高顿项目

国内财会

国际财会

金融证书

公务员

考研

考研

继续教育

继续教育

在职硕博

学历学位

国企求职

军队文职

军队文职

职业提升

语言培训

出国留学

海外留学

SOA历届（2001.11）真题Course8I（第二节课）

来源：高顿网校 2014-08-22

　　SOA历届（2001.11）真题Course8I（第二节课）看完就知道了，希望真的可以帮到北美精算师的考友们。
　　7. (4 points) As a consulting actuary, you have been hired by a managed care organization

　　to measure its medical effectiveness.

　　(a) Describe the challenges of using data to produce management information and

　　how they relate to Actuarial Standards of Practice.

　　(b) Describe your considerations for evaluating health plan performance

　　measurement criteria with regard to:

　　(i) data sources; and

　　(ii) measurement process.

　　8. (7 points) ABC Life insurance company plans to enter the long term care market. You

　　have been asked to develop pricing for a new long term care product.

　　(a) Identify general sources of data available to actuaries when pricing any new

　　product line and explain the cautions which should be taken in using them.

　　(b) Describe assumptions necessary to price the long term care product, and how the

　　Actuarial Standards of Practice will influence your development of those

　　assumptions.

　　(c) When developing financial reporting related to the long term care product,

　　(i) Describe the various financial statement liabilities you need to consider;

　　and

　　(ii) Describe the methods that maybe used to estimate each.

　　COURSE 8: November 2001 -7- STOP

　　Health and Managed Care

　　Morning Session

　　9. (4 points) You have been asked to draft a report which details the various ways that

　　profit and growth may be measured at your company.

　　(a) Discuss methods of measuring growth.

　　(b) Discuss methods of measuring profit.

　　(c) Calculate the pre-tax underwriting gain required to achieve an 18% Return on

　　Equity given the following assumptions:

　　? capital + surplus = 20% of premiums

　　? reserves + capital + surplus = 30% of premium

　　? investments earn 5% after tax

　　? your company is in the 37% tax bracket

　　Show your work.

　　**END OF EXAMINATION**

　　MORNING SESSION

　　COURSE 8: November 2001 -8- GO ON TO NEXT PAGE

　　Managed Care

　　Afternoon Session

　　**BEGINNING OF EXAMINATION **

　　AFTERNOON SESSION

　　Beginning With Question 10

　　10. (3 points) You have been asked to review claims operations at a health insurance carrier.

　　(a) Describe basic information requirements necessary for the proper handling of

　　health claims.

　　(b) Describe the health claim adjudication process.

　　11. (6 points) You are the consulting actuary for Smith Corporation. Due to increasing

　　claims costs, your client wants to review the current noncontributory dental program

　　offered to its employees which includes:

　　Benefits

　　Deductible $25 individual /$50 family

　　Coinsurance

　　? preventive 100%

　　? basic 100%

　　? major 80%

　　? orthodontics 60%

　　The Corporation is thinking of incorporating dental coverage into a flexible benefits

　　program currently under development.

　　(a) Outline design changes for the current free-standing dental plan that can be used

　　to reduce costs and explain how the changes would apply to the current plan.

　　(b) Describe cost and anti-selection issues in the design of a flexible benefits

　　program, including design features that could be used to alleviate these issues if

　　dental is included in the flexible benefit program.

　　COURSE 8: November 2001 -9- GO ON TO NEXT PAGE

　　Managed Care

　　Afternoon Session

　　12. (6 points) You are an actuary for a large reinsurer. You have been asked to provide

　　Company ABC with a reinsurance quote. Company ABC is a medium size disability

　　company which has recently developed a new LTC product and recently acquired a group

　　major medical block of business. In recent years, Company ABC has been unable to

　　achieve its corporate profit objectives.

　　(a) Identify the reinsurer’s underwriting considerations in evaluating whether to offer

　　a reinsurance program to Company ABC.

　　(b) Describe the sources of risk inherent in each of Company ABC’s product lines.

　　(c) Design a reinsurance program for Company ABC that will address the sources of

　　risk for each of Company ABC’s product lines. Justify each recommendation.

　　13. (5 points) You are the group benefit consultant for a U.S. company that offers different

　　managed care plans to its employees. Over the last few years, the employer has noticed

　　that costs have increased rapidly and that employee dissatisfaction is growing. You have

　　to prepare a report to explain a substantial increase in premium rates.

　　(a) Describe the major drivers of consumerism in the health care industry.

　　(b) Describe other current managed care trends and indicate which of these might

　　contribute to the cost increase.

　　(c) Describe approaches the employer could use to mitigate this rate increase.

　　COURSE 8: November 2001 -10- GO ON TO NEXT PAGE

　　Managed Care

　　Afternoon Session

　　Questions 14 through 16 pertain to the Case Study

　　14. (11 points) It is currently late in the year 2000. As The Bedford Group’s pricing actuary,

　　you must prepare manual rates for 2001. In addition to data from Table MC – 6, you

　　have decided to use the following assumptions:

　　? Calendar year 2000 will be used as the experience period

　　? Anticipated increase in average charge per service from 2000 to 2001

　　Hospital Services = 10%

　　Physician Services = 5%

　　All Other Services = 15%

　　? Administrative Costs will increase by 4%

　　? Adjustments for risk sharing, bonus, and withhold arrangements will not

　　affect the currently reported results

　　? Average charges per service are the same for the HMO and POS products

　　? Utilization changes occur uniformly for both the HMO and POS

　　(a) Using the information provided:

　　(i) (3 points) Calculate the expected PMPM hospital inpatient costs for the

　　HMO and POS plans separately for 2001. Show your work.

　　(ii) (1 point) Determine the required total premium PMPM assuming the total

　　projected claims costs for 2001 are $170.00 and $185.00 PMPM for the

　　HMO and POS products respectively. Show your work.

　　(b) (4 points) The head of the Marketing Department has to present a quote effective

　　January 1, 2001 for the HMO product to a prospect, Bailey Industries. He has

　　indicated three-tier premium rates are required.

　　Current Rate Information for Bailey Industries

　　Tier Number of

　　Contracts

　　No. of Persons

　　per Contract

　　HMO Ratio to

　　Single

　　POS Ratio to

　　Single

　　Single 35% 1.0 1.0 1.0

　　Two Party 15% 2.0 1.9 1.7

　　Family 50% 3.8 3.5 4.2

　　COURSE 8: November 2001 -11- GO ON TO NEXT PAGE

　　Managed Care

　　Afternoon Session
　　做了好事受到指责而仍坚持下去，这才是奋斗者的本色。——高顿网校名人感触

扫一扫微信，关注精算师*7考试动态

版权声明：本条内容自发布之日起，有效期为一个月。凡本网站注明“来源高顿教育”或“来源高顿网校”或“来源高顿”的所有作品，均为本网站合法拥有版权的作品，未经本网站授权，任何媒体、网站、个人不得转载、链接、转帖或以其他方式使用。经本网站合法授权的，应在授权范围内使用，且使用时必须注明“来源高顿教育”或“来源高顿网校”或“来源高顿”，并不得对作品中出现的“高顿”字样进行删减、替换等。违反上述声明者，本网站将依法追究其法律责任。本网站的部分资料转载自互联网，均尽力标明作者和出处。本网站转载的目的在于传递更多信息，并不意味着赞同其观点或证实其描述，本网站不对其真实性负责。如您认为本网站刊载作品涉及版权等问题，请与本网站联系(邮箱fawu@gaodun.com，电话：021-31587497)，本网站核实确认后会尽快予以处理。

展开全文咨询在线

严选名师全流程服务

其他人还搜了热门推荐