Description: This paper discusses the need for actuarial judgment to be used in conjunction with statistical analysis in the calculation of incurred but not reported IBNR claim reserves.

Description: Essay states a competing American ideals for the U.S. Health care system include free markets which foster competition, cost effectiveness and quality health care vs.public and private assistance which provides health care independent of a person’s financial means.

Description: In 2007 the International Accounting Standards Board IASB released a discussion paper proposing a new accounting model for insurance contracts, known as the current exit value model. One aspect of the proposed accounting model is that claim liabilities would need to include explicit margins satisfying certain criteria. Currently it is common for U.S. medical insurers to include explicit margins in their claim liabilities. However, we demonstrate that the margin approach most commonly used today by U.S. medical insurers does not satisfy the objectives articulated in the IASB discussion paper regarding the role of margins. We then propose a new formula for including explicit margins in U.S. medical insurance claim liabilities in a manner that is more compatible with the principles articulated in the IASB discussion paper. Finally, we illustrate our proposed claim liability formula using an example drawn from real-life data.

Description: Panel discusses the effects of reduced payment levels to many Medicare managed care organizations. From the Record of the Society of Actuaries, Vol. 24, No. 2.

Description: This panel discussion session examines the marketing and pricing considerations of group insurance in the 1980's.

Description: Discussion of the following topics pertaining to disability income and other health insurance: 1. What portions of the loss of income and of the expenses incurred are properly insurable? 2. What special problems are encountered in providing suitable coverage for the following: a Employees and dependents eligible under Group plans b Individuals employed or not employed and their dependents ineligible under Group plans c Aged persons. 3. Methods for companies to meet the problems of overinsurance arising from duplication of coverage or from other causes?

Description: The purpose of this paper is to analyze several existing versions of the return of premium provision and to attempt to develop a logical critique of the concept, with the object of suggesting certain criteria [cost, equity, and compatibility with the purpose of the basic coverage of the health contract] which could serve as a basis for evaluating the merits of various forms of the provision. From Transactions of Society of Actuaries 1970, Vol. 22, Pt. 1, No. 64.

Description: From a session at the Health/Pension Spring Meeting held in New Orleans, Louisiana June 15-17, 2005 Panelists discussed some of the research behind understanding decision-making and how this type of research can be used to enhance the modeling of consumer choice. Discussion of the field of behavioral economics and its potential application in improving assumptions for modeling health care purchasing.

Description: Panelists discuss pricing issues regarding supplemental products, which for this purpose, are defined as cancer, specified disease, student accident, and other special risk accident and health coverages. From the Record of the Society of Actuaries, Vol. 25, No. 2.