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: 1994 SOA Meeting, San Antonio. This session was about provider network building in nonmetropolitan areas. Question addressed: 1. How can an effective delivery system be built to serve rural areas? 2. What influence will health care reform have on such systems? 3. Does a single-payer system make sense for such populations? 4. How does health care reform impact nonmetropolitan markets?

Description: This paper provides a method for estimating long-tailed unpaid losses from paid loss development using trended generalized bondy development. From Actuarial Research Clearing House 1993, VOL. 3.

Description: This model arose from a project to evaluate the cost of a health care access' program to provide comprehensive medical care to uninsureds in Minnesota, for the Minnesota Health Care Access Commission. The project was to provide estimates of the impact on per-person and aggregate costs for various participation percentages in the access program. In order to evaluate those costs, the antiselection model described in this was developed. Of note, this was the ACTUARIAL EDUCATION AND RESEARCH FUND 1991 PRACTITIONERS AWARD WINNER. From Actuarial Research Clearing House 1991, VOL. 2.

Description: 1994 SOA Meeting, San Antonio. This session on physician reimbursements focused on arrangements that might be offered by managed care companies, such as HMOs. It included an overview of key definitions, concepts, and incentive compensation arrangements.

Description: Analysis of Alzheimer’s Disease as a potential Critical Illness insurance benefit trigger.

Description: This chapter focuses on creating practical models that aid in the prediction of the risk of readmission to a specific hospital within 30 days of discharge for Medicare patients, to aid in the identification and stratification of at-risk patients for hospitals considering building an intervention program in a cost-effective manner. For readers who wish to develop their own predictive model, a dataset is provided on the Actexmadriver.com website, and R code is provided in the appendix to this chapter.

Description: This paper addresses pricing stop loss insurance by employee for two benefits combined when the available information included a claims probability distribution for each benefit and the correlation coefficient between the benefits. From Actuarial Research Clearing House 1991, VOL. 1

Description: 2004 SOA Spring Meeting, Anaheim, CA. In this session panelists presented an overview of underwriting processes for a variety of product lines. They also discuss related topics such as identifying keys to underwriting decisions, the cost of underwriting and protective value, and ensuring consistency with pricing assumptions. Some of the underwriting tools discussed were use of RX history, credit checks, DMV history, and fraud data bases.

Description: 2003 Valuation Actuary Symposium, San Diego, CA. The panel discussed the current challenges in the health reinsurance marketplace. Topics included traditional quota share reinsurance, employer and provider stop-loss coverage, difficulties in obtaining reliable and credible data from a ceding carrier and terrorism reinsurance.