Risk Management
Task Force

Health Risk Management Subgroup

 

 

Credit Risk Management | Economic Capital Calculation and Allocation
Enterprise Risk Management | Equity Modeling | Extreme Value Models
Health Risk Management | Policyholder Behavior in the Tail
Pricing for Risk | Risk Based Capital Covariance | Risk Management Metrics


Health Risk Management
John Stark, Leader

Goals

  • to research risk management in health insurance companies
  • to document risk definitions and risk management techniques appropriate for health insurance companies

Initial Product and Process

Introduction
Research needs to be completed in the area of risk management for health insurance companies, which includes HMOs, PPOs, indemnity carriers, reinsurers, etc. The issues are identical to those for life insurance companies plus others peculiar to the health business such as provider network development and maintenance. The areas of common ground differ in degree; e.g., investment risk is much more critical to life insurers than to most health insurers, while state mandates have a larger effect on health carriers. This subgroup will coordinate with the others as well as identify issues unique to the health insurance business.

Process

  • Identify risks associated with the health insurance business
    • Societal trends are often a major factor in actual claim experience and deviating widely from actuarial projections. An insurer that recognizes and prices for such trends, when its competitors do not, runs the risk of being priced out of the market.
  • Identify areas that assess/control risk such as actuarial, underwriting, and medical management.
  • Consider the role of a Chief Risk Officer in a health insurance company.
  • Determine what risk assessment tools identified and developed for life insurers may carry over to health companies and what additional tools would be helpful.
  • Determine what timeframes should be used to measure economic capital for health insurance businesses.
  • Determine ways a health insurance business could price for risk.

Products

  • Specialty Guide for Health Risk Management
  • Develop and evaluate models to assess and manage risk

Subgroup Teams
Speciality Guide
Solvency Issues
Modeling

Documents & Links

Preliminary work products:
List of Possible Topics
Mapping of Health Company Risks

Recent Meeting Minutes:
Leaders Grouplet Minutes - August 9, 2004

Specialty Guide Minutes – June 30, 2003
Specialty Guide Minutes
– May 14, 2003

Specialty Guide Minutes
– April 30, 2003

Solvency Grouplet Minutes – April 5, 2004
Solvency Grouplet Minutes – October 2, 2003
Solvency Grouplet Minutes – June 13, 2003

Links to HRM related sites:
(coming soon)

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