Description: Learn about key actuarial and analytic tools and methodologies used by commercial health insurance to identify and quantify drivers of healthcare cost and utilization (including wasteful and low-value ones) and risks. Use case scenarios in which these tools and methodologies apply, such as underwriting, reinsurance, medical management for population health and chronic diseases, managed care contracting, insurance market reform, provider payment reform, etc., will also be covered. Experience from the U.S., China and other parts of the world will be shared.

Description: This report explores the adoption and impact of artificial intelligence and large language models in the Greater China insurance industry, drawing from surveys and case studies.

Description: This paper is being produced in conjunction with eight companion pieces reflecting a variety of stakeholder experiences with the development of the risk pool.

Description: A divisive confrontation over health care pricing is almost inevitable over the next few years. What will ultimately happen is a political decision, not an actuarial one—but it will have major consequences for the trend in health care costs and the divergence between public and private insurance premiums.

Description: Data file for Commercial Health Care Cost and Utilization Trends From 2009–2015 research report.

Description: A summary recap of the recent SOA Health Conference held in Dallas, TX in June of 2025. With the intentional use of AI to assist with the summary, this article gives a good overview of the recent conference with personal commentary from one of the attendees.

Description: Patients with diabetes make up 25% of health care spending in the US, and a variety of solutions to address the high cost of diabetes exist today, including disease management programs, clinical interventions including bariatric surgery and GLP-1 drugs, and food as medicine programs.

Description: Research Objective The Society of Actuaries Research Institute General Insurance Research Committee is seeking researchers to identify and analyze the various by-component inflationary forces on pet insurance affordability in the United States and Canada. In addition, we seek ideation of potential solutions that are likely to improve the affordability of pet insurance.

Description: The COVID-19 pandemic helped accelerate many changes in the Health Care system that were already taking place. The major disruptions to the way providers operated was quite evident with shifting of focus away from elective services to create capacity for treating COVID-19. However, even before the pandemic, providers were adapting to changes in their environments.

Description: Similar to how states had made adjustments to their capitation rates to reflect acuity adjustments caused by the onset of the pandemic, states will need to modify the rates to reflect the unwinding since utilization patterns and average acuity per enrolled member will change. When the continuous coverage requirements set forth by the COVID-19 Public Health Emergency (PHE) ended, Medicaid-managed care programs across the country adopted various approaches to phasing out maintenance of effort (MOE) as a result of changes to the PHE-era continuous eligibility requirements. Phasing out the MOE requirement will ultimately result in members who no longer meet eligibility requirements losing their Medicaid coverage. Further, states are facing a wide variety of circumstances and are implementing diverse approaches to the MOE phase-out. This topic will be of significant interest to all actuaries and stakeholders of the capitation rate development process for Medicaid-managed care programs. Join us as we discuss the operationalization of the PHE unwind while referencing the SOA's research project which models the effects of the unwinding on Medicaid eligibility and population costs. You will learn about the various approaches that different states have adopted to manage the unwinding process, which will be instrumental for accurately pricing managed care rates.