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SOA北美精算师——经典真题November2004Course8IC（1）

来源：高顿网校 2014-07-21

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　　COURSE8:Fall2004-1-GOTONEXTPAGE

　　Health,GroupLife&ManagedCare

　　MorningSession

　　**BEGINNINGOFEXAMINATION**

　　HEALTH,GROUPLIFE&MANAGEDCARE

　　MORNINGSESSION

　　1.(4points)Youareanactuaryforareinsurancecompany.Abusinessschoolprofessorat

　　alocaluniversityhasinvitedyoutobeaguestlectureronthetopic,“Reinsurance

　　ProgramManagement.”

　　Outlineanddescribethecontentsofyourpresentation,withrespectto:

　　i.informationareinsurancecompanyshouldseekinordertodecidewhetherto

　　offerreinsurancetoacustomer

　　ii.practicesareinsurershouldfollowtomaintainaprofitablereinsuranceportfolio.

　　2.(5points)YouhavebeenaskedbyyourlocalChamberofCommercetospeakonthe

　　topicofpatient-directedhealthcarebenefitprograms(PDHBs).

　　(a)DescribekeyfeaturesoftheprincipaltypesofPDHBs.

　　(b)ContrastvariationsbetweentypesofPDHBswithrespectto:

　　i.extenttowhichconsumersperceivemoneyspentastheirownwhen

　　makinghealthcarecostandvaluejudgments,

　　ii.consumerflexibilityindirectingtheuseofemployer-providedand

　　personalhealthcarefunds,

　　iii.extentofemployerinvolvementinplandesignandadministration.

　　(c)IdentifypossiblechangesintheU.S.taxrulesthatcouldencouragetheuseof

　　PDHBs.

　　COURSE8:Fall2004-2-GOTONEXTPAGE

　　Health,GroupLife&ManagedCare

　　MorningSession

　　Questions3–6pertaintotheCaseStudy

　　3.(8points)YouarethepricingactuaryforWonderfulLifeandhavebeenaskedbythe

　　underwriterassignedtoGroup6tohelpherprepareforameetingwiththegroup’sCFO.

　　InadditiontoTablesMM-2bandMM-3b,youhavebeengiventhefollowing

　　information:

　　PriorRatingPeriodData:ExperienceperiodJuly1,2001throughJune30,2002

　　Group6CompositeAge/SexFactor

　　Option11.03

　　Option20.85

　　(a)Describemacro-economicvariablesthatmayaffecthealthcaretrendrates.

　　(b)Describeothertrendcomponentsthatmaycausetrendstovary.

　　(c)Discusstherelationshipofhistoricaltrendsandratingtrendassumptions.

　　(d)CalculatethetotalpercentageincreaseinGroup6’sclaimscostperemployeeand

　　calculatecomponentsoftheirclaimstrendforwhichsufficientdataareavailable.

　　COURSE8:Fall2004-3-GOTONEXTPAGE

　　Health,GroupLife&ManagedCare

　　MorningSession

　　Questions3–6pertaintotheCaseStudy

　　4.(6points)YouareanunderwriterforWonderfulLifepreparingaproposalforBailey

　　Industriestoreplacetheircurrentdentalplanwithamanageddentalcareplan.

　　BaileyIndustriesgoalsareasfollows:

　　? limitcomplexity

　　? avoidadverseselection

　　? avoidemployeedissatisfactionduetoproviderdisruption

　　? maintaincurrentemployercontributionsandplandesign

　　(a)Describethefeaturesforeachofthegeneraltypesofdentalbenefitdelivery

　　systems.

　　(b)Developachartrankingtheplantypesalongthefollowingparameters:premium,

　　patientaccess,benefitrichness,costmanagement,utilization,qualityassurance,

　　andfraudpotential.

　　(c)EvaluatethepossibledeliverysystemsbasedonBaileyIndustriesgoalsandmake

　　arecommendationastoadeliverysystem.Justifyyourresponse.

　　COURSE8:Fall2004-4-GOTONEXTPAGE

　　Health,GroupLife&ManagedCare

　　MorningSession

　　Questions3–6pertaintotheCaseStudy

　　5.(9points)YouareanunderwriterwithWonderfulLifepreparingtherenewalfor

　　Group4.

　　AssumethattheretrospectiveformulabalanceinTableMM-3aisasoftheendofthe

　　experienceperiodandthatpricingfactorsasshowninTableMM-2aandMM-2bhave

　　notchanged.

　　(a)CalculateGroup4’sprojectedretrospectiveformulabalanceasofDecember31,

　　2003usingthesameassumptionsaswouldbeusedforrating.Showyourwork.

　　(b)CalculatetheEEonlyandEEandDependentsmonthlyrenewalpremiumsfor

　　2004.Showyourwork.

　　(c)Discusstheprosandconsofvariousfundingarrangements,bothfroman

　　employer’spointofviewandspecificallyforGroup4,

　　i.prospectiveexperiencerating,

　　ii.retrospectiveexperiencerating,

　　iii.self-insurance,and

　　iv.minimumpremiumplans.

　　6.(5points)YouareevaluatingWonderfulLife’sreservesusingNon-Hospitalclaimspaid

　　inTablesMM-4candMM-4d.AssumethattheJuly2002completionpatternis

　　representativeofallmonths.

　　(a)CalculatetheincurredclaimsforincurredmonthsJuly2003throughDecember

　　2003usingage-ultimatedevelopmentfactors.Showyourwork.

　　(b)CalculatetheIBNRasofDecember31,2003forincurredmonthsJuly2003

　　throughDecember2003.Showyourwork.

　　(c)RecommendadjustmentstothisapproachwhichmightproducereasonableIBNR

　　results.

　　COURSE8:Fall2004-5-GOTONEXTPAGE

　　Health,GroupLife&ManagedCare

　　MorningSession

　　7.(7points)Youarethehealthactuaryreviewingthepricingassumptionsandthefirst

　　threeyearsofexperienceforagivenproduct.Thefollowinginformationisgiven:

　　ClassicalPricingAssumptions

　　ProductDuration:5Years

　　interestrates:0.0%

　　annuallapserate:20.0%

　　targetlossratio:60.0%

　　tabularclaimscost

　　DurationTabularClaimsCostSelectionAdjustment

　　010.0.05

　　111.01.1

　　212.01.1

　　313.01.1

　　414.01.1

　　ExperienceData

　　DurationMbrsActualClaims

　　01,0006,000

　　177010,000

　　265011,000

　　3500-

　　4350-

　　CumulativeAntiselectionTheoryAssumptions

　　K1=-

　　K2=4

　　u0.10

　　(a)(1point)DescribehowCASTdiffersfromclassical(selectandultimate)theory.

　　(b)(2points)Calculatethegrosspremiumusingtheclassicalpricingassumptions.

　　Showyourwork

　　(c)(4points)CalculatethegrosspremiumusingCASTassumptions.Showyour

　　work.

　　COURSE8:Fall2004-6-GOTONEXTPAGE

　　Health,GroupLife&ManagedCare

　　MorningSession
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