高顿网校友情提醒，高顿网校小编为您精心编制的2014年7月*7【真题大放送】Course8G（2）——北美精算师考试SOA
　　6.(9points)YouarethegrouppricingactuaryforWonderfulLifeInsuranceCompany.
　　YouarepreparingaproposalforBaileyIndustrieswhichincludesananalysisofprior
　　experience.YouaregiventhedatainTableBI-1bandthefollowingassumptions:
　　?Theonlyitemscausingdifferencesinclaimscostsareplandesignandutilization
　　differencescausedbyplandesign.
　　?TheaveragememberspercontractforboththePPOandHMOplansis2.2.
　　?MemberCostasapercentageofclaimsisasfollows:
　　Utilization
　　AdjustmentRange
　　MemberCost
　　SharingRange
　　ServiceType%ofCostLowHighLowHigh
　　Facility50.0%0.0%5.0%0.0%25.0%
　　Professional30.0%-5.0%20.0%0.0%40.0%
　　Pharmacy20.0%0.0%20.0%0.0%25.0%
　　Total100.0%
　　AverageMemberCostSharing
　　ServiceTypePPOHMO
　　Facility17.5%0.0%
　　Professional25.0%5.0%
　　Pharmacy18.0%18.0%
　　(a)(3points)DescribethecriteriathatWonderfulLifewouldusetounderwrite
　　BaileyIndustries.
　　(b)(2points)Describethemodelsyoumightusetopredictselectioninamultioption
　　environment.
　　(c)(4points)CalculatetheexpectedchangeinutilizationfortheHMOplanusing
　　thememberutilizationcostmodel.Showyourwork.
　　COURSE8:Fall2005-7-GOTONEXTPAGE
　　Health,GroupLife&ManagedCare
　　Questions4-7pertaintotheCaseStudy
 
　　7.(7points)YouareanactuaryatWonderfulLifeandhavebeenaskedtodiscusssources
　　ofprofitusingGroup1dataasanexample.
　　InadditiontothedatainTablesMM-1,MM-2a,MM-2b,andMM-3a,assume:
　　?Single/Familymanualratesfor2005aretheresultoftrendinghistoricalmanualrates.
　　?Expenses,taxes,andinvestmentincomeareexpressedasthepercentagesfromTable
　　MM-1for2004.
　　(a)Discussmajorfactorsaffectingfinancialresultsforthegrouplineofbusiness.
　　(b)Outlinethevarioussourcesofprofitforgroupinsurance.
　　(c)CalculateprofitsbysourceforGroup1fortheexperienceperiod.Showyour
　　work.
　　COURSE8:Fall2005-8-GOTONEXTPAGE
　　Health,GroupLife&ManagedCare
 
　　8.(7points)YouaretheconsultingactuaryforACME,Inc.Theyareinterestedinoffering
　　aPatientDirectedHealthcareBenefit(PDHB)planwiththefollowingstructure:
　　Option1
　　?Multi-planoptionplusFlexibleSpendingAccount(FSA),
　　?Employerprovidescorecontribution,offersmultiplehealthplanchoices,
　　andsetsmenu.
　　Option2
　　?HighDeductiblePlanplusFSAplusPersonalHealthAccount(PHA),
　　?Employerprovidescorecontribution,accesstomultiplehighdeductible
　　plans,andsegregatedPHA’s.
　　(a)Describefactorsthataremakingconsumerismasignificanttrend.
　　(b)CompareandcontrastthekeydimensionsofPDHB’sastheyrelatetothetwo
　　optionsACMEisconsidering.
　　(c)DescribethehealthcarechallengesthatcanbeaddressedbyPDHB’swithrespect
　　to:
　　i.Employees
　　ii.Employers
　　COURSE8:Fall2005-9-GOTONEXTPAGE
　　Health,GroupLife&ManagedCare
 
　　9.(5points)YouarethepricingactuaryforEnamelInsuranceCompany(EIC).EICis
　　interestedinaddingadentalproducttoitsportfolioandhasaskedyoutoprepareareport
　　toseniormanagement.
　　(a)Describewaystocontroldentalclaimscosts.
　　(b)Describetheunderwritingandratingparametersusedfordentalinsurance.
　　COURSE8:Fall2005-10-GOTONEXTPAGE
　　HealthandGroupLifeSegment
 
　　10.(3points)YouaretheValuationActuaryforBeltandSuspendersHealthInsurance
　　Company.Yourcompanyoffersavarietyofhealthproductsthatmayrequireavarietyof
　　methodsfordeterminingclaimliabilities.
　　(a)Describeconsiderationswhichmightinfluencethelevelofconservatismtargeted
　　foragivenblockofbusiness.
　　(b)Describeapproachestointroducingconservatismintoeachofthecommon
　　methodsusedtocomputeclaimliabilities.
　　COURSE8:Fall2005-11-GOTONEXTPAGE
　　HealthandGroupLifeSegment
　　**BEGINNINGOFEXAMINATION**
　　HEALTHANDGROUPLIFESEGMENT
　　BeginningwithQuestion11
 
　　11.(4points)Regardingclaimspracticesforshorttermdisability(STD)coverages:
　　(a)DescribethetoolsavailabletochallengequestionableSTDclaims.
　　(b)Discussmethods,includingtheprosandconsformeasuringoverallSTDclaims
　　levels.
　　(c)DescribethesourcesofinformationavailabletoaclaimsexaminerregardingSTD
　　claims.
　　COURSE8:Fall2005-12-GOTONEXTPAGE
　　HealthandGroupLifeSegment
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