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 article, the author discusses the considerations and advantages of implementing an integrated enterprise risk management program for a health insurance company, and presents a summary of Aetna's experience with ERM as a case study.

Description: To be financially "well" is unique to an individual. Following a hierarchy of needs is key, along with saving more than the talking heads tell you to.

Description: The actuary’s key role in the ORSA process should be to quantify the uncertainty surrounding the future financial results of the firm. By providing relevant standardized reports that clarify the uncertainty in terms easily understood by all stakeholders, the actuary will provide an essential element in the ORSA process. The dictum, "You can't manage what you can't measure." demonstrates the need to quantify risk, not just describe it qualitatively. While the ability to provide firm estimates of aggregate risk for complex organizations may not exist currently, doing so should be a target for the profession. The end result will be to enhance the financial security of the insurance industry at a time when all financial institutions are facing stakeholders skeptical about their financial condition. Part of the essay collection "Risk Metrics for Decision Making and ORSA"

Description: Using basic actuarial principles to develop a reasonable spending budget and to keep spending/savings on track to meet financial objectives.