Description: Presented at April 1985 Spring Meeting. This session focused on recent experience of programs designed to contain health care costs.

Description: The presenters will provide insights into fraud and abuse risk in the health insurance industry, including an examination of traditional and predictive modeling techniques for both prevention and detection. Emphasis will be placed on current and emerging risks. Canadian examples and perspectives will be offered, but the applications for attendees to use in practice are non-nation specific.

Description: This discussion is on the availability of utilization and cost experience data for group medical care insurance coverages. Specifically, it highlights the role of the Society of Actuaries in intercompany data collection, employer demands for sophisticated utilization data for comparison by industry and geographic location, sources of industry-wide data, data resource potential of health claims processing by the National Electronic Information Corporation, and antitrust implications. From Record of the Society of Actuaries 1981, Volume 7, No. 4.

Description: Panelists at this session of the SOA 2001 Annual Meeting discuss pricing issues and business risks associated with life, annuity, medical expense and disability income insurance products and compare them to long-term care [LTC].

Description: Presented at May 1986 Spring Meeting. This session discussion is about credit card distribution systems, association endorsed marketing, direct response marketing and single premium credit insurance.

Description: Panelists at this session of the SOA 1995 Vancouver Spring Meeting discuss the major features of the Canadian health care program and the U.S. market, including current deliberations for change. An assessment of how aspects of each country's handling of health care could be applied to the other country is discussed.

Description: The panel at this session of the SOA 1989 Chicago Spring Meeting discusses the mass marketing of individual health insurance, including Section 125 products, trends and problems in direct response, and claim settlement issues.

Description: This presentation is a panel discussion, session 54PD, from the 2004 Spring Meeting of the Society of Actuaries, held June 14-15 in San Antonio, TX. This session covers the impact of segmentation and underwriting on expected mortality and morbidity. Panelists discuss the importance of data mining and customer selection on ultimate experience, setting up direct marketing applications with the right type of questions to maximize responses but limit risk, the use of prescription drugs and other databases, and industry practices for obtaining customer information. Discussion from participants is included. From the Record of Society of Actuaries, Volume 30, No. 2.

Description: Panelists at this session of the SOA 1998 Maui II Spring Meeting offer several approaches to creative provider reimbursement where a single capitation and fee schedule was not the best solution.

Description: This session discussion is about a review of experience under PPOs, measuring the success of PPOs, PPOs affect on employer health care expenditures, employee utilization of PPOs, the future of PPOs. From Record of the Society of Actuaries Vol. 11, No. 4A.