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  • Issue Brief: Changing Financial Risks for Medigap Insurance, Part 2

    Issue Brief: Changing Financial Risks for Medigap Insurance, Part 2 This is Part 2 of 2 on changes affecting Medigap insurers. It focuses on marketing and regulatory differences between Medigap ...

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    • Date: Mar 2024
    • Competency: External Forces & Industry Knowledge; Strategic Insight and Integration
    • Publication Name: Health Watch
    • Topics: Health & Disability; Health & Disability>Health insurance; Public Policy; Public Policy
  • Restoring the Indifference Ideal: If It’s Not Adjusting for “Risk,” It’s Not “Risk Adjustment”

    Restoring the Indifference Ideal: If It’s Not Adjusting for “Risk,” It’s Not “Risk Adjustment” ACA risk adjustment is intended to "bridge the gap" between allowed rates and actuarial rates.

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    • Authors: Greg Fann
    • Date: Jun 2022
    • Competency: Strategic Insight and Integration
    • Publication Name: Health Watch
    • Topics: Experience Studies & Data; Health & Disability>Health care
  • SIPF Goes to the Health Meeting

    SIPF Goes to the Health Meeting Social Insurance & Public Finance Section council members provide a recap of sessions from the 2021 SOA Health Meeting, with a focus on sessions covering ...

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    • Authors: Stephanie Dawn Entzminger , Marilyn Medved McGaffin, Gregory Fann
    • Date: Jul 2021
    • Competency: External Forces & Industry Knowledge
    • Publication Name: In The Public Interest
    • Topics: Health & Disability>Health insurance; Public Policy; Social Insurance; Social Insurance>Government-funded healthcare; Social Insurance>Medicaid; Social Insurance>Medicare; Health & Disability>Affordable Care Act (ACA)
  • Better Care Through Understanding the Customer Not Just the Patient

    As actuaries in health care, we spend most of our time focused on reviewing claims, enrollment and clinical data. That information is captured while patients are in health care facilities. Yet ...

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    • Authors: James Dolstad, Craig Cartossa, Justin Hartmann
    • Date: Dec 2021
    • Competency: Results-Oriented Solutions; Strategic Insight and Integration; Technical Skills & Analytical Problem Solving
    • Publication Name: Health Watch
    • Topics: Health & Disability; Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health insurance; Health & Disability>Health risks; Health & Disability>Payment models; Predictive Analytics; Health & Disability>Provider networks; Health & Disability>Provider risk; Predictive Analytics>Modeling techniques
  • Claims Reserve Margin in the Health Annual Statement: A Review of 2016–2021

    Claims Reserve Margin in the Health Annual Statement: A Review of 2016–2021 In preparing claims reserves in the annual statement, health insurers and their opining actuaries will generally include ...

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    • Authors: Robert Lang, Elliot McLeRoy
    • Date: Nov 2023
    • Competency: Strategic Insight and Integration
    • Publication Name: Health Watch
    • Topics: Financial Reporting & Accounting; Financial Reporting & Accounting>Statutory accounting; Health & Disability; Health & Disability>Claims - Health & Disability
  • session-6d

    In this session, we will address the current landscape of the standalone Medicare Part D market and the challenges to its sustainability. Specifically, we will discuss some headwinds for plan ...

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    • Date: Jan 2025
    • Topics: Health & Disability; Public Policy; Social Insurance
  • Seeing The Big Picture: ERM In The Health Care Industry

    Seeing The Big Picture: ERM In The Health Care Industry Article discussing the use of enterprise risk management in the health care industry. Enterprise risk management=ERM; Seeing The Big ...

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    • Authors: Robert F Wolf
    • Date: Apr 2009
    • Competency: External Forces & Industry Knowledge
    • Publication Name: The Actuary Magazine
    • Topics: Enterprise Risk Management; Health & Disability>Health care
  • The Crisis in Healthcare Cost in the United States–An Actuary's Perspective

    The Crisis in Healthcare Cost in the United States–An Actuary's Perspective Examines the question of whether health-care costs, or health insurance costs, are in crisis. Health care ...

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    • Authors: Application Administrator
    • Date: Dec 2006
    • Competency: External Forces & Industry Knowledge
    • Publication Name: The Actuary Magazine
    • Topics: Health & Disability>Health care; Health & Disability>Health insurance
  • 2023-waiver-reserve-table

    Discuss changes in group life waiver of premium claim recovery and mortality experience since the 2005 table was released, the development of the 2023 table, and the new statutory valuation ...

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    • Authors: Mike Krohn
    • Date: Nov 2023
    • Competency: External Forces & Industry Knowledge
    • Topics: Experience Studies & Data; Health & Disability
  • Raising the Bar in Medicaid: Actuarial Driven Solutions to Support the Most Vulnerable

    Actuaries have the business acumen, problem-solving capabilities, and technical skills to develop innovative and data-driven solutions in the social insurance space. It is time we expand our ...

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    • Authors: Khurram Taufiq
    • Date: Jan 2022
    • Competency: External Forces & Industry Knowledge; Leadership; Strategic Insight and Integration
    • Publication Name: In The Public Interest
    • Topics: Health & Disability; Social Insurance; Social Insurance>Medicaid