Description: In preparing claims reserves in the annual statement, health insurers and their opining actuaries will generally include a provision for adverse deviation (PAD) in their reserved amount in order to satisfy language in both in the National Association of Insurance Commissioners (NAIC) Health Annual Statement Instructions and in Actuarial Standards of Practice. This article explores the total level of PAD (both implicit and explicit margin combined) included in the reported claims reserves by examining NAIC filing data from 2016 through 2022.

Description: Internal audit (IA) projects typically focus on evaluating the risks and operational effectiveness of a company’s technological, regulatory/compliance, and/or financial processes and procedures. Because LDTI and IFRS 17 compliance will require extensive rewiring of existing and possibly the implementation of new processes and procedures to comply with the new accounting requirements, IA will be critical in conducting the initial risk assessment of these changes, monitoring of the process changeover, and conducting a post-implementation validation after conversion. Explore many specific areas that will be impacted, highlight those aspects likely to be under the IA magnifying glass, and find out how you can best prepare your IA teams to understand the changes and expedite the testing timeframes of their audits. By attending the session, you will be able to: • Understand general IA testing approach and framework. • Identify and address the key processes and procedures likely to be impacted by accounting change. • Build a communication plan that tailors the level of detail of documentation to the intended audience. (e.g., Leadership and BOD) • Document decisions made and implemented with IA in mind.

Description: Presents a step-by-step methodology for calculating confidence intervals for IBNR estimates derived using the Averaqe PMPM method. It is a companion article to the January 2023 Health Watch article presenting the Average PMPM method for generating point estimates of IBNR with zero claims runout.