Description: In this article, the authors explore how the recession has impacted new member enrollment in the various state health care programs and the resulting impact on trend.

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: This article discusses the growing number of cases of dementia and its effects on economics and loved ones.

Description: An update on HMO market trends and reinsurance products, and services supporting them.

Description: Recently, actuaries have become more involved in formulary decisions due to high and variable pharmacy cost and utilization trends. How can actuaries and pharmaceutical manufacturers work together to better predict the market while covering key drugs? What discussions are currently taking place between manufacturers and payers? Is there value in these discussions that actuaries are missing? This presentation will provide both actuarial and manufacturer perspectives in order to create a mutual understanding that will begin to direct future conversations to benefit both stakeholders.

Description: The evolving specialty pharmacy environment has created difficulties for actuaries pricing and forecasting pharmacy coverage. Unpredictable specialty pharmacy trends have increased insurers' earnings volatility and affected members' health care affordability. The presenters will highlight the current specialty drug development pipeline and explore specialty pharmacy drug trend management strategies. They will also provide concepts to help manage the coming wave of gene and cell therapies.

Description: Discussion regarding who's to blame for cost increase, Government's role to ensure coverage and keep costs down, steps to control costs, plan design changes. Issue No. 47.

Description: An examination of LTCI rate increases from three different perspectives: the insurance company, the policyholder, and the insurance department.

Description: An examination of the underlying reasons for the concept of health expectancy, some alternative approaches to developing the measurement and some of the powerful uses of this new tool.

Description: Overview of the book: Overtreated, Why Too Much Medicine Is Making Us Sicker and Poorer.