Description: As actuaries in health care, we spend most of our time focused on reviewing claims, enrollment and clinical data. That information is captured while patients are in health care facilities. Yet most people spend only a small fraction of their time in these facilities. This article explores what types of data are available to actuaries the provide a more holistic view of the member so that a members physical and emotional needs, the social determinants of health can be taken into consideration along with their clinical needs. Two uses cases are presented so actuaries can see how these types of analyses can be leveraged to improve clinical, operational, and financial performance of risk bearing health entities. Understanding the customer (member) not just the patient enables actuaries to provide new insights and values to our stakeholders across a wide range of business and risk applications.

Description: The article provides an overview of the federal tax treatment of long-term care insurance contracts, including a brief history of the tax treatment of long-term care insurance, the requirements that must be satisfied in order to be treated as qualified long-term care insurance under the Internal Revenue Code, and a brief discussion of qualified long-term care combination products and chronic and terminal illness accelerated death benefits offered under life insurance contracts.

Description: The summary and introduction of an SOA research paper that explores valuable insights and recommendations for insurance companies considering entering the market of commercial long-term care insurance (LTCI) in the Asia-Pacific, based on individual health status.

Description: Milliman was engaged by the SOA to conduct two Accelerated Underwriting (AU) surveys, one of direct companies and another of reinsurers. The surveys explored actual results from 2019–2021 and expected results from 2022.

Description: The introduction and effective application of US GAAP LDTI have increased the scrutiny of those reviewing the updated financial results. That is because LDTI has resulted in significant changes in actuarial reserving and deferred acquisition cost (DAC) models for long-duration contracts, including significant changes to data, assumptions and required disclosures. In light of the changes, greater reliance has been put on companies’ model risk management (MRM) teams and model validations to assess the conceptual soundness and accuracy of their companies’ actuarial models and to assess that the underlying data and process utilized are suitable and appropriate. This article covers a brief background on model validation, walk through a sample LDTI-focused model validation framework/test plan, then provide insights on common LDTI-related validation observations based on the authors' prior validation experience.

Description: Provides an update, as of September 2022, on Financial Reporting Section sponsored research projects in process and those recently completed.

Description: The direct and indirect effects of the pandemic have impacted many actuaries’ work since the spring of 2020. This article addresses three considerations actuaries should account for when using risk evaluation models which are focused on projecting remote, highly unlikely losses: model effectiveness, asset risk, and insurance (mortality and mortality) risk.

Description: As a follow-up to a previous five-part series on accounting for ceded reinsurance under LDTI, this article focuses on one issue that has, until now, been left without a general solution—how to measure the reinsured portion of a direct loss from capping a net premium ratio or flooring a liability. After acknowledging limited guidance on the issue, the article describes the various events that can lead to a loss, how reinsurance protects against loss, and how that is translated into formulas for measuring the reinsured portion of a loss.

Description: This article provides an update, as of October 2023, on Financial Reporting Section research projects in process and those recently completed.

Description: The article describes the factors that should determine the asset allocation of an employer's QDIA, especially Target Date Funds, and suggests that in general QDIAs have insufficient equity in retirement asset allocations.