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SOA往年北美精算师真题课程—November2002Course8M（三）

来源：高顿网校 2014-08-27

　　赶紧鼠标点击进来学习，请重视起来我们的文章——SOA往年北美精算师真题课程—November2002Course8M（三）。
　　8. (10 points) You are an underwriter at Wonderful Life and have been given the following

　　information:

　　? Tables BI with the following assumptions:

　　? The experience shown is for July 1, 2000 to June 30, 2001

　　? Amount of claims greater than $50,000 totals $540,000

　　? Tables MM-2

　　? Table MM-3a

　　(a) (3 points) Calculate the retrospective refunds for Group 4 and for Group 5. Show

　　your work.

　　(b) (5 points) Wonderful Life is quoting its most popular $250 deductible plan to

　　Bailey Industries for a March 1, 2002 effective date. Assume the quote will cover

　　existing PPO employees with a fully insured plan and that quoted benefits are the

　　same as their current plan. Calculate the composite, employee only, and

　　employee plus dependent rates. Show your work.

　　(c) (2 points) Explain considerations in using past experience data for projecting

　　future experience.

　　COURSE 8: Fall 2002 -8- STOP

　　Managed Care Segment

　　Morning Session

　　9. (3 points) Your consulting firm is hosting a roundtable breakfast for business leaders.

　　The topic of your presentation is “Recent Managed Care Trends Affecting Employers.”

　　Most attendees will be large, local employers.

　　(a) Describe general considerations related to this topic affecting all employers.

　　(b) Describe other relevant factors specific to the size of the employer.

　　**END OF EXAMINATION**

　　MORNING SESSION

　　COURSE 8: Fall 2002 -9- GO ON TO NEXT PAGE

　　Managed Care Segment

　　Afternoon Session

　　**BEGINNING OF EXAMINATION 8**

　　MANAGED CARE SEGMENT

　　AFTERNOON SESSION

　　Beginning With Question 10

　　10. (4 points) Senator Ima Crook from Anystate, USA has proposed a bill requiring

　　Medicare to provide a prescription drug benefit.

　　This plan would be separate from medical benefits and would be the primary plan for

　　purposes of coordination of benefits.

　　The plan would offer the following benefits:

　　? 90% of generic drugs after a $50 annual deductible.

　　? 80% of brand drugs after a $100 annual deductible.

　　? Unlimited annual benefit.

　　ACME Widget Company currently pays the entire cost of a retiree prescription drug plan

　　with the following copayments per prescription:

　　? $10 on generic drugs

　　? $20 on brand drugs

　　Jill Pill is a retiree of ACME anticipating the following monthly drug usage:

　　Number of

　　Prescriptions

　　Average

　　Cost/Prescription

　　Generic 5 $20

　　Brand 5 $100

　　If this bill is adopted:

　　(a) Describe the different coordination of benefit (COB) approaches an employer

　　could consider in relation to the new plan.

　　(b) For each COB approach, calculate the total annual cost to ACME in connection

　　with Jill’s anticipated claims.

　　COURSE 8: Fall 2002 -10- GO ON TO NEXT PAGE

　　Managed Care Segment

　　Afternoon Session

　　11. (3 points) You are the individual health insurance actuary for XYZ Insurance company.

　　(a) Describe the type of expense allocations that could be used for individual

　　health products.

　　(b) Describe expenses that are typically taken into account in the pricing process

　　and how they are reflected.

　　(c) Explain the criteria that the expense allocation method must meet.

　　12. (5 points) Using the US and Canadian tax treatment as examples, discuss the impact of

　　taxation of premiums and benefits received on the design of employer-provided insurance

　　programs. Include examples for Life, Disability, Medical, and Long-Term Care and

　　discuss from both the employee and employer perspective.

　　COURSE 8: Fall 2002 -11- GO ON TO NEXT PAGE

　　Managed Care Segment

　　Afternoon Session
　　再长的路，一步步也能走完，再短的路，不迈开双脚也无法到达。——高顿网校名人话语

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