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: In September 2017, the China Insurance Regulatory Commission (CIRC) issued the “C-ROSS Phase II project construction plan”, planned to be used across three years’ time, by perfecting the regulations, improving the operational mechanism and strengthening the regulatory cooperation.

Description: The October/November 2015 edition of The Actuary magazine—the Society of Actuaries’ flagship publication.

Description: The August/September 2013 edition of The Actuary magazine—the Society of Actuaries’ flagship publication.

Description: In today’s business world, many financial decisions undergo considerable analysis before the decision is made and the decision-maker is often held accountable for the outcomes. The purpose of this research is to introduce the concept of total risk analysis (TRA), which is designed to help the decision-maker answer key questions at the time the decision is made. This paper will focus on a specific example of a typical healthcare decision: setting a budget for claims in the upcoming year. In addition to explaining TRA and providing a case study, this paper presents quantitative research regarding cost distributions for health care costs.

Description: The Mortality and Longevity and Catastrophe and Climate Strategic Research Programs are pleased to make available a report summarizing an expert panel brought together to discuss the impact of wildfires on U.S. health and life insurers.

Description: The document is a Call for Essays from the Society of Actuaries Research Institute. Share your real-world experiences with AI in actuarial work—challenges, wins, and lessons—to shape the future of the profession.

Description: The CIA, CAS Institute (iCAS) and the Society of Actuaries (SOA) are joining forces once again to launch the Predictive Analytics Hack-A-Thon!

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: The prospects for China's health insurance has increased significantly in 2018, incentivized by a series of favorable government policies to support the development of commercial health insurance. However, the market still lacks relatively mature products and services. Overall there is a common understanding in the industry that good coverage plus service is the foundation for health insurance future development, and product innovation plus care management is key for an insurance company to maintain sustainable development in the competition. In this presentation, Dr. Yang will discuss the market trend both at home and abroad with respect to health management as well as its impact on product design, pricing and cost control. With the development of internet and big data, today’s health actuary has a special role in taking advantage of the digital transformation and achieving a high-quality and efficient health care service model.