Description: Strategic Risk Management was given lower priority in a recent survey of ERM Objectives. This article tells how the author believes that recent events have caused many to shift to a more short term focus and in the future there will be a shift back to a priority for the longer term view that stands behind Strategic Risk Management when the environment settles down and things again seem to be more predictable.

Description: Duration matching is a risk management strategy, commonly used in the insurance industry, where the duration (price sensitivity to a yield curve movement) of an asset portfolio is adjusted to be made equal to the duration of the liability. However, this approach has flaws. In this essay, I note some key failures of duration matching and offer a potential alternative.

Description: Since most cash flows being discounted in the value calculation are dependent on the forward rates, in the key-rate calculation forwards (not spots) should be shifted. I will show that if spots are shifted up/down, they would not necessarily result in forwards being up/down for all the years in the particular key rate, resulting in unexpected results. I will further show how metrics calculated by shifting forwards versus spots enhance the accuracy of the approximation of projected value in various rate environments.

Description: Profile of an actuary in a non-traditional actuarial role: focusing on medical cost and analysis, both retrospective and prospective.

Description: An economics professor and a health care consumer advocate weigh in on the Patient Protection and Affordable Care Act, including implementation issues, directions for the future and what role actuaries shoudl take.

Description: Since health care reform has made accountable care organizations a hot topic, an SOA workgroup is addressing relevant questions, including provider risk under various ACO models, limitations of the Medicare model for motivating change in the health care delivery system, strategic priorities, attribution of members, meaurement, and the roles actuaries can play.

Description: Update on Health Section research projects and topics, including health care reform, complexity science, and strategic planning.

Description: Health insurance company assets and liabilities have evolved since the Patient Protection and Affordable Care Act (ACA) was signed into law in March 2010. The ACA fundamentally rearranged how commercial health insurance is funded by integrating federal premium subsidies and pass-throughs together with a marketplace interwoven with transfer payments among stakeholders. The impacts of these programs can be seen in specific accounting items on the balance sheets of health insurance companies over the past 10 years. Their emergence follows three primary trends: (1) balance sheet items tend to be larger and take longer to settle, (2) there are more interactions among items, and (3) the final settlement amounts are more uncertain.

Description: An introduction to the ACA@10 Strategic Initiative, which examines the impact of the Affordable Care Act 10 years after its passage.

Description: Any prudent organization that is obligated to cover health claims will consider the risk that those medical claims vastly exceed expectations. This is true for an employer self-funding employee health benefits, a health system contracted with two-way risk (e.g., Accountable Care Organizations ACOs), and a small or mid-sized health insurance company. Without protection, these risk bearers can incur ruinous losses. Interestingly, the forms of insurance sold to cover such large medical claims, although quite similar, sometimes go by different names depending upon the buyer. • Employer Stop-loss (ESL): self-funded employers who want protection against large unanticipated claims • Provider Excess (PXS): at-risk health systems who have taken delegated risk from a public or private payer and desire protection against large unanticipated claims • Medical Excess/HMO Reinsurance (HMO Re): health insurers (including HMOs) who desire protection against large unanticipated claims The concepts we discuss in this article apply to all three categories of large claim risk.