Description: This report provides morbidity experience under Individual Loss-of-Time policies, 1974-1975.

Description: After the bid process, desk review, rebate reallocation, an “enjoyable” audit, and open enrollment; the Medicare plan year starts. Throughout the year, organizations find it pertinent to get an accurate picture of their Part D liability as reinsurance, LICS (Low Income Cost-Sharing) subsidy, and risk corridors are accrued. Attendees will learn about the basics of Part D accruals, how future accrual amounts are estimated based on patterns in the data, and how bid assumptions versus actual results impact plan sponsor profitability. We will also discuss financial statement treatment of these items. Real-life examples from bids to outcomes will be provided to enhance the discussion. Ultimately, attendees will come away with a deeper understanding how their bid assumptions play out, and how they can use Part D accruals to plan for future bid development.

Description: More and more providers are desiring risk-based contracts instead of traditional FFS-based contracts. This session is intended to outline some of the actuarial best practices in risk-based contracting related to the many flavors of the CMS ACO programs, as well as Commercial risk-based contracts.

Description: This presentation from Session 4PD of the SOA 1996 Orlando Annual Meeting provides an update on the issues addressed and findings reached by the American Academy of Actuaries [AAA] work group responsible for Medical Savings Accounts [MSAs]. From the Record of the Society of Actuaries, Vol. 22, No. 3.

Description: Panelists at this session of the SOA 1997 Palm Desert Spring Meeting discuss how clinicians and actuaries work together in a managed care environment and how they can serve as a resource to each other. Views are presented from both a clinician and an actuary.

Description: Panelists at this session of the SOA 1998 Maui II Spring Meeting offer several approaches to creative provider reimbursement where a single capitation and fee schedule was not the best solution.

Description: Panel discusses the effects of reduced payment levels to many Medicare managed care organizations. From the Record of the Society of Actuaries, Vol. 24, No. 2.

Description: Panelists discuss recent innovations in the 'special risk' market, the regulatory environment, and pricing issues. Focus is on critical illness insurance.

Description: Panel discusses trends in large health claims, recent experience, and future expectations, as well as the impact of managed care on large individual health claims under self-insured programs and under an HMO setting. From the Record of the Society of Actuaries, Vol. 25, No. 2.

Description: This session discusses what will happen to supplemental coverages under health care reform. Topics include traditional group ancillary benefits, health care reform supplements, and traditional individual/group niche products? From Record of Society of Actuaries Vol. 20, No. 3A.