Description: Identifying and submitting all appropriate ICD-9 diagnosis codes to CMS will result in a higher risk score for the member and increased payments to Medicare Advantage plans. Milliman's HCC prevalence study illustrates the significant variations in HCC prevalence rates by age/gender, geography, and population type and will assist plans in benchmarking the effectiveness of their own diagnosis code capture efforts.

Description: The study of Employee Benefits has always been aided by using financial algorithms. During recent semesters, the Lotus 1-2-3 package Lotus has been introduced to students due to the explosion of its use in the business community. This paper will show how our students use Lotus to design a spreadsheet for computing minimum annual distributions from tax-sheltered plans.

Description: This paper presents an approach to analyzing continuing care retirement community [CCRC] data, and demonstrates the methods using data from a large CCRC. It is assumed that residents make transitions among a number of states that represent the levels of care required by residents. There is randomness associated with both the transition times and the states entered at these times. The model is conveniently characterized in terms of transition intensity functions, which represent the instantaneous rates of transition between pairs of states.

Description: This article introduces SymPy, a computer algebra system (CAS) for the Python programming language.

Description: Explores the open vs. closed systems debate with regards to actuarial modeling and exposes the over-simplification. Valuable for anyone who uses models.

Description: Although rate structures where low-cost cohorts subsidize high cost cohorts may be justified from a actuarial, marketing, or legal standpoint, the subsidization creates risks which must be understood and monitored. This article presents the concept of subsidization signature to measure and interpret the effects of rate subsidization, and to assess the sustainability of rating structures and the sensitivity of business mix assumptions.

Description: A new health insurance pricing model takes external market prices into account, as well as regulatory rate restrictions and other traditional pricing factors. Rather than being assumed at the outset, lapse rates emerge from the model, along with assessment spiral & loss ratio projections. Under the model optimal pricing strategy depends on whether the class being rated has a healthier than average mix of risks.

Description: The guest editorial details some valuable lessons during the author’s career as an employee benefits (mostly retirement) consultant, turned P&C predictive modeling, reporting and data warehousing lead, turned an analytic strategist and independent consultant.

Description: A description of the Technology Section's goals and accomplishments.

Description: This paper deals with how the credibility levels change based on this lack knowledge. Group insuraace models are used, bill some of tile techniques could apply to any insurance risk.