Description: According to the Actuarial Standards Board’s Actuarial Standard of Practice No. 49 (ASOP 49), actuarially sound Medicaid managed care capitation rates will include a provision for underwriting gain in order to provide compensation for the risks assumed by an MCO. However, there is no generally accepted method for quantifying underwriting gain in managed Medicaid capitation rates. This article discusses a new model developed to address this void and calculate underwriting gain. The model was developed by researching existing financial literature and performing a statistical analysis of industry data to build out a framework that can be leveraged to estimate underwriting gain.

Description: Given the limits of classical actuarial modeling and forecasting techniques, this newsletter contains articles discussing several ways to supplement your toolset.

Description: As the portion of inforce business valued under PBR grows, it becomes increasingly important to not only calculate reserves for point-in-time valuation but to also project reserves. This is especially critical for actuarial functions such as pricing, business strategy/forecasting, and asset adequacy testing. In this session, we will review PBR projection techniques based on work completed by the American Academy of Actuaries when developing the PBA Projection Practice Note. In addition, this session will examine specific challenges that can arise when actuaries use models to project reserves at future dates. Topics covered include mortality improvement, credibility, scenario generation, starting asset projections, and various other technical issues related to nested modeling requiring both inner and outer loop projections.