Description: This article examines the history, theory, and effectiveness of high-deductible health plans and health savings accounts.

Description: A new health insurance pricing model takes external market prices into account, as well as regulatory rate restrictions and other traditional pricing factors. Rather than being assumed at the outset, lapse rates emerge from the model, along with assessment spiral & loss ratio projections. Under the model optimal pricing strategy depends on whether the class being rated has a healthier than average mix of risks.

Description: This article describes methodologies for detection and deterrence of Medicare fraud. It also describes the validation of PRIDIT for fraud detection in Medicare.

Description: This article discusses the advantages, logistical concerns, and pricing formulas of implementing a TNHP, in which members pay less for treatment from providers who meet higher quality and cost-effectiveness standards.

Description: An economic analysis of bariatric surgery and health care costs supports the case for health plans to cover these procedures.

Description: This article provides an overview of the financial results of managed care plans over time using a collection of the NAIC financial statements.

Description: An interview with Dawn Helwig on developments in the Long Term Care market.

Description: Overview on current trends in medical practice impacting the LTC insurance business with a focus on dementia, risk stratification, and predictive modeling.

Description: Article presents arguements for actuarial involvement to facilitate use of pharmaceutical research within managed care organizations MCO. Issue No. 44.