Description: Presented at May 1985 Spring Meeting. Discusses current financial reporting topics related to both group and individual health insurance, including: Standards of practice for health actuaries, Deficit Reduction Act of 1984 DEFRA, Qualifications for health certification, Internal management reporting needs, New state reporting requirements.

Description: Presented at October 1985 Annual Meeting. This session is about actuarial implications of individual choice, antiselection problems for medical coverages, plan design considerations, flexible benefits program experience, impact of alternative delivery systems on insured plan.

Description: This 1978 panel discussion is about personal casualty lines on a group basis. It focused on: 1. The traditional approaches of group life and health versus individual policies for fire and casualty 2. Problems in product design and underwriting, and 3. The impact of federal income tax laws. 4. Regulatory constraints. The discussions were primarily on personal automobile insurance.

Description: This 1978 session focused on regulatory considerations in Group Health Insurance focused on the following questions: 1. What is the impact of National Health Insurance and Federal Hospital Cost Control? 2. What is the impact of non-discrimination legislation and regulation? 3. What is the impact of recent OASDI financing changes and changes in mandatory retirement age? 4. What is the future of multi-employer trusts and self-insurance?

Description: This session from the 1984 SOA Atlanta Meeting covers the issues in the individual medical insurance market - escalating costs, utilization rates and anti-select lapsation, the potential solutions and the challenges facing the actuary.

Description: This session from the 1984 SOA Atlanta Meeting covers cost containment in health care costs, cost sharing and cost containment features, underwriting, the use of deductibles or co-payments, different delivery systems and utilization.

Description: After the bid process, desk review, rebate reallocation, an “enjoyable” audit, and open enrollment; the Medicare plan year starts. Throughout the year, organizations find it pertinent to get an accurate picture of their Part D liability as reinsurance, LICS (Low Income Cost-Sharing) subsidy, and risk corridors are accrued. Attendees will learn about the basics of Part D accruals, how future accrual amounts are estimated based on patterns in the data, and how bid assumptions versus actual results impact plan sponsor profitability. We will also discuss financial statement treatment of these items. Real-life examples from bids to outcomes will be provided to enhance the discussion. Ultimately, attendees will come away with a deeper understanding how their bid assumptions play out, and how they can use Part D accruals to plan for future bid development.

Description: More and more providers are desiring risk-based contracts instead of traditional FFS-based contracts. This session is intended to outline some of the actuarial best practices in risk-based contracting related to the many flavors of the CMS ACO programs, as well as Commercial risk-based contracts.

Description: This discussion from the 1983 SOA Vancouver Meeting reviews the movement to small group health plans, group insurance underwriting, the plan design of non-traditional benefit programs such as cafeteria plans, HMO's and PPO's and new financial processes. From Record of Society of Actuaries, Vol. 9, No. 3.

Description: The process of setting initial and renewal premium rates for small group medical block of business using risk characteristics. Presents three pricing schemes and compares profitability Following the Curve, Lowest Best Rate and Highest Worst Rate.