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: The editors preview the articles in the February 2010 issue of Health Watch.

Description: Chapter 1 presents the background to the current study, followed by the methodology used, and a summary of the findings of the study. From Group Medical Insurance Large Claims Database Collection and Analysis, M-HB97-1.

Description: Chairperson's thoughts on the evolving nature of actuarial modeling, and results of a survey.

Description: Prepared for the Society of Actuaries by STATLAB at the University of Western Ontario, this report contains the results of a cash flow testing, ‘CFT,’ software survey performed in 2004. The results were based on the responses of 110 life insurance companies in the U.S. and Canada. The goal of the survey was to produce a report that will serve as a reference for comparing the available CFT packages and lead to better software and modeling techniques. CFT refers to analysis which is used to support both the Asset Adequacy Analysis for the Actuarial Opinion for U.S. companies, and the ALM Provision for Adverse Deviations in applying the Canadian Asset Liability Method to determine reserves for Canadian companies.

Description: A review of Section 404 of the Sarbanes-Oxley Act, including a review of the need for life and health insurance actuaries to review and, in most cases, substantially strengthen their internal controls over financial reporting.

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: Four appendices are attached to the monograph: a letter requesting information, two letters requesting participation, and a set of general database specifications. From Group Medical Insurance Large Claims Database Collections and Analysis, M-HB97-1.

Description: This article discusses techniques for modeling credit risk, including discussion of default assumptions and recovery rates.

Description: Following up on recent articles on claim reserves and retrospective testing, this article examines some data quality and methodology issues related to calculating LTCI claim reserves.