Description: This article describes some of the traditional profit measurement standards for direct marketing and then presents a more comprehensive and up-to-date foundation for insurance direct marketers and actuaries to use when reviewing individual direct marketing campaigns or total marketing programs.

Description: The presenters will provide insights into fraud and abuse risk in the health insurance industry, including an examination of traditional and predictive modeling techniques for both prevention and detection. Emphasis will be placed on current and emerging risks. Canadian examples and perspectives will be offered, but the applications for attendees to use in practice are non-nation specific.

Description: Managed care networks are important to control rising health care costs . these need to be priced appropriately to produce the right results for all stakeholders . This includes analysis of utilization and costs for both in and out of network claims . A variety of risk and administrative service options exist for entities assuming such risk .

Description: This is the abstract for the paper entitled 'Pricing Long Term Insurance Contracts.' This paper considers several models describing the changes in the needs of the insured for care over time. From Actuarial Research Clearing House 1994, VOL. 1.

Description: Update on Affordable Care Act topics, including Section 1332 waivers, Association Health Plans, silver loading and cost sharing reductions.

Description: The article provides insights about the need for revolutionary actuaries in Saudi Arabia due to the reform that is happening across the kingdom under all sectors. Then I talk briefly about the health sector and the transformation that is happing in the sector, and how qualified health actuaries can contribute to this health reform.

Description: HIV is still a big public health concern, but there are therapies available to prevent infection before and immediately after exposure. As legislatures and the USPSTF considers adding these therapies to the list of preventive care covered without cost share, actuaries will need to estimate the impact on their care cost. The presenters will share an actuarial tool kit to estimate the impact of covering PrEP and PEP for different populations. Examples are provided and discussion is welcome.

Description: Using data from the Health & Retirement Study [HRS], a two-part medical claim prediction model is estimated for a cohort of survey respondents approaching Medicare-eligibility age. A High Deductible Health Plan [HDHP] with a companion Health Savings Account [HSA] is applied to simulated claims streams to model the build-up of HSA assets over the near-retirement years. Results show that the HSA is a grossly inadequate savings vehicle to provide for retiree medical care expenses at age 65. Moreover, HSA adequacy worsens exponentially with diminishing health status. Based on this simulation, it is apparent that Baby Boomers cannot adequately provide for the costs of medical care in retirement using HSAs exclusively.

Description: This section presents book reviews and summaries of recent publications on a variety of topics.

Description: This is the complete January 2012 issue of Health Watch.