Description: Health care predictive analytics varies between payers and providers as well as being a powerful tool in business decision modeling.

Description: In an effort to build a bridge between epidemiological and actuarial modeling, this paper analyzes possible financial arrangements made against expenses resulted from medical treatments given to insured patients. Based on classical compartment models, the first part of this paper designs insurance policies for susceptible participants facing the risk of infection and formulates the financial obligations of both parties using actuarial methodology. For practical purposes, the second part employs a variety of numerical methods for calculating premiums and reserves. The last part illustrates the methods by designing insurance products for the Great Plague in Eyam and the SARS Epidemic in Hong Kong.

Description: The PPACA imposed a market share-based health insurance provider fee, known as the "Section 9010 Fee", "Health Insurer Fee", or simply the "HIF", on each “covered entity” with net premiums written in excess of $25 million that is engaged in the business of providing health insurance coverage for U.S. health risks. This article provides background information to help unpack the language behind the Section 9010 Fee and highlights a few areas of special interest including merger and acquisition-related issues, application of the Section 9010 fee to expatriate plans, and considerations regarding fee administration.

Description: Chapter 2 analyzes, in table form, the study's claimant counts and charge totals, broken down by gender, age, diagnosis category, year, and by subscriber vs. dependent status. From Group Medical Insurance Large Claims Database Collection and Analysis, M-HB97-1.

Description: Chapter 7 analyzes, in table form, the study's claimant counts & charges per claimant in relation to deductible and broken down by diagnosis category. From Group Medical Insurance Large Claims Database Collection and Analysis, M-HB97-1.

Description: An economic analysis of bariatric surgery and health care costs supports the case for health plans to cover these procedures.

Description: Article Disparate Origins Of Life And Non-Life Insurances by Beard in The Actuary, February 1979, Volume 13, Number 2

Description: Presentation on estimating rates of early-onset Alzheimer's Disease. This document contains incident rates, critical illnese insurance information, adverse selection, and more.

Description: Read the March 2017 issue of Health Watch, published by the Health Section. Practical information for actuaries, articles impact sections, section activities.

Description: Health Watch, Issue 79, December 2015, Health Watch