Description: Panelists discuss employers' perspective of defining strategies to identify best-in-market opportunities. From the Record of the Society of Actuaries, Vol. 24, No. 1.

Description: This article describes methodologies for detection and deterrence of Medicare fraud. It also describes the validation of PRIDIT for fraud detection in Medicare.

Description: In this interview Dr. Reinhardt shares his thoughts on the role he believes actuaries should take in the health care system reforms.

Description: This article is a companion to “They Go Bump in the Night: Life Insurance Policies and the Law of Material Change,” an article written by John T. Adney and Craig R. Springfield (May 2012 Taxing Times Supplement) that describes the various material change rules found in the Code, highlighting the complexities insurers face in navigating through these rules when a life insurance contract is materially changed. The Adney and Springfield article also addresses the difficulties in interpreting the tax law requirements under the various effective date rules contained in the Code sections affecting life insurance contracts.

Description: The article explores the possibility of using the emerging technology for life insurers to build a monitor system for better risk and profitability management.

Description: We highlight a new approach leveraging predictive analytics to identify high risk and rising risk opioid users for more effective screening and follow-up care.

Description: This paper presents a generalization of the principal current methods of financial decision making. In the way physical sciences benefit from new general theories that encompass those theories they succeed, the science of finance can benefit from the development of a general framework that encompasses many of the current methods of financial analysis. The paper develops a general framework for financial decision-making from a few simple axioms of rational economic behavior.

Description: This article discusses the advantages, logistical concerns, and pricing formulas of implementing a TNHP, in which members pay less for treatment from providers who meet higher quality and cost-effectiveness standards.

Description: This session is about meeting the needs for financial information in managing an insurance company. Topics include: 1. What are management's basic needs how are they met can financial systems continue to meet the challenge? 2. Are fundamental changes ahead for GAAP reporting? 3. Is it time for mutual companies to provide more meaningful financial information? 4. Can current regulatory reporting meet the needs of the 21st century? 5. Can separate statutory and GAAP systems continue to coexist? 6. Will the United States regulatory environment reduce our global competitiveness? 7. Variance analysis - Why your predictions were wrong - Which variances are acts of God? - Which variances should be blamed on somebody? - How to deal with interest rate fluctuations 8. Market valuation, why? - What questions are being addressed with market valuation