Description: To inform and educate stakeholders for health plans and insurers on novel ways to optimize reinsurance structures to meet capital related goals and boost RBC and liquidity ratios. In lieu of traditional market-based financial instruments involving equity and/or debt, a quota share transaction can be used with potentially far more attractive terms and achieving essentially the same result.

Description: Employer stop loss is an insurance coverage offered to employers who self-fund their employee benefits program pursuant to an ERISA plan document. From Reinsurance Section News, November 2007, Issue No. 61.

Description: Each health plan is unique, and different factors must be considered when making a decision regarding reinsurance deductibles. This overview offers considerations when selecting a medical excess deductible for commercial, Medicare and Medicaid programs. It is more applicable for large payers, such as HMOs, rather than self-funded employers because there’s usually not enough claims data to warrant such analysis on any given employer group. From Reinsurance Section News, May 2005, Issue No. 55.

Description: An update on HMO market trends and reinsurance products, and services supporting them.

Description: Feature article focuses on the regulators who determine risk-based capital or RBC standards applicable to health plans.

Description: This article describes the common uses , reinsurance structures , advantages , and risk- based capital repercussions of utilizing a captive to accept health care risks .

Description: With the medical insurance market experiencing health care inflation of 10 to 13 percent and medical costs averaging above $8,000 per year per employee less for single employees and more for employees with families, employers are looking at alternative options. Politicians and regulators are as well.

Description: Provider Excess is an insurance coverage offered to health care provider organizations that have a capitation agreement with a manged care organization. From Reinsurance Section News, November 2007, Issue No. 61.

Description: this article provides an overview of coverage and claim trends for managed care medical excess of loss insurance and reinsurance programs. it addresses features such as deductible, maximum benefit, inside limits , comprehensive versus non- comprehensive , and claims by diagnosis for commercial , Medicare and Medicaid risk. It also reviews cost containment support programs for catastrophic claims .

Description: Cell and Gene Therapy (CGT) are life-changing treatments where conditions such as cancer, hemophilia, spinal muscular atrophy and blindness are being cured. These are great for individuals and society, but the treatment costs are expensive which is bad for payers and reinsurers. This article explores ways for health reinsurance actuaries to participate in the space and evaluate the risk associated with these treatments