Description: This research report provides an evaluation and synthesis of the methodologies and data samples used on characterizing health care fraud.

Description: This research report provides an evaluation and synthesis of the methodologies and data samples used on characterizing health care fraud.

Description: The SOA’s research objective is to provide guidance to state exchange officials and administrators, federal officials and administrators, and actuaries assisting states and health plans. The goal of the project is to estimate the morbidity and/or cost for newly insured individuals in the individual market (and to some degree, the small group exchange) relative to the morbidity and/or cost for the current commercially insured population. This analysis will primarily focus on the individual, non-group market. In order to plan for the impact that these currently uninsured individuals will have on the health insurance markets, it will be important to understand their costs relative to the costs for people already enrolled, for whom many health insurers have experience and data.

Description: This research material provides an evaluation and synthesis of the methodologies and data samples used on characterizing health care fraud

Description: A research report describing aspects of provider network performance in health care settings with particular focus on experiences with Exchanges.

Description: This discussion on major medical expense insurance examines the trends in the types of plans sold, popularity of the comprehensive type of medical expense insurance plan, special problems, and dependent coverage. From Transactions of Society of Actuaries 1959, Vol. 11, No. 29 AB.

Description: With the increase of membership in Blue Cross / Blue Shield, this paper presents the practices and experience under the plans using the United Medical Service, Inc as a model. Transactions of SOA Vol. 6, No. 14

Description: This paper explores the legislation of Mass 65, the intent of which was to offer health benefits to persons aged 65 and older without evidence of insurability. From TRANSACTIONS OF SOCIETY OF ACTUARIES, 1962 VOL. 14 PT. 1, NO. 40.

Description: This paper suggests that many problems in health insurance pricing can be solved by requiring a minimum mandatory paid-up period [i.e., premium period shorter than insurance period], and by encouraging insureds to persist by providing them adequate pricing information. This will generate significant investment income for insuring programs and reduce the cost of insurance.

Description: This paper explores the legislation of New York 65, the intent of which was to offer health benefits to persons age 65 and over without health examination or other evidence of insurability. From TRANSACTIONS OF SOCIETY OF ACTUARIES, 1962 VOL. 14, PT. 1 NO. 40.