Description: This article provides an overview of critical illness insurance: history, product description, and the three primary ways to offer critical illness coverage in the United States. This article also contains an illustration of an issue age premium rate calculation, as well as product features and rating applications specific to the various types of critical illness coverage.

Description: ACA risk adjustment is intended to "bridge the gap" between allowed rates and actuarial rates. If risk adjustment methodology is not bridging that gap & becomes an additional input to pricing formulae, it is not serving its intended purpose.

Description: This article describes Medicare Supplement and short-term care products in more detail, and we compare their risk profiles. We explore the concept that these two products—when offered together—may provide a complementary hedge of certain policyholder behavior risks.

Description: There are early indications of a six year cycle in ACA markets reminiscent of the traditional underwriting cycle.

Description: Read the October 2020 issue of Health Watch published by the Health Section. Newsletters provided practical information for the working actuary, articles on trends that impact sections and news about section activities.

Description: Read the May 2020 issue of Health Watch, published by the Health Section. Practical information for actuaries, articles impact sections, section activities.

Description: Part II of a two-part series discussing individual market evolution from before the ACA through President Trump's first term.

Description: This paper will examine why CSR defunding produces pricing uncertainty and how regulators can alleviate these risks when insurers price 2020 premiums.

Description: Read the October 2018 issue of Health Watch, published by the Health Section. Practical information for actuaries, articles impact sections, section activities.

Description: Joe Wurzburger, Staff Fellow at the SOA, shares his views and insights about the health care industry in general and the Health Section's role in particular.

Description: A brief description of current events and techniques that may impact trend models.

Description: Read the February 2018 issue of Health Watch, published by the Health Section. Practical information for actuaries, articles impact sections, section activities.

Description: This interview article summarizes the work being done by a Health Section Strategic Initiative Committee.

Description: The CMS Risk adjustment model allows actuaries to apply our analytical skills and business knowledge to solve risk and revenue challenges within Health Plans.

Description: Highlights from the SOA's June 2017 Health meeting in Hollywood, Florida

Description: Read the June 2017 issue of Health Watch, published by the Health Section. Practical information for actuaries, articles impact sections, section activities.

Description: How can actuaries tailor their work to a target audience? This article explores success stories and key considerations when preparing work for others.

Description: Article highlighting upcoming Health Section events

Description: Joe Wurzburger, Staff Fellow at the SOA, shares his views and insights about the health care industry in general and the Health Section's role in particular.

Description: This article is an interview with an actuarial leader.

Description: Read the March 2017 issue of Health Watch, published by the Health Section. Practical information for actuaries, articles impact sections, section activities.

Description: Joe Wurzburger, Staff Fellow at the SOA, shares his views and insights about the health care industry in general and the Health Section's role in particular.

Description: Read the November 2016 issue of Health Watch published by the Health Section. Newsletters provide practical information for the working actuary, articles on trends that impact sections and news about section activities.

Description: Health Watch, Issue 79, December 2015, Health Watch

Description: Abstracts from the latest edition of the North American Actuarial Journal

Description: How predictive analytics techniques can be used in the health practice.

Description: Review of 2015 from perspective of the Health Section

Description: Chairperson's corner October 2014 Health Watch

Description: Complete issue of the October 2014 Health Watch Newsletter

Description: The article compares the financial features between Medicare Part D and the ACA exchanges. As highligted in the article, while the two programs share many similar features, the programs still have many different characteristics that make simple comparisons among the programs and their ultimate financial performance not appropriate.

Description: May 2013 issue of the Health Watch newsletter

Description: The article is a case study of various actuarial concepts invovled in the design and implementtion of the AQC - a global budget provider payment arrangement implemented by Blue Cross Blue Shield of MA.

Description: October 2012 issue of Health Watch newsletter

Description: ERM and Investment strategies for healthcare companies

Description: Explanation of Medicare Advantage STAR rating program as it relates to payment rates for MA bids. Also describes important features of the program from an actuarial perspective, how the components of the STAR rating are calculated and implications and considerations for actuaries.

Description: January 2011 issue of Health Watch newsletter.

Description: Update on Health Section research projects and topics, including health care reform, complexity science, and strategic planning.

Description: A proposal to reform current health care market, from a 'preferred payer' system, in which Medicare and Medicaid pay less than the true cost while others must then pay more, to a 'value for money' system. This would be achieved by requiring providers to bill all patients the same rate for the same services, with a standard bundling format to make all providers' rate differences transparent. Differences between billed charges and what Medicare pays would be made up by the Medicare patient, rather than subsidized by those outside of Medicare.

Description: Summary of recent SOA-sponsored research on Enterprise Risk Management practices as applied to health insurers, self-insured plans, and health finance professionals.

Description: September 2008 issue of Health Watch.

Description: Congress has been debating a revision to Medicare Advantage payments including limiting payments to the Medicare Fee-For-Service FFS cost. A county-specific impact study to the benchmark payment rates for each county nationally based on the FFS limitation criteria was performed. This article includes results for Florida, California, Pennsylvania and New York.

Description: Full version of Health Watch News, Issue No. 57, January 2008.

Description: Full version of Health Watch News, Issue No. 56, September 2007.

Description: Full version of Health Watch News, Issue No. 52, May 2006.

Description: This article reviews Canada's Medicare Plan, the Chaoulli Supreme Court decision and looks at factors affecting waiting times. From Health Watch Newsletter, May 2006, Issue No. 52.

Description: Full version of Health Section News, Issue No. 51, January 2006.

Description: Full version of Health Section News, Issue No. 50, August 2005.

Description: The intention of this piece is to introduce the general premise of ERM to those of you who are just now starting to hear about it.

Description: This article looks at pharmacy benefit management and the use of data, reviews standard pharmacoeconomic analysis methods, and discusses points for formulary decision making and what is known about the process. From Health Section News, March 2005, Issue No. 49.

Description: Full version of Health Section News, Issue No. 49, March 2005.

Description: Discussion regarding who's to blame for cost increase, Government's role to ensure coverage and keep costs down, steps to control costs, plan design changes. Issue No. 47.

Description: Full version of Health Section News, April 2004, Issue No. 47.

Description: Incorporating Pended Claims in Medical IBNR Estimates. Issue No. 45.

Description: Adding value in the development, production and marketing process of medical devises regulatory environment, designer/manufacturer perspective, product failure and litigation risk. Issue No. 44.

Description: Full version of Health Section News, October 2002, Issue No. 44.

Description: Full version of Health Section News, September 2001, Issue No. 41.

Description: Financial Reporting for Healthcare Plans objectives, defining market segments, preparing & recasting segment monitoring reports, quantification of liabilities, reconciliation of claim payments, medical management reports, expense control, company plans & projections & budgets, financial indicators & measurements. Issue No. 41.

Description: Actuarial appraisal and role of the actuary with regards to Health Insurance Mergers and Acquisitions. Issue No. 40.

Description: Full version of Health Section News, April 2001, Issue No. 40.

Description: Full version of Health Section News, December 2000, Issue No. 39.

Description: Using the Internet as a Pricing Tool clinical background information, defining the change in coverage, collecting data, data quality and data limitations. Issue No. 39.

Description: Full version of Health Section News, August 2000, Number 38.

Description: Past problems with Association Group Disability Coverage inadequate pricing, contract deficiencies, less restrictive underwriting standards, lack of risk diversification Issue No. 38

Description: A discussion of an alternative valuation methodology which addresses many of the shortcomings of the current valuation system for U.S. life and health insurers one of which is the proliferation of undesirable variations in state requirements. Issue No. 37

Description: Full version of Health Section News, April 2000, Issue No. 37.