Description: Diabetes mellitus type 2 is an excellent model for assessing the setup of medical coverage in the U.S. health care system. It is a chronic disease that has genetic, behavioral and other medical causes, and causes many complications over the long term. From Financing Chronic Care Monograph, M-HB05-1.

Description: After the bid process, desk review, rebate reallocation, an “enjoyable” audit, and open enrollment; the Medicare plan year starts. Throughout the year, organizations find it pertinent to get an accurate picture of their Part D liability as reinsurance, LICS (Low Income Cost-Sharing) subsidy, and risk corridors are accrued. Attendees will learn about the basics of Part D accruals, how future accrual amounts are estimated based on patterns in the data, and how bid assumptions versus actual results impact plan sponsor profitability. We will also discuss financial statement treatment of these items. Real-life examples from bids to outcomes will be provided to enhance the discussion. Ultimately, attendees will come away with a deeper understanding how their bid assumptions play out, and how they can use Part D accruals to plan for future bid development.

Description: 1993 SOA Spring Meeting, San Diego. This session discussed credibility theory. Areas addressed included defining credibility and the complexities of measuring it with an emphasis on group medical insurance.

Description: This paper presents a method involving re-sampling 'with replacement but without random numbers', numerical convolutions for sums and quotients, and estimation of confidence intervals for trend in average size claim. In this paper, this method is applied to major medical claims.

Description: This report provides morbidity experience under Individual Loss-of-Time policies, 1974-1975.

Description: This discussion about group Life and group Accident and Health insurance covered over insurance, medical catastrophe coverage, conversion privilege, and the regulatory environment. From TRANSACTIONS OF SOCIETY OF ACTUARIES, 1953 VOL. 5 NO. 11.

Description: This paper develops net claim costs for each major type of dental service, using experience data under group dental contracts covering 250,000 persons from 1974-1977. From Transactions of Society of Actuaries 1979, Vol. 31.

Description: Provides an overview of developments in the healthcare market including provider billing practices. Provides an overview of the Government Finance Officer’s Association (GFOA) in New York on Dec. 6, 2018

Description: This 1978 panel discussion is about personal casualty lines on a group basis. It focused on: 1. The traditional approaches of group life and health versus individual policies for fire and casualty 2. Problems in product design and underwriting, and 3. The impact of federal income tax laws. 4. Regulatory constraints. The discussions were primarily on personal automobile insurance.

Description: This 1978 session focused on regulatory considerations in Group Health Insurance focused on the following questions: 1. What is the impact of National Health Insurance and Federal Hospital Cost Control? 2. What is the impact of non-discrimination legislation and regulation? 3. What is the impact of recent OASDI financing changes and changes in mandatory retirement age? 4. What is the future of multi-employer trusts and self-insurance?