Health Econ Module discussion

[goldenclouds]

I am working on Health Econ module. who else are on this module?

[dyl06]

Me too.

Do you have an idea on a suitable length of the memo? I am pertaining to Part 1.

I feel it would take at least 3-4 pages to answer all the points.

[goldenclouds]

I agree. Each point takes about one page with tables included.

For project1, how do you allocate employee payroll contributions?

I think I should consider the salary factors.

Is it allowed to adjust contribution based on age/gender factors?  I remember gender is not allowed in some insurance pricing, but age and area factors are.

This is a self insured plan, not considered as insurance, so I think I can adjust for age/gender in EE contribution, right?

 

[dyl06]

I think sticking to the existing monthly employee contributions format may be more appropriate.

[ccd26]

How are you using the age/gender factors? If you apply the manual rate adjustment to the experience by area, aren’t you already accounting for the differences in age and gender?

[actuary2022]

Hi All,

 

Anyone is working in the module?

 

Thanks,

[ccd26]

I am!

[actuary2022]

I have started it today.

What I am doing is that I started with current plan designs; I explained some of the key issues in the design.

We are given some of the manual rates; the current plan is PPO1 ( based on the cost sharing) and EPO1. The experience under PPO is 701 but under the EPO is lower than manual rate.

 

[ccd26]

Here is a good place to read other’s idea’s and chat about your ideas: https://groups.google.com/g/health-economics-module

[actuary2022]

thanks a lot .. It was helpful…

 

just want to check project 2 Task 1… How much you got under Cap and FFS PMPM? Because it is below incurred claim  400 PMPM? In the group they compared PMPY under cap with trended PMPM to find PMPM break even

[ccd26]

My answer was consistent with what I was seeing in the group. $21.48 for FFS and $20.41 Cap.

Feel free to add questions to the group on what specific posts you have questions about.

[ccd26]

Submitted module 5/16

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