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  • Design and Pricing of Tiered Network Health Plans

    Design and Pricing of Tiered Network Health Plans This article discusses the advantages, logistical concerns, and pricing formulas of implementing a TNHP, in which members pay less for treatment ...

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    • Authors: Peter Horman
    • Date: May 2009
    • Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Results-Oriented Solutions; Strategic Insight and Integration>Effective decision-making; Technical Skills & Analytical Problem Solving>Process and technique refinement
    • Publication Name: Health Watch
    • Topics: Economics>Health economics; Health & Disability>Health care quality; Modeling & Statistical Methods
  • Commercial Health Care: What’s Next?

    Commercial Health Care: What’s Next? This article contains a condensed summary and excerpts from a recent white paper regarding the Individual Mandate. health care reform;health economics;health ...

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    • Authors: David Dillon
    • Date: Jun 2018
    • Competency: External Forces & Industry Knowledge>Actuarial theory in business context; Professional Values>Public interest representation; Technical Skills & Analytical Problem Solving>Process and technique refinement
    • Publication Name: Health Watch
    • Topics: Public Policy; Public Policy
  • Using the Internet as a Pricing Tool

    Using the Internet as a Pricing Tool Using the Internet as a Pricing Tool clinical background information, defining the change in coverage, collecting data, data quality and data limitations.

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    • Authors: Application Administrator
    • Date: Dec 2000
    • Competency: Technical Skills & Analytical Problem Solving>Process and technique refinement
    • Publication Name: Health Watch
    • Topics: Experience Studies & Data; Technology & Applications
  • A Practical Method for Incorporating Pended Claims in Medical IBNR Estimates

    A Practical Method for Incorporating Pended Claims in Medical IBNR Estimates Incorporating Pended Claims in Medical IBNR Estimates. Issue No. 45. Health reserves;Modeling efficiency;Predictive ...

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    • Authors: Peter Reilly
    • Date: Apr 2003
    • Competency: Technical Skills & Analytical Problem Solving>Process and technique refinement
    • Publication Name: Health Watch
    • Topics: Health & Disability>Health care; Modeling & Statistical Methods>Estimation methods
  • Incurred Health Claims:One Lag Report is Not Enough

    Incurred Health Claims:One Lag Report is Not Enough Discussion of methods to estimate unpaid claim liability UCL for health plans. Includes traditional IBNR lag method and a lag method based on ...

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    • Authors: Henry Frantz
    • Date: Apr 2003
    • Competency: Technical Skills & Analytical Problem Solving>Process and technique refinement
    • Publication Name: Health Watch
    • Topics: Health & Disability; Modeling & Statistical Methods
  • Statistical Tools for Actuaries?First in New Series of Guides Available

    Statistical Tools for Actuaries?First in New Series of Guides Available Recognizing an opportunity to help serve its members in this age of increased financial oversight, the Health Section of ...

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    • Authors: Steven Siegel
    • Date: Jan 2008
    • Competency: Technical Skills & Analytical Problem Solving>Process and technique refinement
    • Publication Name: Health Watch
    • Topics: Health & Disability>Health care
  • Pricing Aggregate Stop-Loss Coverage

    Pricing Aggregate Stop-Loss Coverage 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 ...

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    • Authors: Charles S Fuhrer
    • Date: Jun 2002
    • Competency: Technical Skills & Analytical Problem Solving>Process and technique refinement
    • Publication Name: Health Watch
    • Topics: Reinsurance>Stop-loss insurance
  • Comparison of Risk Adjusters

    Comparison of Risk Adjusters Analysis of diagnosis and pharmacy-based methods of health risk assessment. Issue No. 44. Medicare;Prescription drug costs;Risk adjustment; 9406 10/1/2002 12:00:00 ...

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    • Authors: Robert Cumming
    • Date: Oct 2002
    • Competency: Technical Skills & Analytical Problem Solving>Process and technique refinement
    • Publication Name: Health Watch
    • Topics: Health & Disability
  • Applying Diagnosis-Based Predictive Models to Group Underwriting

    Applying Diagnosis-Based Predictive Models to Group Underwriting Applying Diagnosis-Based Predictive Models that use medical and pharmacy claims to measure expected costs for Group Underwriting.

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    • Authors: Randall P Ellis, Marilyn Kramer
    • Date: Aug 2003
    • Competency: Technical Skills & Analytical Problem Solving>Process and technique refinement
    • Publication Name: Health Watch
    • Topics: Health & Disability
  • Estimating the Impact of Disease and Treatment on Life Expectancy

    Estimating the Impact of Disease and Treatment on Life Expectancy Analysis of the impact of disease progression and treatment on life expectancy provides perspective on the long term costs to the ...

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    • Authors: Tzu-Chun Kuo, Philipp Vetter
    • Date: Jan 2011
    • Competency: Leadership>Thought leadership; Professional Values>Public interest representation; Strategic Insight and Integration>Big picture view; Technical Skills & Analytical Problem Solving>Process and technique refinement
    • Publication Name: Health Watch
    • Topics: Demography>Longevity; Health & Disability>Health care quality; Health & Disability>Health risks; Modeling & Statistical Methods>Data mining