Description: This article overviews the results of the 2008 survey of Third Party Administrators of Employer Stop Loss business.

Description: This paper examines five alternative valuation methods - prospective, retrospective, global, intermediate, and static - for the proper application of GAAP to Medicare supplement insurance. The focus of this paper is on the changes to expected future claim costs due to changes in the Medicare deductibles.

Description: This discussion looks at recent claim experience in group accident and health, experience rating criteria, the advantages and disadvantages of providing medical coverage with a schedule of benefits, and the extent to which total and permanent disability income clauses are being offered in new group life policies.

Description: When setting reserves, multiple methods are often used in the creation of the reserve estimate. Judgment is warranted to combine these different estimates into a final recommendation. This paper describes two techniques that can be used to combine these estimates that may result in better accuracy and lower variance.

Description: This session discussion is about surplus requirements, unique health insurance surplus needs, and the impact of A.M. Best and other rating agencies. From Record of the Society of Actuaries Vol. 15, No. 1

Description: This paper describes a modified development method for analyzing claims experience and calculating claim reserves and liabilities on short-term health insurance benefits. It identifies many of the influences on claim development and discusses various ways to recognize them. From Transactions of Society of Actuaries 1989, Vol. 41.

Description: Relative to group medical plans, discusses: recognition given to effect on morbidity of various demographic factors, consideration given to inflation in making rate guarantees, consideration given to group size, and underwriting transfer cases.

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: This report compares health care utilization and expenditures between individuals with Crohn’s disease who had used infliximab and those who had not. Claims data from the 1999-2003 Thomson Reuters MarketScan commercial claims and encounters databases and inpatient, outpatient, and prescription drug claims data of individuals older than 18 years of age with a diagnosis of Crohn’s were included.

Description: Panelists use defined-contribution health plan case studies to review successful plan designs, effective plan communication strategies and plan implementation issues. From the Record of the Society of Actuaries, Volume 29, No. 2, Session 64