on modeling assets and liabilities in the Valuation Actuary's work to comply with the Standard Valuation Law. Comparisons of the methods discussed are occasionally made with the requirements of New York Regulation 126. Session 12 of the 1991 Valuation Actuary Symposium.

Description: This is a presentation From 38th Annual Actuarial Research Conference 8/9/2003, University of Michigan, Ann Arbor, Michigan. Pricing health insurance presents numerous statistical problems. This paper develops a non-parametric method for handling these problems. This method involves kernel density estimation of the charge level distribution and also kernel smoothing between the reimbursement function derivatives. It derives some properties of the estimates so obtained. It illustrates the method with some dental data and compares the results to some other simpler estimation techniques.