Description: The supplemental health market is changing. Carriers are looking to simplify claims processes, proactively identify missed claim opportunities, and reduce barriers to claim payment. As a result, more and more companies are looking at ways to use data from medical diagnostic and treatment codes. Take an introductory look at the most used medical codes—ICD (9 and 10), CPT, and HCPCS. Discuss the history and purpose of each code system and decipher the structure. Dive into how medical codes can be used in the supplemental health market (automatic claims adjudication, fraud identification, pricing), as well as common pitfalls encountered when using medical coding. By attending this session, you will have a basic understanding of the different types of medical codes, their actuarial applications, and common pitfalls.

Description: Level funded products often target the small group market (2-50) and can result in many manual and tedious processes for underwriting to perform risk assessment. Learn how a carrier used technology to help automate risk assessment without the need for paper medical questionnaires, and exposed a risk engine for broker quoting to enable near real-time of pricing for risk-based products. The approach reduced labor and allowed underwriting to focus solely on fallout cases while also improving pricing consistency. Discuss broader trends in the health market for risk assessment, including new machine learning cost predictions that can be used for automation and better predictions of future costs. Discussion topics will include underwriting guidelines, business rules, risk scores, and machine learning. By attending this session, you will have a better idea of new trends in risk assessment for small groups where no claims experience is available. And, better understand business rules that are common in underwriting for flags for review as well as how risk scores and machine learning can be used during the underwriting process.

Description: Decentralized insurance alternatives is a rapidly expanding sector of Decentralized Finance (DeFi), an emerging and growing financial ecosystem powered by blockchain technologies. The purpose of this report is to review and discuss the business models and operating designs of decentralized insurance alternatives, which may have significant implications for traditional insurance businesses, as well as the actuarial profession.

Description: Decentralized insurance alternatives is a rapidly expanding sector of Decentralized Finance (DeFi), an emerging and growing financial ecosystem powered by blockchain technologies. The purpose of this report is to review and discuss the business models and operating designs of decentralized insurance alternatives, which may have significant implications for traditional insurance businesses, as well as the actuarial profession.

Description: 2022 Welcome and Strategic Themes for the Marketing and Distribution Section Council.

Description: This study would assess the impact of recent patient care innovation(s) on health care and the health insurance industry.

Description: Artificial intelligence (“AI”) adoption in the insurance industry is increasing. One known risk as adoption of AI increases is the potential for unfair bias. Central to understanding where and how unfair bias may occur in AI systems is defining what unfair bias means and what constitutes fairness.

Description: View the Avoiding Unfair Bias in Insurance Applications of AI Models

Description: Decentralized insurance alternatives is a rapidly expanding sector of Decentralized Finance (DeFi), an emerging and growing financial ecosystem powered by blockchain technologies. The purpose of this report is to review and discuss the business models and operating designs of decentralized insurance alternatives, which may have significant implications for traditional insurance businesses, as well as the actuarial profession.

Description: Session 9B: Actuaries and Technology: Perspectives on Actuarial Workflow Automation The life insurance industry has experienced unprecedented growth in modernization efforts, with special attention paid to automating actuarial workflows. Companies are creating processes that are more scalable and maintainable, helping actuaries meet strict deadlines and deliver meaningful information to stakeholders. Discuss practical examples of automation, potential compositions of the modern actuarial toolkit, and different ways actuaries and technology teams interact during implementation and production states. Examine how automation can help actuarial teams shift from a quarterly to a monthly valuation process by overcoming challenges in traditional actuarial processes-long run times, the need for highly specialized legacy software skills, and inadequate control. Shifting to a monthly schedule can increase alignment on company objectives, deepen insurers' understanding of their business, and improve strategic decision-making. Leave with new ways of thinking about technology, from day-to-day best practices to full-scale actuarial transformation. By attending the session, you will: - Explain and understand the benefits of automating actuarial workflows with the purpose of operating on a monthly, rather than quarterly basis. - Describe the categories and purposes of several kinds of automation and supporting tools that might be used to accomplish this. - Understand different actuarial IT operating models and consider the application of such strategies at your organization. - Identify best practices for implementing automation based on the presented case studies.