Description: 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 most people spend only a small fraction of their time in these facilities. This article explores what types of data are available to actuaries the provide a more holistic view of the member so that a members physical and emotional needs, the social determinants of health can be taken into consideration along with their clinical needs. Two uses cases are presented so actuaries can see how these types of analyses can be leveraged to improve clinical, operational, and financial performance of risk bearing health entities. Understanding the customer (member) not just the patient enables actuaries to provide new insights and values to our stakeholders across a wide range of business and risk applications.

Description: This article describes Medicare Supplement and short-term care products in more detail, and we compare their risk profiles. We explore the concept that these two products—when offered together—may provide a complementary hedge of certain policyholder behavior risks.

Description: The article investigates the reasons behind non-zero financial implications for fully reinsured businesses within the regulatory frameworks of US GAAP Long Duration Targeted Improvements (LDTI) and International Financial Reporting Standards (IFRS) 17. It helps companies grasp the nuances of these standards, thereby enhancing their risk management strategies, improving regulatory compliance and optimizing their decision-making processes.

Description: In this editorial the author discusses how actuaries can help mitigate the impact of managed care lawsuits. Examples are provided. From: The Actuary, April 2000 – volume 34 - Issue 4.

Description: This article discusses how small insurance companies can get into the complex equity indexed market by using alliances wherein there is one primary company and one or more secondary companies. The primary company would perform all of the functions for itself and some of the functions for the secondary companies. The companies pool assets to reach critical mass.

Description: Milliman was engaged by the SOA to conduct two Accelerated Underwriting (AU) surveys, one of direct companies and another of reinsurers. The surveys explored actual results from 2019–2021 and expected results from 2022.

Description: Private LTC insurers are paving the way for value-based care through working to implement care management programs that improve the lives of their policyholders before and during a claim. However, measuring the effectiveness of these new programs is a challenging task. In this article, we will explore powerful tools that can enhance traditional effectiveness studies and address some of their existing weaknesses.

Description: Long-term care policy buyouts have been discussed within the industry lately as an additional policyholder option alongside a premium rate increase. This article discusses potential advantages and disadvantages of long-term care policy buyouts from the perspective of insurance carriers, regulators, and policyholders. It also explores certain key actuarial considerations relating to long-term care policy buyouts including potential approaches to valuing a buyout, adverse selection, and reinsurance.

Description: The article provides a summary of key issues presented at the 2023 U.S. Living to 100 Symposium focused on the interests of retirement professionals and retirees. It provides an overview of the subjects covered. The discussion focused on the well-being of retirees and the development of the retirement system. It is focused on late-in-life issues and having the best life possible during that period. It balances technical and lifestyle issues, with an emphasis on mortality and longevity trends and influences. Some of the topics discussed include the impact of COVID, climate, housing, and age-friendly communities. The Elder Tech Symposium was merged into Living to 100 and includes discussion of a variety of technology approaches to improve lives and simplify support. The symposium recognized that the decisions needed and concerns during retirement are different later in life, particularly as people decline.

Description: The article provides insights about the need for revolutionary actuaries in Saudi Arabia due to the reform that is happening across the kingdom under all sectors. Then I talk briefly about the health sector and the transformation that is happing in the sector, and how qualified health actuaries can contribute to this health reform.