Description: This report explores AI bias in insurance and health data, highlighting the ethical role of actuaries and offering cross-disciplinary guidance for fairer decision-making systems.

Description: Healthcare costs have been rising faster than general inflation for many years. Early models that predicted this past pattern projected healthcare expenditure growth that continued to outpace total expenditure growth leading to the fallacious position that the whole of the US economy would ultimately be consumed by healthcare. The Society of Actuaries' Pension Section and Health Section Research teams commissioned Professor Thomas E. Getzen of Temple University to construct a resource model for the projection of long term healthcare cost trends that includes capacity constraints to ensure the long-term projection is rational. The motivation for creation of the model was driven by its potential usage as a resource for the estimation of reportable liabilities for retiree healthcare benefits as specified under FAS 106 and GASB 45 accounting statements. This is a zip file containing the following: 1. A background paper on the creation of the health trend model, 2. The model, programmed in Microsoft Excel [xls format], that projects per-person expenditures and growth rates through 2099 using baseline assumptions, but also permits the flexibility for user–inputted alternative assumptions, and 3. Technical documentation providing transparency and support for the ultimate results.

Description: 2014 marked a new beginning for small group(SG) health insurance market ushered in with adjusted community rated products priced from a single risk pool. It was anticipated that the mandated pooling of the risk would result in higher rates, especially for healthier groups. It is the aim of this article to show whether that view bears out in the actual market rates and if it is higher, then by how much. The article provides a point in time(1st quarter 2025) comparison of premium rates under two segments of the small group market, namely Qualified Health Plans(QHP) available under the small group ACA market versus self-insured Multiple Employer Welfare Arrangements(MEWA) plans.

Description: This report is presented in the form of a Tableau dashboard and is the sixth public release from this report series and contains the results of an excess mortality analysis for the fourth quarter of 2021. Data from 30 companies representing approximately 69% of the industry’s face amount inforce were included in the analyses in this report. A total of 3.2 million death claims from individual life policies from 2015 through December 31, 2021 make up the basis of the analyses. The report also compares the experience under COVID-19 of the insured population versus the general population.

Description: It's your first full day of productive learning! Start it off right with a delicious breakfast and warm welcome.

Description: Actuaries team up with Payers and Providers, to share insight into their data-driven approaches for improving health plans' CMS Medicare Star Ratings, which leverage experiential analytics to create solutions. 'Experience' is the king-it is broader umbrella, which includes and addresses engagement, cultural competency, equity, cost, and lastly, 'quality'. By attending this session, you will be better equipped to turn real-life data into actionable business solutions-essentially, data science in action. Further, you will better appreciate the importance of stars and risk adjustment in the Medicare Advantage space, along with the consequences of coming up short.

Description: The Individual Disability Experience Committee (IDEC) of the SOA has gathered industry data covering 2006-2015. The presenters will highlight findings on the recent industry experience compared to the 2013 Individual Disability Income Valuation Table (2013 IDIVT), including the impact of the recession on incidence and terminations. They will cover claim incidence and claim termination Actual to Expected (A/E) using 2013 IDIVT as the expected basis. The adequacy of the modifiers will also be discussed.

Description: The presenters will cover the variation in risk adjustment approaches used across state Medicaid programs and compare them to other Federal programs. Additionally, recent developments, such as the use of OCR to extract data from medical charts for risk adjustment, will be discussed.

Description: Unpaid Loss Reserve fair and reasonable test and two legal cases Utah Medical and Minnesota Lawyers Issue No. 39.