Description: This paper presents a method involving re-sampling 'with replacement but without random numbers', numerical convolutions for sums and quotients, and estimation of confidence intervals for trend in average size claim. In this paper, this method is applied to major medical claims.

Description: This paper provides a description of a method that one can use to develop an estimate of accident year incurred losses if the only available data is aggregate paid losses by calendar year for a number of calendar years. An exhibit demonstrating the use of this method follows this description. From Actuarial Research Clearing House 1993, VOL. 3.

Description: There is some reason to believe that the trend of life companies entering the A & S business will continue. Both the public and the government are becoming increasingly aware of the need and desirability for the widest possible coverage against the loss of income because of disability and against the cost of medical care. This should lead to an expansion of the market for A & S insurance which should attract still other companies to the field in the future. Followed by several discussion papers submitted

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: This paper describes seven methods used in care management in the order of their historical development: 1. Pre-Authorization 2. Concurrent Review 3. Case Management 4. Demand Management 5. Disease Management 6. Specialty Case Management 7. Population Health Management Paper 1 of a 8 paper series

Description: This research project offers guidance and a model for actuaries to use when performing their professional services related to Medicaid (Title XIX) and Children’s Health Insurance Program (CHIP or Title XXI) managed care capitation rate setting, including, but not limited to, their certification on behalf of a state in accordance with the requirements for actuarial soundness as set forth in law, federal regulation, and CMS guidance, as well as the actuary’s professional obligations under the Actuarial Standard of Practice (ASOP) 49 issued by the Actuarial Standards Board.

Description: On March 22, 2022, the Wall Street Journal hosted its annual Health Forum, a virtual all-day event which included several sessions. This session was attended by experts across the healthcare space and attendees included many from the healthcare technology companies. This report summarizes the event.

Description: A study of whether tobacco, area and industry rating in one state may be reflecting unintended factors such as race, ethnicity or socioeconomic status. This study does not consider whether the rating factors accurately reflect underlying claims costs.

Description: A divisive confrontation over health care pricing is almost inevitable over the next few years. What will ultimately happen is a political decision, not an actuarial one—but it will have major consequences for the trend in health care costs and the divergence between public and private insurance premiums.

Description: This paper explores how change in societal forces can affect the systems for providing security including private pensions, social security, life insurance and health insurance. The societal forces examined are changes in family, role of women, inflation and the age composition of population. From Transactions of Society of Actuaries 1978, Vol. 30.