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Passacaglia
10-22-2009, 08:56 PM
Looks like the solution is not included in the SOA set. Does anyone want to share how they did it here?

monkey2003
10-22-2009, 11:33 PM
i was wondering the same thing today when i was looking at this problem.. I also have absolutely no clue how to calculate this.. hah...

mykem
10-23-2009, 10:42 AM
that really annoyed me after i spent 20 minutes calculating it out.

MATE Seminars
10-23-2009, 10:55 AM
I've never tried posting an attachment on this board before, so hopefully this works. This is the way I solved this problem (see attached).

Passacaglia
10-23-2009, 11:24 AM
The attachment worked -- only problem is that the answer doesn't match mine! I'll have to check it out when I get home.

erosewater
10-23-2009, 10:47 PM
I remember spending a really long time on this one last time, and punching tons of numbers into the calculator. Looking at Mark's solution I clearly did not do it very efficiently. Got a 10 on the question, but wasted valuable time.

Passacaglia
10-24-2009, 08:04 AM
I made some mistakes, then kept having to redo it as I realized other stuff. In the end, I still managed to do the 4-point math part in roughly 12 minutes, so the pace was good. I did it pretty much the same way as the attachment, but I forgot to divide by the coinsurance in the beginning, and to divide by 12 at the end. That's probably still good for 3 of the 4 points, right? :)

LouWorm
10-28-2009, 11:04 AM
I solved this differently and, as a result, got a slightly higher answer. I wonder what folks think about it.

The big difference is that I assumed that the 80% that chose PPO would all be among the low-cost category. I made this decision based largely on the highly anti-selective nature of dental benefits, in addition to the fact that it is, after all, the conservative assumption. Incidentally, I think I do a little less math this way.

I end up with 54.42 PMPM.

Anyone think this approach is indefensible?

LouWorm
10-28-2009, 11:12 AM
Oh, and I didn't say:

Thanks so much, Mark, for posting your solution.

sideout1212
10-28-2009, 11:17 AM
I solved this differently and, as a result, got a slightly higher answer. I wonder what folks think about it.

The big difference is that I assumed that the 80% that chose PPO would all be among the low-cost category. I made this decision based largely on the highly anti-selective nature of dental benefits, in addition to the fact that it is, after all, the conservative assumption. Incidentally, I think I do a little less math this way.

I end up with 54.42 PMPM.

Anyone think this approach is indefensible?

It says that the PPO utilization is 20% less in the PPO for Basic/Major so it sounds to me like your assumption is in conflict with this statement.

sideout1212
10-28-2009, 11:20 AM
How many points do you think I would get if I followed the exact same steps as Mark's attached solution but made 2 mistakes. I used a 1,000 max instead of 1,500 on the FFS option by accident and I also applied the 20% PPO utilization to preventative services after trying to do this too quickly. 3 of 4? I forget, are there fractions of points?

sideout1212
10-28-2009, 11:23 AM
It says that the PPO utilization is 20% less in the PPO for Basic/Major so it sounds to me like your assumption is in conflict with this statement.

Actually, now that I read it again (3 times actually) I could see defending what you did. I assume a grader would not see it that way though. Interpreting the wording on these problems is as big as knowing the material in my opinion and that is just stupid.

PSU2002
10-28-2009, 04:06 PM
I think this question gave everyone headaches. I also think that it may have been ignored or that so few people did it properly that having the full answers for parts a and b may have been enough for full credit on the question. I remember having a hard time trying to handle the overall deductibles. Applying it proportionately technically isn't correct, though it is probably the best you can do with the given information.

i see it was an overall maximum not an overall deductible. I don't know what my issue was...

Passacaglia
10-28-2009, 05:32 PM
Just did this one again -- probably not fair since I just did it 6 days ago. I accounted for the mistake where I forgot to divide the coinsurance at the beginning, but I still forgot to divide by 12 at the end, and this time I applied the 80% decrease in utilization to all classes, not just 2 and 3. I always screw up some mundane detail!

Passacaglia
10-28-2009, 05:34 PM
that having the full answers for parts a and b may have been enough for full credit on the question.

You think so? The question pretty clearly states that a and b were two points each, and c was four points. I can't imagine them labeling each part like this but still grading it like that.

sideout1212
10-28-2009, 07:26 PM
I think this question gave everyone headaches. I also think that it may have been ignored or that so few people did it properly that having the full answers for parts a and b may have been enough for full credit on the question. I remember having a hard time trying to handle the overall deductibles. Applying it proportionately technically isn't correct, though it is probably the best you can do with the given information.

i see it was an overall maximum not an overall deductible. I don't know what my issue was...

What overall deductible? The only deductible was the one on Basic services so there was no need to decide which services were likely to occur first. I have had that issue on models in real life but it wasn't one on this problem. The hardest part of this one is that it was alot of calcs and there were alot of places to make mistakes so going fast and getting it right was unlikely.

MATE Seminars
10-28-2009, 08:06 PM
Passacaglia, you are correct. If they state separate point values for separate parts of the question, then those parts are graded separately. So there is no opportunity to get spillover points from parts a and b on this one.

Sideout1212, on a complicated question like this one, missing a couple of the smaller details should not have a noticeable impact on your score. You do not have to get all possible grading points to get a 10 on a question. So it is quite possible that you would have still received a 10 in the scenario you outlined.

Mark Bird

Boargius
10-22-2010, 10:22 PM
Bump.

moniccazz
10-23-2010, 10:37 AM
Excellent!! Thanks I need to start searching harder!!

DoctorNo
10-23-2010, 07:31 PM
Thank you, Mark, for posting your solution - I was able to see two mistakes which I made (applying the deductibles to all classes, and applying the utilization decrease to all classes).

Without your solution, I wouldn't have noticed.

MATE Seminars
10-25-2010, 08:36 PM
You're welcome. Let me know how else I can help.