Description: Identifying and submitting all appropriate ICD-9 diagnosis codes to CMS will result in a higher risk score for the member and increased payments to Medicare Advantage plans. Milliman's HCC prevalence study illustrates the significant variations in HCC prevalence rates by age/gender, geography, and population type and will assist plans in benchmarking the effectiveness of their own diagnosis code capture efforts.

Description: A new health insurance pricing model takes external market prices into account, as well as regulatory rate restrictions and other traditional pricing factors. Rather than being assumed at the outset, lapse rates emerge from the model, along with assessment spiral & loss ratio projections. Under the model optimal pricing strategy depends on whether the class being rated has a healthier than average mix of risks.

Description: Using Healthcare Claims Data to Create Actuarial Models.

Description: Applying the new GDPR terms to Actuarial work, to secure private data in portfolios while using those for pricing and reserving modelling in all business lines.

Description: Possible usage of tools that can automate time consuming processes, and lead to a different team structure and organization for predictive analytics team.

Description: Medical management programs have traditionally addressed more acute and short-term issues with chronic disease. As LTC becomes an important product in the insurance industry, including disease management is likely to be valuable for reducing costs and prolonging the healthy, premium-paying portion of a claimant's life.

Description: This article summarizes some of the operational considerations necessary to optimize the usefulness and impact of a predictive model, such as cross-functional support and involvement in model build, adequate training and reporting, and strategic model build.

Description: A closer look at family tier factor rating assumptions, and how well they reflect actual claim cost data.

Description: SOA Product Development Section Contest Winning Article. Contest was to provide a creative article on future technology for the life insurance industry.