Description: "Most patients enter the health care system through their primary care provider or through the Emergency Room or an Urgent Care Center. How an emergency room is structured, managed, and provides care is one of the major forces impacting the total cost of care. Yet it is often an after-thought and ignored by both health plans and health systems. In reality, the structured introduction of efficient practices can substantially reduce the quantity and cost of health care services. Further explore useful information to better understand and see how there are still substantial opportunities for improvement."

Description: The implementation of the IFRS 17 insurance accounting standard has brought significant changes to the financial reporting landscape of insurance companies. With new disclosure requirements and altered profit analysis, understanding and interpreting future profitability have become a topic of concern for the industry. While stability remains a key objective for insurance companies, the earning patterns might become more volatile especially when the contractual service margin (CSM) is exhausted, and a loss component (LC) needs to be established. Reinsurance, a common risk mitigation tool, can play a pivotal role in managing earnings volatility and minimizing losses for onerous measurement units. In this article, we propose a new key performance indicator (KPI) called “loss recoverability” to assess the performance of reinsurance treaties in achieving these objectives. We explain how this KPI can be utilized in multiple scenarios to evaluate the effectiveness of reinsurance strategies and pursue stability in earning patterns.

Description: S&P Global released its initial version of proposed changes regarding its Insurer Risk-Based Capital Adequacy methodology and assumptions on Dec. 6th, 2021. Unlike prior guidance notes or criteria releases, the proposed changes comprehensively updated the current S&P rating criteria released in 2010. These updates would directly impact many insurers. S&P Global anticipates that 10 percent of existing ratings in the insurance sector would be impacted and the change would lead to more positive rating implications than negative impact. This article focuses on the proposed changes on the S&P risk-based capital (RBC) vs. the current model, then simulate impacts to a representative U.S. life insurer through an illustrative case study.

Description: In preparing claims reserves in the annual statement, health insurers and their opining actuaries will generally include a provision for adverse deviation (PAD) in their reserved amount in order to satisfy language in both in the National Association of Insurance Commissioners (NAIC) Health Annual Statement Instructions and in Actuarial Standards of Practice. This article explores the total level of PAD (both implicit and explicit margin combined) included in the reported claims reserves by examining NAIC filing data from 2016 through 2022.