This text is a comprehensive treatment of all aspects of group insurance in the United
States and Canada, both life and health, with emphasis on the actuarial aspects of this
important field of insurance.
Table of Contents
Preface
Section One. Introduction
Chapter 1. The Group Insurance Marketplace
Chapter 2. Overview of Sales and Marketing
Chapter 3. Health Care Policy and Group Insurance
Section Two. Group Coverages, Benefits, and Plan Provisions
Chapter 4. Group Life Insurance Benefits
Chapter 5. Group Disability Income Benefits
Chapter 6. Medical Beneflts in the United States
Chapter 7. Health Benefits in Canada
Chapter 8. Dental Benefits in the United States
Chapter 9. Prescription Drug Benefits in the United States
Chapter 10. Group Long-Term Care Insurance
Chapter 11. Miscellaneous Benefits
Chapter 12. Government Old-Age, Survivors, and Disability Plans in the United States
Chapter 13. Government Health Care Plans in the United States
Section Three. Overview of Legal and Regulatory Environment
Chapter 14. Principles of Health Insurance Regulation
Chapter 15. Regulation in the United States
Chapter 16. Regulation in Canada
Section Four. Actuarial Practice in a Regulated Environment
Chapter 17. Group Insurance Financial Reporting: U.S.
Chapter 18. Group Insurance Financial Reporting: Canada
Chapter 19. Risk-Based Capital Formulas
Chapter 20. Actuarial Certification of Reserves
Chapter 21. Small Group Rate Filings and Rate Certifications
Chapter 22. Filings and Certifications for Medicare-Related Group Coverages
Chapter 23. Information Management
Chapter 24. Underwriting Large Groups
Chapter 25. Underwriting Small Groups
Chapter 26. Managing Selection in a Multiple-Choice Environment
Chapter 27. Claim Administration and Management
Section Six. Funding and Rating
Chapter 28. Health Risk Adjustment
Chapter 29. Estimating Claim Costs for Life Benefits
Chapter 30. Estimating Medical Claim Costs
Chapter 31. Estimating Claim Costs for Disability Benefits
Chapter 32. Estimating Dental Claim Costs Leigh
Chapter 33. Pricing Group Long-Term Care Insurance
Chapter 34. Calculating Gross Premiums
Chapter 35. Experience Rating and Funding Methods
Section Seven. Actuarial Models
Chapter 36. Medical Claim Cost Trend Analysis
Chapter 37. Forecasting
Chapter 38. Applied Statistics
Chapter 39. Data Sources and Structures
Chapter 40. Short-Term Reserves
Chapter 41. Claim Reserves for Long-Term Benefits
Chapter 42. Underwriting Gain and Loss Cycles John
Section Eight. Management
Chapter 43. Analysis of Financial and Operational Performance
Chapter 44. Product Development
Chapter 45. Planning and Control
Chapter 46. Management of Provider Networks
Chapter 47. Medical Care Management
1056 pages, hardcover
