2005年真题Course8G北美精算师考试（最后一部分）高顿网校小编与您一起分享才精彩。
　　20. (3 points) You are an actuarial consultant hired by XYZ Corporation to help them
　　redesign their medical plan. XYZ Corporation is a manufacturing company that has
　　3,000 active employees and 500 retirees. All employees are located in a single
　　metropolitan area. The Human Resources (HR) manager at XYZ Corporation has told
　　you that she wants to redesign the medical plan options to encourage employee
　　responsibility and consumerism.
　　(a) Describe factors which would make a patient directed healthcare benefit approach
　　appropriate for XYZ.
　　(b) Outline next steps the HR manager could take to implement this type of plan.
　　COURSE 8: Fall 2005 - 21 - GO TO NEXT PAGE
　　Health and Group Life Segment
　　21. (5 points) You have been asked to review the impact of changing the specific deductible
　　for the aggregate stop loss arrangement of one of your client’s self-funded plans.
　　You are given the following information for the most recent plan year:
　　Stop Loss Information
　　Expected total losses (PEPM) $400
　　Expected Monthly Employees 240
　　Aggregate Attachment Factor 120% of expected total losses
　　Minimum Attachment Point 90% of the expected annual
　　attachment point
　　Actual Loss Information
　　Employee Months 3,000
　　Total Losses $1,635,000
　　Covered Losses Exceeding $100,000
　　Person A $300,000
　　Person B $125,000
　　Person C $250,000
　　You are considering two specific stop loss deductible scenarios:
　　i. $100,000 (current plan)
　　ii. $250,000 (alternative plan)
　　(a) Explain the process for setting the expected losses and aggregate attachment
　　factor.
　　(b) Describe aggregate stop loss underwriting considerations from the insurer’s point
　　of view.
　　(c) Calculate the total stop loss reimbursement for the most recent plan year under
　　each specific stop loss deductible scenario. Show your work.
　　COURSE 8: Fall 2005 -22- STOP
　　Health, Group Life & Managed Care
　　22. (4 points) You are the pricing actuary of ONLY Life Insurance Company. The company
　　is looking into entering the Individual DI market. The V.P. of Marketing has come to
　　you with the following proposed plan:
　　? Target Market Association of Physicians
　　? Underwriting Non-Cancelable
　　? Definition of
　　Disability
　　Pure Own Occupation
　　? Premium Rate
　　Structure
　　Unisex, varying by age
　　? Monthly Benefit Greater of: average monthly benefit over prior 12 months; or
　　greatest average monthly earnings for any 2 successive years
　　over the prior 5 years
　　? Inflation COLA riders included with a minimum annual increase of
　　6% per year
　　? Maximum Benefit Unlimited
　　? Elimination Period 1 month
　　(a) Discuss each element of the proposed plan design with respect to the company’s
　　exposure to risk and recommend changes to limit the company’s risk.
　　(b) Discuss various factors that should be considered to ensure profitability of the
　　product in today’s environment in terms of pricing, underwriting, and management.
　　高顿网校之名人心语：学习的敌人是自己的满足，要认真学习一点东西，必须从不自满开始。对自己，“学而不厌”，对人家，“诲人不倦”，我们应取这种态度。