Description: This 1991 panel discussion is about the NAIC and HIAA models, as well as state regulations proposed or adopted to regulate small group underwriting and rate guidelines. From the Record of the Society of Actuaries Vol. 17, No. 3A.

Description: This is a discussion about medical care insurance rating including morbidity, impact of group size and underwriting transfer cases. From Transactions of Society of Actuaries 1965, Vol. 17 Pt. 2, No. 47 AB

Description: This 1991 open forum discussion is about the resource-based relative value scale [RBRVS] and its impact on physician fee trends [Medicare and non-Medicare], physician specialization, utilization, Medicare supplement plans, employer plans [active and retired], HMOs, and physicians and senior citizens. From the Record of the Society of Actuaries Vol. 17, No. 3A.

Description: This paper describes a new major medical policy from The Equitable. The author describes the policy and discusses anticipated claims experience and the calculation of gross premiums. From Transactions of Society of Actuaries 1955 Volume 7, Number 17.

Description: This 1991 panel discussion is about medical claims management and keeping up with changes in technology. The panelists discuss the use of artificial intelligence in claims processing, 'intelligent' coverage cards, and code gaming problems. From the Record of the Society of Actuaries Vol. 17, No. 4B.

Description: This 1991 panel discussion considers several valuation issues from the point of view of an actuary of an insurance Company, a Blue Cross/Blue Shield Plan, and a Health Maintenance Organization [HMO]. The issues discussed include basic methodology, source of data/coding conventions, extended benefit provision, loss adjustment expense, provider arrangements, employer refund arrangements and cash flow testing. From the Record of the Society of Actuaries Vol. 17, No. 3B.

Description: This 1991 panel discussion is about mid-size and large group medical issues, including: 1. Managing the underwriting cycle, 2. Effectively managing the risk, 3. Controlling medical costs, 4. Financial arrangements offered to control or shift risk [i.e., Administrative Services Only [ASO] and minimum premium contracts], and 5. The effect of the Resource-Based Relative Value Schedule [RBRVS] on provider fees and plan costs. From the Record of the Society of Actuaries Vol. 17, No. 4A.

Description: At this presentation, the panelists address the following questions: 1. How is health insurance risk measured? 2. How and why do surplus requirements differ between health insurance and life insurance? 3. How and why do surplus requirements differ among health insurers [e.g., Commercial, Blue Cross, HMO] and among health insurance products? 3. What are some of the current techniques being used by health insurers for determining target or required surplus and for managing surplus? 4. How do the rating agencies view surplus requirements for health insurers? From the Record of the Society of Actuaries Vol. 17, No. 3A.

Description: This presentation is a Health Section meeting from the 1991 Annual Meeting of the Society of Actuaries, held October 20-23 in Toronto. The session leader, the incoming chair of the section, covers administrative matters, and then the next speaker addresses a newly completed research project, sponsored by the Society and Health Section, on the variation by duration in small group medical insurance claim costs. The speakers then discuss current developments in small group reform, and the various parties involved, including the National Association of Insurance Commissioners [NAIC], and the Health Insurance Association of America [HIAA], and the work that has been done, including modeling to address the impact of a small group reform mechanism. The speakers discuss how the various parties' objectives can differ. Discussion from participants is included. From the Record of Society of Actuaries, Volume 17, No. 4B.

Description: This 1991 panel discussion about individual health rate filings asks the following seven questions and answers each pro and con: 1. Should individual accident and health be guaranteed renewable? 2. Should there be rate increase caps? 3. Should duration rating be permitted? 4. Should optional pre-filing be permitted? 5. Should loss ratios be increased? 6. Should the pending small-group regulation laws apply to the individual policy area? 7. Should the loss ratio be the only determinant in the approval of a rate change? From the Record of the Society of Actuaries Vol. 17, No. 4B.