Description: Discussion of the standards set by ASOP 23 on data quality within a health insurance context.

Description: Discussion of methods to estimate unpaid claim liability UCL for health plans. Includes traditional IBNR lag method and a lag method based on claims reported but not paid RBNP. Issue No. 45

Description: This article describes employer considerations when evaluating Private Exchanges and potential financial impacts of a multi-carrier, fully-insured model

Description: This is an introduction to the SOA call for essays around risk strategies pertaining to the diverse risks found in retirement. We are pleased that these essays can be included in this issue of Pension Section News, along with a short interview with each author.

Description: In this paper we propose a model that can be used to analyze correlated claims data. In the process we introduce a class of multivariate generalized Poisson distributions. Then we present posterior distributions of its parameters. These distributions are difficult to manipulate, so we employ Markov chain Monte Carlo methods to draw random numbers from posteriors and predictive distributions. We present a collection of EXCEL VBA functions and subroutines to perform the simulations.

Description: This is a case study on group health from the spring 2012 exam of the Society of Actuaries.

Description: With the 2024 presidential election one week in the rear-view mirror, actuaries and health policy experts will discuss the potential health policy implications in the next four years in relation to the election results. Focus will be on the changing dynamics within Affordable Care Act (ACA) marketplaces with the knowledge benefit of the next president having administrative experience in the ACA environment. Session attendees will be well-equipped to discuss the post-ACA health policy implementation of presidents Biden and Trump, recent policy proposals, and potential legislative/regulatory changes as a result of the 2024 election outcomes.

Description: There are growing concerns that the Asian bird flu virus will evolve into a form that can be transmitted from human to human, thus unleashing a new global flu pandemic. This article uses the Spanish flu epidemic and the German life insurance portfolio to analyze the additional claims expenditure due to a pandemic.

Description: This paper helps the audience understand the actuary’s role in estimating the financial impact of primary care programs. In addition, the paper can be used by actuaries to think about key issues when estimating the financial impact of their employers’ and clients’ own primary care programs.

Description: Report to give actuaries practical information and guidance on LTD claim credibility for case level pricing and underwriting. Stage 2 of the GLTD Credibility Study, this analysis was expanded using the industry data gathered during Stage 1.