下边是甄选真题Course8M（二）：北美精算师考试SOA，这是考前珍贵北美精算师的官方资料，不得不珍惜对待。
　　E
　　Health, Group Life & Managed Care
　　Questions 4-7 pertain to the Case Study
 
　　4. (7 points) You are the actuary at Wonderful Life and have received a request for
　　proposal from JLB Company (JLB) for a multi-option health quote effective January 1,
　　2005. JLB currently offers only a $100 deductible indemnity plan.
　　Using data found in Tables MM-2a and MM-2b and the following additional information:
　　?? Total claims incurred for July 1, 2003 to June 30, 2004 were $4,063,000.
　　?? Claim amounts in excess of $50,000 were $278,000.
　　?? Average employee enrollment during this period was 500 single and 750 family
　　contracts.
　　?? Wonderful Life’s PPO network discount is 30%.
　　?? In-network utilization is 85%.
　　?? Use of the network reduces utilization by 5% as compared to indemnity.
　　(a) Discuss pricing considerations in a multi-option environment.
　　(b) Calculate 2-tier gross premium rates for a $100 deductible indemnity option, and
　　a $500 deductible PPO option, assuming no selection impact. Show your work.
　　(c) Outline considerations if JLB’s current plan was a managed care plan instead of
　　an indemnity plan.
　　COURSE 8: Fall 2005 -5- GO TO NEXT PAGE
　　Health, Group Life & Managed Care
　　Questions 4-7 pertain to the Case Study
 
　　5. (9 points) Wonderful Life’s management is *uating the company’s profit and surplus
　　requirements. You are given the data in Table C-1 and the assumption that Risk-Based
　　Capital (RBC) is 18% of premium.
　　(a) (1 point) Discuss methods of measuring profit.
　　(b) (2 points) Discuss distortions that may require adjustment to avoid
　　misrepresentation of profits.
　　(c) (3 points) Describe implications of the following when modeling required surplus
　　for Wonderful Life:
　　i. Reinsurance strategy
　　ii. Dividend philosophy
　　iii. Expense management controls
　　iv. Premium growth
　　(d) (3 points) Determine i
　　高顿网校之为人处世：失败也是我需要的，它和成功对我一样有价值。——爱迪生