Description: First dollar carriers, stop loss carriers, and reinsurers play a different role in reimbursing healthcare claims. This article explores the reinsurer's role in reimbursing COVID-19 related claims.

Description: A proposal to address provider payment issues by gradually moving to accountable care organizations. Capitations would be risk-adjusted, non-capitated costs would be covered by hospitalization fund and stoploss, incentives for quality & effective preventive care would be tied to the amount remaining in the fund, and government involvement would be through incentives rather than mandate.

Description: An essay suggesting a health care financing system.

Description: Excess Reinsurance is a coverage purchased by insurance carriers to limit loss in a year from any one claim. This article addresses the issues when purchasing medical excess reinsurance on a medical portfolio. The most important consideration in the reinsurance purchasing decision is determining the risk objectives of the organization. The proper risk analysis by the carrier or in conjunction with its reinsurer will address the following questions: What is predictable risk versus unpredictable risk?

Description: Adding aggregating specific provisions to individual stop loss contracts reduces premium outlay but often priced incorectly by insurers. Includes lasering concept. Issue No. 46.

Description: Article builds on similar article in January 2002 issue and presents brief discussion on extra stop-loss risk. Health Section News, June 2002, Issue 46

Description: Contains two separate articles, called notes. The first note, “A note on correlation in mean variance portfolio theory,” is an elementary discussion of how negative correlation coefficients can be, given any set of N random variables. The second note, “Two essential formulas in actuarial science and financial mathematics,” gives a more or less self-contained introduction to Jensen’s inequality and to another formula, which the author decided to call the “survival function expectation formula.”

Description: Feature article discussing the American Academy of Actuaries Academy review of the various risk-based capital RBC formulas for health insurance products.

Description: In the context of reinsurance, this paper addresses finding the quota share retention level and the retention limit, with a diffusion process being added to the claim process, that maximizes the adjustment coefficient in the Sparre Anderson model. From Actuarial Research Clearing House, 2006.