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2005年真题Course8G北美精算师考试（最后一部分）

来源：高顿网校 2014-08-05

　　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.

　　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。

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