以下则是精算师北美考区往年真题November2002Course8G（最后一个章节），知识要点很多。
　　18. (7 points) You have been hired as the consulting actuary for Company XYZ. Company
　　XYZ implemented a flexible benefits plan four years ago, including broader choices for
　　group life, LTD, medical, and dental benefits. Employees re-enroll for all benefits once a
　　year. The life and LTD benefits each have one rate applicable to all employees, whereas
　　the medical and dental benefits have different prices by option and family status.
　　Company XYZ has observed higher than expected claims experience each year, and has
　　noticed significant employee movement amongst the options from one year to the next.
　　You are given the following data for the most recent year.
　　Option Dental
　　Enrollment
　　Actuarial
　　Value
　　Price Tag Actual
　　Claims
　　High 100 $1000 $1300 $150,000
　　Intermediate 250 $800 $900 $220,000
　　Low 150 $500 $400 $45,000
　　Total 500 $415,000
　　(a) (2 points) Describe design approaches that could be used to reduce the chance of
　　unfavorable experience.
　　(b) (1 point) Explain the advantages and disadvantages of maintaining a single rate
　　for the life and LTD benefits.
　　(c) (3 points) Assuming no change in the dental coverage offered and a 5% trend rate
　　for the coming year:
　　(i) Propose potential pricing strategies, and
　　(ii) Calculate the resulting prices for the upcoming year.
　　(d) (1 point) Describe methods that XYZ may use to better estimate employee
　　participation for next year.
　　COURSE 8: Fall 2002 -16- GO ON TO NEXT PAGE
　　Health and Group Life Segment
　　Afternoon Session
 
　　19. (4 points) Your Uncle Henry is shopping for an LTC policy for himself and his spouse.
　　Henry works for a large employer that offers group LTC coverage as part of its employee
　　benefit package.
　　(a) Compare and contrast the benefit features and underwriting requirements between
　　individual and group LTC coverages.
　　(b) Describe various ways that insurers determine eligibility for LTC benefit
　　payments.
　　(c) Explain differences in continuity of coverage provisions between group and
　　individual LTC policies.
 
　　20. (5 points) The Worksite Marketing area of your company is exploring the idea of
　　offering a range of supplemental accident and health (A&H) products to associations of
　　professionals. The proposal is to distribute the following A&H products through direct
　　marketing methods:
　　?  Cancer
　　?  Hospital Indemnity Plan (HIP)
　　?  Disability Income
　　?  Critical Illness
　　(a) Describe underwriting guidelines and direct marketing approaches appropriate to
　　this target market.
　　(b) For each of the proposed products:
　　(i) Describe common product features
　　(ii) Evaluate their appropriateness for the direct marketing initiative. Support
　　your *uation.
　　COURSE 8: Fall 2002 -17- STOP
　　Health, Group Life & Managed Care
　　Afternoon Session
 
　　21. (3 points) You are a consulting actuary working in the Medicare supplement market.
　　You have been asked by a state regulator to provide insight into Medicare supplement
　　pricing. The state regulation allows only the NAIC model benefits, no underwriting, and
　　insurers can only use community rating. Pre-existing conditions may be excluded for up
　　to 6 months.
　　The following is an example of some of the monthly premium rates in one of the
　　major markets in the state.
　　Model Model
　　Plan B Plan H
　　Insurer A $109.86 174.82
　　Insurer B $114.75 205.25
　　HMO A $118.72 173.84
　　Medicare Select Product $84.80 Not offered
　　Explain what would cause different insurers to charge materially different rates for the
　　above products.
 
　　22. (4 points) Company ABC is planning to implement a flexible benefits plan. The draft
　　plan design includes life, LTD, medical and dental benefits, as well as a health care
　　expense account. The medical and dental benefits include a core level of coverage plus
　　two options, where the first option represents current coverage, and the second option
　　provides enhanced benefits.
　　The current plan includes realistic prices for all benefits. Some of company
　　ABC’s competitors who offer a flexible benefits program include “time off with
　　pay”.
　　(a) Describe alternative pricing schemes for the proposed flexible benefits plan,
　　including advantages and disadvantages of each.
　　(b) Describe the advantages of including time off with pay within the flexible benefit
　　plan and outline the plan design considerations.
　　学习外语并不难，学习外语就像交朋友一样，朋友是越交越熟的，天天见面，朋友之间就亲密无间了。——高顿网校做人原则

 

 
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