MEDICAL INSURANCE CLAIMS - Society of Actuaries

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TRANSACTIONS OF SOCIETY OF ACTUARIES 1991-92 REPORTS VARIATION BY DURATION IN SMALL GROUP MEDICAL INSURANCE CLAIMS STEPHEND.BRINK,JAMES C.MODAFF,AND STEVENJ.SHERMAN I. OVERVIEW The purpose of this researchreport is to measurethe variation in small group medical insuranceclaim costs by duration from issue. For purposes of this study, a small group is defined as a group with 1 to 25 employees. This report also examines the durationalvariation by underwriting approach, size of group and preexisting-conditionlimitation. This study was based on more than $1.2 billion of small group medical claims incurred during 1988 and 1989. Data were provided by seveninsur- ance carriers active in the small group market, who generously contributed to this study. All claims were adjustedto remove any companydifferences due to benefits, geographic area, time period, and demographics. The resultsindicate that small group medical claim costs vary significantly by duration from issue as a result of underwriting and preexisting-condition limitations. In general, claim costs are relatively low in the first year of issue and rise rapidly during the next three to five years, after which the effect tends to wear off. Significant variation also occurs by group size. In addition to measurement of the variation by duration, the data allowed a comparison of adjustedclaim costsby underwriting approach, group size, andpreexisting-condition limitation. While the differencebetween long-form and short-form underwriting was inconclusive, guarantee-issue claim costs were significantly higher than those for underwritten business. By size, claim costs tended to exhibit a U-shapedpattern with the highest claim costs ex- periencedby the smallestand largest of groups. Groups without a preexist- ing-condition limitation experiencedmuch higher claim costs at the later durations. The remainderof this report summarizes the study methodology and re- sults in greaterdetail. A disk containing the resultsof this study is available. II. METHODOLOGY A. Participating Companies Twenty-two major insurancecompanies active in the small group market were initially contactedby telephoneto determine their interest in contrib- uting data for this researchproject. Of these, 17 companiesindicated an 333

Transcript of MEDICAL INSURANCE CLAIMS - Society of Actuaries

Page 1: MEDICAL INSURANCE CLAIMS - Society of Actuaries

TRANSACTIONS OF SOCIETY OF ACTUARIES 1991-92 REPORTS

VARIATION BY DURATION IN SMALL GROUP MEDICAL INSURANCE CLAIMS

STEPHEND.BRINK,JAMES C.MODAFF,AND STEVENJ.SHERMAN

I. OVERVIEW

The purpose of this research report is to measure the variation in small group medical insurance claim costs by duration from issue. For purposes of this study, a small group is defined as a group with 1 to 25 employees. This report also examines the durational variation by underwriting approach, size of group and preexisting-condition limitation.

This study was based on more than $1.2 billion of small group medical claims incurred during 1988 and 1989. Data were provided by seven insur- ance carriers active in the small group market, who generously contributed to this study. All claims were adjusted to remove any company differences due to benefits, geographic area, time period, and demographics.

The results indicate that small group medical claim costs vary significantly by duration from issue as a result of underwriting and preexisting-condition limitations. In general, claim costs are relatively low in the first year of issue and rise rapidly during the next three to five years, after which the effect tends to wear off. Significant variation also occurs by group size.

In addition to measurement of the variation by duration, the data allowed a comparison of adjusted claim costs by underwriting approach, group size, and preexisting-condition limitation. While the difference between long-form and short-form underwriting was inconclusive, guarantee-issue claim costs were significantly higher than those for underwritten business. By size, claim costs tended to exhibit a U-shaped pattern with the highest claim costs ex- perienced by the smallest and largest of groups. Groups without a preexist- ing-condition limitation experienced much higher claim costs at the later durations.

The remainder of this report summarizes the study methodology and re- sults in greater detail. A disk containing the results of this study is available.

II. METHODOLOGY

A. Participating Companies Twenty-two major insurance companies active in the small group market

were initially contacted by telephone to determine their interest in contrib- uting data for this research project. Of these, 17 companies indicated an

333

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interest and were sent a copy of the written datd request summarizing the form and extent of the desired information. Seven companies ultimately contributed to this study: l Boston Mutual Life Insurance Company l Celtic Life Insurance Company l Continental American Life Insurance Company l Employers Health Insurance Company l John Alden Life Insurance Company l The New England l Time Insurance Company.

The data for Boston Mutual Life Insurance Company, Continental Amcr- ican Life Insurance Company and The New England were provided by Dtm s( Bradstreet Plan Services.

A significant effort on each company’s part was required to develop the detailed reports that formed the basis for this study. Without their assistance and timely cooperation, this study would not bc possible.

Combined, the data submitted included more than $1,250,000,000 of ciaims incurred during 1988 and 1989 and nearly 12,200,OOO employee exposure months. All data submitted by the companies were included in the study and were combined for purposes of analysis.

B. Data Collection Guidelines A study period of calendar years 1988 and 1989 was selected since pay-

ments for claims incurred in these years would be nearly complete as of early 1991, the commencement of this study. The data were separated by month for the first three years and by year through the sixth year, with data for years seven and later combined.

Incurred claims and exposure data were separated by underwriting ap- proach, group size and preexisting-condition limitation. Underwriting ap- proaches included long-form, short-form, and guarantee issue. The five group size categories used were 1 employee, 2-4 employees, 5-9 employees, lo- 14 employees, and 15-25 employees. The four defined preexisting-condition limitation provisions were: none, 3 months, 6 months, and 12 months of insurance coverage.

Separate reports were produced by each company, summarizing earned premium, incurred claims, claim adjustments and exposure, for each com- bination of underwriting approach, group size and preexisting-condition lim- itation. The format is shown in Table 1. While the combination of these

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variables produces a potential of 60 study cells, only 20 cells were available, since little business was written by contributing companies in many of these cells.

TABLE 1

INPUT DATA REPORT FORMAT

i6 mo 1 1988

(4) (9 (6) (7) (8)

Incurred BCllCfil Am Trend Demographic Claims Adjustment Adjwmcnl Adjustment Adjustment

(9) (W illi Adjusted Incurred

Adjusted Claims Incurred Per Claims Expoeurc Exposure

Several guidelines were followed in compiling the study data. These guidelines include: 1. Only groups of 1 to 25 employees were included in the study. Group size was

determined as the average number of covered employees in the group during each experience period.

2. Only major medical plans with deductibles of $500 or less were included. Plans such as hospital only, accident only, cancer, disability, and dental were excluded. How- ever, maternity, supplemental accident and other related optional medical benefits were included when part of a major medical plan.

3. Incurred claims represent services rendered during the study period. Dependent, as well as employee, claims were included. The incurred claim data were prior to any reinsurance, with no adjustments made to reflect any reinsurance coverage.

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4. Date of issue was defined as the most recent date when a group was subject to medical underwriting. Thus, if a group was subject to medical underwriting or a new pre- existing-condition limitation after the original date of issue, the later date was used as the date of issue.

5. Duration was measured as the number of months or years elapsed from the date of issue to the experience period. For example, a group with a January 1, 1988 date of issue is defined as being in its second duration month during February 1988. A group with a June 1, 1985 date of issue would be in its fourth duration year from June 1, 1988 through May 31, 1989.

6. Exposure was measured as the number of months an employee was eligible for benefits during the study period. An exposure unit was counted as either one single employee or one employee with dependent coverage.

?I Short-form underwriting included applications with less than five general health ques- tions, while long-form underwriting included applications with more detailed ques- tions. Evaluation of the underwriting questions, how companies use the underwriting Information, and how a company’s underwriting practices changed over timi: WYIY outside the hope of our study.

8. Because a wide variety of preexisting-condition limitations arc in common use, these limitations were grouped by the number of months of continuous insurance coverage required prior to coverage of preexisting conditions. Therefore, a 3-6-12 preexisting condition clause (3 months without treatment, 6 months of active work, or 12 months of insurance coverage) was defined as a 1Zmonth clause in the study.

C. Data Adjustments Incurred claims for each study cell were adjusted by the contributing

carriers to remove the effect of differences due to benefit plan, geographic area, time period, and the demographic characteristics of covered employ- ees. The factors used to normalize the data were developed from information contained in the Milliman & Robertson, Inc. Health Cost Guidelines. l Benefit adjustment factors were developed for 52 broad deductible, coinsurance and

out-of-pocket limit combinations. For plans that did not exactly match the combina- tions provided, the benefit factor for the plans closest to the actual policy benefit was used.

l Area adjustment factors were based on the first three digits of the zip code corre- sponding to the location of the employer,

l Trend adjustment factors assumed an annual rate of 13 percent. Trend was calculated from the midpoint of the experience period to July 1, 1989 in order to properly weight the data within the study period. A small change in the assumed trend factor does not have a significant effect on the study results.

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l Demographic adjustment factors were developed based on the age, sex, and family status of covered employees. Separate factors were provided for policies that cover maternity and those that exclude maternity.

Aggregate incurred claims for each data cell were divided by the product of the adjustment factor for benefits, geographic area, trend, and demo- graphics to develop adjusted incurred claims. General reasonableness checks were performed based on aggregate premium, incurred claims, and exposure along with the adjustment factors submitted by each company to ensure that data collection procedures were followed and adjustment factors were ap- plied appropriately.

Adjusted monthly claim costs were then calculated for each duration by dividing the adjusted incurred claims by the monthly exposure for each data cell. Durational slopes were then calculated by dividing the adjusted monthly claim cost at each duration by the average second-year claim cost for each study cell.

D. Data Credibility and Limitations When interpreting the results shown in this report, the reader should con-

sider the volume of data available in any one data cell and the mix of carrier data included in the study.

Most of the data reflect short-form underwriting, although a considerable amount of long-form data were included. Relatively little data were available on either a guarantee-issue basis and/or with no preexisting-condition limi- tation. All the guarantee-issue business was written with a 1Zmonth pre- existing-condition limitation. All the no preexisting-condition limitation business was written with short-form underwriting. No business was written with a 3-month or 6-month preexisting-condition limitation. By size, most of the exposure was for 2-9 employee groups. In all instances, the volume of data tends to decrease significantly at the later durations because of the relatively high lapse rates associated with small group coverage.

Not all companies contributed data in equal volume by underwriting form, size and preexisting-condition limitation. The long-form underwriting data were submitted by a few companies, as were the guarantee-issue and no preexisting-condition limitation data. In addition, while claim costs have been adjusted for benefits, geographical area, time period, and demograph- ics, many other factors can influence actual claim costs by company, making comparisons difficult.

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There is a significant amount of employee turnover for small group em- ployers. New entrants are generally subject to the underwriting approach applicable to the group at the time the new employee is to be added. There- fore, results shown in this report include the impact of some newly under- written employees at each duration.

Finally, while we have reviewed the data submitted by the contributing companies for reasonableness, we have not verified or audited this infor- mation. Thus, we have relied on the data as submitted.

E. Exposure As shown in the following tables, the exposure varied significantly by

underwriting approach, group size, and preexisting-condition limitation. Ex- posure also varied by duration.

I. Uderwitirrg Approach (Tabk 2 I Approximately 70 percent of the total study exposure is based on short-

form underwriting. Long-form underwritten business represents another 23 percent of the total exposure, while guarantee issue represents 7 percent of total exposure.

This exposure excludes 492,000 exposure units for groups with no preex- isting-condition limitation, since these groups were also excluded when de- termining the results by underwriting approach, as shown Section III of this report, Overall study exposure was 12,194,OOO employee months.

TABLE 2

EXPOSURE BY UNDERwRrnNc APPROACH (000’s)

Duration Year

1

: S 6 7+

Total

hg Form

1,162 703

232 360 154

1;: 2,822

Undcmiting Shari Form

8:;

‘916 512 258 111 138

8,491

Guarantee Issue TOId

129 104 5,915 2,739

z 1,328 788 34 446 19 222 7 264

389 11,702

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2. Group Size (Table 3) Exposure by group size is concentrated in the 2-4 and 5-9 life categories.

These categories account for roughly 36 percent and 30 percent of total exposure, respectively.

The exposure shown in Table 3 excludes 389,000 and 492,000 exposure units for groups with guarantee-issue underwriting and no preexisting-con- dition limitation, respectively, to be consistent with the tabulation of results shown by group size in Section III of this report.

TABLE 3

EXPOSURE BY GROUP SIZE (000’S)

Duration Year

:

: 5

!+ Total

I 2-4

403 253 1,901 1,004

144 4’;

543 336 189

1; 1:; Y58 4,173

Group Sis 5-9

1,738 828

378 205 112

:: 3,390

lo-14 15-25 TOld

1,004 740

E “ii

5,786 2,635

1,276 743 3”: :i 413

:; 1: 203 257 1,631 1,161 11,313

3. Preexisting-Condition Limitation (Table 4) More than 92 percent of the exposure is for groups with a 1Zmonth

preexisting-condition limitation. Little exposure was available for business with no preexisting-condition limitation, especially at the later durations. Also, none of the companies submitted data for business with a three-month or six-month preexisting-condition limitation.

This exposure excludes 389,000 exposure units for groups with guarantee- issue underwriting, to be consistent with the exposure underlying the results shown by preexisting condition limitation in Section III of this report.

III. RESULTS

A. Variation by Duration The results of the study indicate that small group medical claim costs vary

significantly by duration since issue as a result of underwriting and pre- existing-condition limitations. These results also vary by size of group. The

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TABLE 4

EXPOSURE BY PREEXISTING-CONDITION LIMITATION

@00’sl

Duration

lt Total

Prccxisring-Gmdirion Limitadon

NOlIe 12 Months Total

282 5,786 6,068 115 2,635 2,750

;; 1,276 744 1,325 767 16 412 428 6 203 209 I 257 258

492 11.313 11 .a05

durational slope in the first year generally appears to be quite steep in relation to subsequent periods. For example, Table 5 shows the durational slope in the first year for all group sizes combined with a 12-month preexisting- condition limitation and short-form underwriting. Other study cells produce different results.

TABLE 5

SHORT-FORM UNDERWRITING

IIURATI~NAL SLOPE

DUWKJfl

Month 1 Month 2 Month 3 Month 4 Month 5 Month 6 Month 7 Month 8 Month 9 Month 10 Month 11 Month 12 Year 2 Year 3 Year 4

Durational S&c

0.38 0.56

Ei 0:72 0.78 0.78 0.82 0.85 0.83 0.90 0.91 1.00 1.13 1.12

Year 5 1.24 Year 6 1.27 Years 7+ 1.22

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The following sections summarize the observed variation by duration by year. Monthly durational data for the first three years are also shown in the Appendix. Tables Al, A2, and A3 summarize the detailed durational slope, adjusted monthly claim cost and monthly exposure data, respectively, while Table A4 contains the detailed data for each study cell.

1. Underwriting Approach For purposes of comparison, contracts with no preexisting-condition lim-

itations were excluded when measuring the effects of underwriting. Thus, these results all reflect a 12-month preexisting-condition limitation. Annual durational patterns by underwriting approach are summarized in Table 6.

TABLE 6

DURATIONAL S~PE BY UNDERWRITTNG APPROACH

Underwriting

Long Form Short Form

0.68

:*z 1:17

0.71 1.00

1.13 1.12

1.24 1.21 1.24 1.27 1.23 1.22

Guarantee Iarue

0.57 1.00

0.98 0.88

0.93 0.92 0.71

The durational slopes for short-form and long-form underwriting are fairly similar, after allowing for data fluctuations. The slope increases fairly rapidly in the first three to five durations, followed by a relatively flat slope at later durations. First-year claim costs are roughly 30 percent less than second- year costs.

The guarantee-issue slope is relatively flat after the first year, as might be expected. The lower first-year slope is probably due to the 12-month preexisting-condition limitation.

2. Group Size (Table 7) The annual duration slopes by group size include experience for long-

form and short-form underwriting and 12 months preexisting-condition lim- itation. Experience for guarantee-issue policies and policies with no preex- isting-condition limitation are not included.

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TABLE 7

DURATIONAL SLOPE BY GROUP SIZE

Duralion Group Sire

YeaI 1 2-4 5-9 lo-14 IS-25

: 0.65 1.00 0.65 0.69 1.00 0.71 1.00 0.81 1.00 3 1.10 :TY 1.10 1.25 1.25

: 1.02 1.29 1:11 1.26 1.15 1.30 1.18 1.34 1.43 1.07 ;+ 1.32 1.30 t::: 1.24 1.34 1.27 1.17 1.40 1.37

The variation by duration for medical claim costs generally follows the same pattern for all group sizes. The slope increases fairly rapidly in the first three to five years and remains relatively flat thereafter. However, the smaller groups tend tls exhibit a somewhat steeper slope at the early durations and a flatter slope at the later durations than the larger groups. This effect may be due to the tighter underwriting rules typically used with smaller groups.

3. Preexisting-Condition Limitation (Table 8) Limited information was available to measure duration patterns by pre-

existing-condition limitation. No data were available for three- and six-month clauses, and a relatively small amount of data was available for the no preexisting-condition provision. The data submitted for the no preexisting- condition limitation include short-form underwriting and primarily groups of l-9 employees. Experience for guarantee-issue policies is not included in this analysis.

TABLE 8

DURATIONAL SLOPE BY PREEXISTING-

CONDITION LIMITATION

Duration Preexisting-Condition Limitation

2 1.44 1.50 1.27 1.29 7-b 0.58 1.28

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In general, the durational slope for contracts with no preexisting-condition limitation is steeper than that for contracts that include a 12-month pre- existing-condition limitation.

B. Claim Cost Variation In addition to measurement of the variation of small group medical claims

by duration, the data allow for comparisons of adjusted claim costs by un- derwriting approach, group size, and preexisting-condition limitation. The claim costs per employee represent a composite cost of those employees with single coverage and those employees with dependent coverage. Medical claim costs require medical trend and experience adjustments when project- ing for future periods.

The results of the study indicate that small group claim costs are signifi- cantly higher for guarantee-issue than for underwritten business. Also, claim costs tend to vary significantly by group size and preexisting-condition limitation.

1. Underwriting Approach (Table 9) Short-form and long-form underwriting data were combined to compare

claim cost differences between underwritten and guarantee-issue business. The study data show long-form underwriting claim costs to be higher than short-form claim costs. However, this comparison is inconclusive, since short-form and long-form underwriting data were primarily submitted by different companies. Therefore, the difference in claim cost may reflect company differences in target markets, administrative practices, and many other factors. As with the analysis of variation by duration, contracts with no preexisting-condition limitation have been excluded for purposes of com- paring adjusted claim costs by underwriting approach.

As shown in Table 9, guarantee-issue claim costs are significantly higher than the underwritten claim costs for durations 1 through 3. Low exposure exists at the later durations, making comparisons difficult.

2. Group Size (Table 10) Claim costs also varied significantly by group size. The experience for

guarantee-issue policies and for policies with no preexisting-condition lim- itation are excluded from this analysis.

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TABLE 9

MONIHLY ADJUSTED CLAIM COST BY UNoERwRmra APPROACH

Duntion

Undcrwiting

Long Form and 1 ciuaranrcc

TABLE 10

MONINL~ ADJUSTED CLAIM COSTS BY GROUP SIZE

Duratian Group Size

Year 1 24 5-9 m-14 15-25

:. $ 135.22 87.64 $ 121.26 78.87 "lE!i $ 121.80 86.14 $ 121.51 98.27

3 149.11 142.10 125.78 151.89 152.03

t 138.36 173.89 134.81 ::E

131.13 147.72 143.57 163.00 173.80 129.35 6 175.71 153.22 141.96 166.02 I+ 177.84 154:80 141.74 154.17 169.69

The monthly incurred claim costs exhibit a U-shaped pattern by group size. The claim costs for one-employee groups are relatively high, with 5- 9 employee groups exhibiting the lowest costs. Claim costs then climb for lo-14 and 15-25 employee groups. This effect may be due to more restric- tive marketing and underwriting practices as groups become smaller. Even with these practices, however, adverse selection appears to be increasing the claim costs for one-employee groups.

3. Preexisting-Condition Limitation (Table 11) The claim costs by preexisting-condition limitation are summarized in

Table 11. Guarantee-issue business was excluded from this analysis.

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TABLE 11

MONTHLY ADJUSTED CLAIM COST BY PREEXISTING-CONDITION LIMITATION

Preexisting-Condition Limiratian

In general, the claim costs during the first two durations appear to be fairly consistent between the two preexisting-condition limitations. How- ever, the no preexisting-condition limitation claim costs are significantly higher at the later durations.

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APPENDIX

TABLE Al

DURATIONAL SLOPE

Group Size

Dudon I 2-4 s-9 lo-14 Is-2s All

1 mo 2 mo 3 mo 4 mo 5 mo 6 mo 7 mo 8 mo 9 mo

10 mo 11 mo 12 mo

13 mo 14 mo 15 mo 16 mo 17 mo 18 mo 19 mo 20 mo 21 mo 22 mo 23 mo 24 mo

25 mo 26 mo 21 mo 28 mo 29 mo 30 mo 31 mo 32 mo

;: ::

:‘6 2

1 Yr 2 Yr 3 Yr 4 Yr

2,‘: 7-k yr

0.225

FiE Oil0 0.429 0.454 0.434 0.560 0,532 0.599 0.655 0.610

%‘6 oh34 0.970 0.648 0.792 1.375 1.026 1.101 0.944 1.213 1.552

1.264 0.869

:% 1:075 1.081 1.033 1.307 1.233 1.468 1.280 1.610

0.511 l.CQO 1.201 1.162

:% 1:740

0.302

k% 0:694 0.604 0.674 0.727 0.767

EE $73:

0.894 0.887 0.914

%; ;:W&

1:055

:%i 1:125 1.157

1.322

:%i 1:143 1.243 1.343 1.296 1.005 1.081 1.630

k32E

0.651 1.000

: *;i: 1:076 1.183 1.219

~g-Form Summi

0.383 0.437 0.697 0.629 0.760 0.683 0.914 0.749 0.932 1.032 0.885 0.859

0.961 1.104 0.950 0.956 0.935 0.967 1.010 0.965 1.063 1.046 1.093 0.995

1.173 1.023 1.354 1.132 1.152 1.352 1.095 0.891 0.945 1.047 1.092 1.347

0.737 1.000 1.137 1.270 1.365 1.257 1.192

346

0.340 0.497 ti762 0.613 0.587 0.523 0.577

1.499 1.322 1.036 1.575 1.020 1.041

E 0:812 1.348

Ki 0.653 1.000 1.200 1.154 1.451 0.898 1.462

0.991 0.353 0.542 0.460 0.730 0.625 0.816 0.659 0.783 0.648 1.011 0.663 0.979 0.764 0.775 0.751 0.651 0.808

8:; 0:912

Et; 0:791

0.918 0.732 1.302 1.697 0.955 1.016 0.657 0.869

k% 0:909 1.179

0.899 0.972 0.948 0.956 0.951 0.979

:~x:~ I:081 1.007 1.107 1.107

0.592 0.789 1.119 3.371 1.521 0.722 1.188 1.139 2.557 1.316 1.073 0.809

1.263 1.138 1.290 1.238 1.195 1.294 1.198 1.013 1.063 1.405 1.200 1.328

i%i 1:288 1.449 1.210 1.253 1.018 ’

0.675

Ei 11165 1.238

t-z: L

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TABLE Al-Continued

Duration 1 2-4

Group size

5-9 l&14 15-u All

1 mo 2 mo 3 mo 4 mo 5 mo 6 mo 1 mo 8 mo 9 mo

10 mo 11 mo 12 mo

13 mo 14 mo 15 mo 16 mo 11 mo 18 mo 19 mo 20 mo 21 mo 22 mo 23 mo 24 mo

25 mo 26 mo 27 mo 28 mo 29 mo 30 mo 31 mo 32 mo 33 mo 34 mo 35 mo 36 mo

1 yr 2 yr 3 yr 4 yr 5 yr 6~ l+ vr

0.347

8% 0:714 0.635

XE p3;

0:751 0.905 0.913

0.962 1.026 1.002 0.924 1.007 0.949 1.017 1.139 0.995 0.932 0.950 1.129

0.980 1.159 1.444 1.147 0.929 1.015 0.926 1.498 0.950 1.023 0.924 0.902

EE 1:oss

?~E 1:213 1.180

0.314

i% 0:570 0.688 0.704 0.676 0.748

x.z 0:905 0.930

0.938 0.915 1.075 1.016 0.935 0,984 1.107 0.958

:-E 0:979 1.009

1.008 1.145 1.089 1.198 1.173 1.191 1.105

:E 1:136

::E

0.656

:E 1:112 1.366 1.221 1.163

n-Form Summi

0.379

X% 0:686

E: 0:777

F%i 01732 0.838 0.879

0.959 0.947 1.017 1.072 0.952 0.959 1.043 0.992 0.989 1.057 0.907 1.184

1.048 0.999 1.038 1.032

:% 1:19s

:%!I 1:097 0.994 0.990

0.690 1.000 1.065 1.011 1.142 1.318 1.086

0.399 0.572 0.649 0.732 0.700 0.776

E%: $9;

0:943 0.909

l%; 0:942 1.114 1.006 1.114 1.045 0.927 0.781

:E 1:063

1.456 1.011 1.412 1.089 1.302

E: 1:310 1.631

:*:4: 1:149

0.734 1.000 1.262 1.192 1.309 1.255 1.184

0.454 0.704 0.825

8E 0:79a 0.868 0.911 0.996 0.973 0.943 0.942

% 1:101

%i: 0:903 0.853 0.953

:% 1:033 1.274

1.171 1.323 1.238 1.156 1.116 1.159 1.691 1.360 1.433 1.041 1.029 1.302

0.813 1.000 1.251 1.436 1.040 1.388 1.432

0.377 0.559 0.643 0.692 0.715 0.779 0.778 0.820 0.851 0.832 0.902 0.914

0.944 0.948 1.032 1.026 0.971 0.983 1.046 0.988 0.989 1.074 0.982 1.102

1.078 1.106 1.176 1.131 1,111 1.094 1.181 1.206 1.232

Kiz 1:057

Kzi 1:126 1.117 1.239 1.271 1.224

347

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TABLE Al -Continued

Group Size

Duration 1 2-4 s-9 l&14 15-25 All

1 mo 2 mo 3 mo 4 mo 5 mo 6mo 7 ma 8 mo 9 mo

10 mo I1 ma 12 mo

13 mo IJmo 15 mo 16 mo 17 mo 18 mo 19 mo 20 mo 21 mo 22 mo 23 mo 24 mo

:‘6 iii:: 27 mo 28 mo 29 mo 30 ma 31 mo 32 mo 33 mo 34 mo 35 mo 36 mo

1 Yr 2 yr 3 yr 4 Yr 5 Yr 6 yr 7+ yr

0.322

k% 0:669

Ez 0:741 0.652 0.807 0.716 0.852 0.850

ShOti-R

0.305

%i 0:610 0.654 0.689 0.692 0.753 0.780 0.809 0.861 11.858

and Long-Form

0.373 0.503 0.624 0.663 0.696 0.794 0.805 0.774 0.825 0.810 0.846 0.868

0.928 1.020 0.967 0.937 0.933 0.919 1.098 1.118 1.014 0.933 1.001 1.212

0.922 0.906 1.015 0.964

%% 1.107 0.995 1.041 1.068 1.030 1.060

0.955 0.993 0.994 1.034 0.947 0.963 1.033 0.985 1.015 1.056 0.975 1.123

E; 1:401 1.156 0.958 1.023 0.941 1.455

EZI 0.981 1.021

1.120 1.180 1.164 1.176 1.199 1.250 1.178 1.030 1.156

:*::; 1:158

1.099 1.015 1.159

:z3” 1:168 1.169 1.077 1.112 1.092 1 .oso 1.156

0.648 0.650 0.694 1.000 1.000 1.000 1.103 1.172 1.104 1.023 1.112 1.151 1.286 1.261 1.296 1.299 1.266 1.345 1.315 1.277 1.244

31111

348

mmaly

0.386 0.554

i:% 0.674 0.731 0.774

E%f 0:873 0.915 0.398

0.888 0.963 0.957 1.078 0.925 1.040 1.042 1.115

zz 1:161 1.008

1.475 1.108 1.315 1.218 1.232 0.965 1.288 1.291 1.431 1.370 1.018 1.191

0.712 1.000 1.247 1.179 1.338 1.165 1.266

0.480 0.690 0.813 0.819 0.838 0.811 0.873 0.894 0.9% 0.955 0.913 0.93.1

0.923 0.937 1.133 1.044 1.046 0.926 0.816 0.938 0.997 1.125 1.010 1.257

1.070 1.236 1.218 1.430 1.163 1.107 1.632 1.331 1.535 1.064 1.029 1.249

0.809 1.000 1.251 1.430 1.065 1.366 1.396

0.363 0.527

KT: ;::g;

0:764 0.793 0.831 0.828 0.870 0.874

0.926 0.953 1.005 1.004 0.966 0.983 1.055 1.018 1.020 1.054 1.025 1.106

1.140 1.120 1.215 1.169 1.143 1.164 1.191 1.147 1.181 1.22s 1.076 1.155

0.693 1.000 1.160 1.146 1.268 1.290 1.283

Page 17: MEDICAL INSURANCE CLAIMS - Society of Actuaries

TABLE Al-Continued

I Grour, Sire Duration 1 2-4 5-9 lo-14 15-25 All

1 mo 2mo 3 mo 4 mo 5 mo 6 mo 7 mo

Ei 10 mo 11 mo 12 mo

13 mo 14 mo 15 mo 16 mo 17 mo 18 mo 19 mo 20 mo 21 mo 22 mo 23 mo 24 mo

25 mo 26 mo 27 mo 28 mo 29 mo 30 mo 31 mo 32 mo 33 mo 34 mo 35 mo 36 mo

lYr 2yr 3yr 4yr

2; 7f yr

0.026 0.424 8.177 3.005 0.574 0.459 1.082 0.746 1.845 2.430 0.812 0.795

G

0.290 0.878 0.865 0.675 0.666 1.898 1.058 0.369 0.462 0.847 1.127 0.804

0.509 1.397 0.820 1.194 1.388 0.904 0.232 0.972 0.314 1.973 0.872 1.026 1.177 0.426 2.567 0.932 0.859 0.717 0.218 1.116 0.847 0.687 2.094 0.525

0.965 2.059 0.853 0.256 0.514 0.452 0.349 0.314 1.530 0.715 0.533 8.663

:% 1:208 1.066 0.757 3.577 3.232 3.299 5.681

Ei 0:601

1.264 l.ooO 1.614 1.048 1.120 1.501 1.169

0.841

Ei 0:982

% 0:814

antcc-issue Sum1

0.371 0.351 0.419 0.380 0.394

E:

E6 0:SSl 0.597 0.511

0.911 0.767 0.715 0.875 0.909 0.987

ix: $;;;

2:168 1.416

0.696 0.718 0.631

Ez 1:174 1.244

%i 0:582 0.446 0.623

0.470 1 .ooo 0.768 0.822 0.870 0.868 0.654

Y

0.843 0.642

EZ 1:032

E% 0:952 1.266 1.182

E% 1:s31 0.950

0.660

i% 0:992 0.437 0.835

0.736 0.669

0.632 1.000 0.841 0.909

x-2: 0:600

0.583 0.447 0.372 0.230 0.816 1.160 0.362 0.651

EZ 0:665 0.711

0.528 0.634 1.842 0.965 1.005 0.655 0.707 2.374 1.363 0.410 0.752 0.622

0.842 0.823 1.052

% 0:907

%T 0:941 0.992 1.620 1.101

0.384 0.640 1.151 1.278 0.518 0.721 0.985 0.979 0.411 0.552 0.923 0.687

F%: 0.848

EE 1:319 1.466 1.295 1.362 0.719 0.612 0.996

0.649 0.568 1.000 1.000 0.775 0.979 0.599 0.881 0.808 0.928 0.816 0.921 0.719 0.711

0.367 0.379 0.429 0.408 0.707 0.722 0.500 0.507 0.661 0.751 0.618 0.614

349

Page 18: MEDICAL INSURANCE CLAIMS - Society of Actuaries

TABLE Al-Continued

Gr0

Duration 1 2-4 s-9

1 mo 2 mo 3 mo 4 mo 5 mo 6 mo 7 mo 8 mo 9 mo

10 mo I1 mo 13 mo

13 mo 14 mo 15 mo 16 mo 17 mo 18 mo 19 mo 20 mo 21 mo 22 mo 23 mo 24 mo

25 mo 26 mo 27 mo 28 mo 29 mo 30 mo 31 mo 32 mo

:: 1:: 35 mo 36 mo

1 yr 2 yr 3yr

tg 6~ 7+ yr

0.289 0.580 0.443 0.618 0.520 0.508

E; 0:902 0.826 0.786 (!.783

1.093 0.758 0.856 0.891 1.073 1.115 0.988 1.333 1.208

EFl 1.122

1.302 0.882 1.396

Ez 2:343 3.351 1.715 1.453 1.407 1.416 2.249

0.649 1.000 1.677 1.991 1.316 1.652 1.887

No Recxirtii

0.273 0.455 0.474 0.630 0.625 0.492 0.541 0.715 0.717 0.747 0.799 0.879

0.731 0.957 1.377

iE”sY 1:oss 1.010 1.000 0.781 1.212 1.117 0.869

1.132 0.940 1.12s 1.071

:*::i 0:896 2.003 1.142 1.636 2.556 1.115

K% 1:330 0.969 1.011 1.740 0.424

ng-Condition Limit 0.258

I---

0.443

EE ok44 0.649 0.788 1.157 0.976 0.785 1.134 1.022

0.807 0.878 0.982 1.029 0.886 1.071 1.117 1.254 0.999 1.082 0.489 1.672

:% 0:697 0.391 0.842

E:: 0:500 0.857 1.451 1 .oso 0.668

0.727 1.000 1.007

8% 1:280 0.308

lo-14 1 15a / All ” Summary

0.155 0.451 0.375 0.509 0.453 0.578

Ez ;:;;;

0:329 0.429

0.386 0.875 0.350 2.116 2.506 0.638 0.921 0.883

oo*z 0:740 1.773

i% 0:560 0.508 0.490 0.917 1.329 0.631 0.812 1.345 0.507 0.977

%!I 0:760 0.885 8.743 0.510 0.000

0.475 1.507 1.566

S%fl 4:535

:%i 0:983 1.309 0.429 0.59::

0.265 0.496 0.477 0.636 0.638 0.582 0.678 0.895 0.794 0.748 0.831 0.852

1.768 0.814 0.590 0.890 0.571 1.109 0.710 1.017 0.873 1.068 0.965 1.065 0.833 1.019 1.333 1.123 0.823 0.905 0.334 1.061 0.456 0.885 2.544 1.188

1.487 0.785 0.165 0.434 0.729 5.934 6.501 4.438

IL% 5:913 1.303

1.308 1.045 1.033 1.126 1.143 1.438 1.552 1.581 1.192 1.625 1.893 1.229

1.802 1 .ooo 3.109 1.148

%i 0.103

0.642 1.000 1.319 1.109 1.442 1.495 0.576

350

Page 19: MEDICAL INSURANCE CLAIMS - Society of Actuaries

Duration

TABLE A2

s‘iDJU.STED MONTHLY CLAIM &ST

Group Size

1 24 s-9 E-14 E-L5 All

1 mo 2 mo 3 mo 4 mo 5 mo 6 mo 7 mo 8 mo 9 mo

10 mo 11 mo 12 mo

13 mo 14 mo 15 mo 16 mo 17 mo 18 mo 19 mo 20 mo 21 mo 22 mo 23 mo 24 mo

25 mo 26 mo 27 mo 28 mo 29 mo 30 mo 31 mo 32 mo

:: iii 35 mo 36 mo

:g 3yr 4Y 5 Yr 6 yr 7-b yr

% 43.04 83.91

111.88 97.71 82.08 86.87 83.20

107.27 101.82 114.69 110.51 125.37 114.92 116.89 107.54

155.58 194.56 159.66 185.79 124.10 151.71 263.32 196.45 210.79 180.73 232.21 297.22

129.81 128.74 132.71 127.40 155.13 152.21 160.86 153.06 150.08 150.57 163.24 167.91

241.98 166.40 237.94 231.21

%:E 197.89 2.50.31 236.11 281.10 245.22 308.28

97.84 191.51 229.99 222.51 302.62 220.33 171.64 333.31 176.98

$ 43.85 68.17 82.72

?-:: 97175

105.57 111.38 119.83

191.80 180.59

::% 180:34 194.85 188.09 145.86 156.86

z-:s 187:82

94.55

:::*i; 157:27 156.10

89.89 81.11 98.03 88.05

117.87 96.56

120.26 133.07 114.17 110.73

:z; 122:48

:z-:: 124:74 130.25

K: 134:93 140.91 128.30

151.34 131.94 174.66 145.9s 148.64 174.39 141.25

::% ;$g

173:73

95.02 128.97 146.67 163.78 176.01 162.07 153.69

E: 138:13 131.21 92.82

143.46 115.77

:FE 140:28 213.29

::% 148:53

88.48 135.46 162.50 156.37

2’6;’ 198:07

$126.91 69.40 93.48

:%~ 129:55 125.43

75.88 101.12 143.40

:;::i: -92.45

103.62

:E*E 165:02 185.63

%Y 130:43

$ 49.43 64.56 87.65 92.46 90.80 93.02

107.13 105.23 113.22 118.80 113.57 110.91

125.99 136.25

:%?: 133:31 137.27

::$!i 151.55 141.23 155.24 155.23

177.12 159.59 180.90 173.54 167.48 181.41 167.91 142.02

:;:-z 168:22 186.18

94.69 140.20 170.82 163.40 173.59 169.24 172.77

351

Page 20: MEDICAL INSURANCE CLAIMS - Society of Actuaries

TABLE AZ-Conhued

I Duration I 2-4 I

Group Site

s-9 lo-14 15-2s All

1 mo 2 mo 3 mo 4 mo 5 mo 6 mo 7 mo 8 mo 9 mo

10 mo 11 mo 12 mo

13 mo 1J mo 15 mo 16 mo 17 mo 18 mo 19 mo 20 mo 21 mo 22 mo 23 mo 24 mo

25 mo 26 mo 27 mo 28 mo 29 mo 30 mo 31 mo 32 mo 33 mo 34 mo 35 mo 36 mo

’ Y’ 2 3

Y’ YT

4 Y’ 5 YT 6 Y’ 7-f yr

$ 43.59 72.02 65.88 89.70 79.72 92.70

102.16 85.72

110.04 94.30

113.72 114.64

120.83 128.86

:z: 126:49 119.26

:::2 125:02 117.09 119.32 141.80

123.08 145.66 181.43 144.05 116.75 127.54 116.33 188.25 119.40 128.48 116.04 113.35

86.51 125.64 136.26 123.79 136.07

%:“2;’

$ 5342.:: 64:18

%i 77159 74.51 82.45 83.40 92.62 99.78

102.47

103.41 100.82 118.45 111.97 103.07 108.48 122.06 105.65 115.55 120.35 107.91 111.17

111.12

:%% 132:OR 129.26 131.34 121.76 114.93

%% 110:40 116.43

72.36 110.23 122.70

:% 134:58 128.20

on-Form Summi

% 40.91 57.59 66.06 74.01 73.93 91.20 83.87 85.64

%Z 90:42 94.85

103.42 102.18 109.76 115.70

E’: 112:52

:z% 114:09 97.82

127.77

113.09 107.77 111.98 111.32 112.04 111.21 128.97 127.01 129.43 118.38 107.28 106.78

74.42 107.90 114.94 109.07 123.21 142.21 117.15

% 47.04

%Z 86:23 82.47 91.50 96.50

110.21 109.60 104.47 111.19 107.17

111.06

::E 131:31 123.16 109.30 92.02

136.56 140.63 125.31

112.07 117.27 132.38 109.24 128.15 108.59 102.59 114.58 125.04 144.38 124.13 153.10

171.54 140.78 119.18 159.06 166.37 148.78 128.32 138.96 153.45 134.13 110.46 139.36 159.43 203.20 154.41 163.47 192.28 172.20 163.04 125.15 132.70 123.71 135.47 156.48

86.51 97.77 117.86 120.20 148.71 150.33 140.53 172.60 154.24 125.05 147.91 166.84 139.60 172.09

$ 54.58 84.61 99.17 99.10

101.92 95.98

104.32 109.55 119.73 116.94 113.40 113.17

$ 42.64 63.27 72.72

i%;: 88:19 88.02 92.85 96.30 94.18

102.06 103.50

106.79 107.25

: :% 109:91 111.25 118.41 111.78 111.98 121.51 111.20 124.69

122.03 125.23

E-i! 125:73 123.88 133.72

:2:: 127.89 113.97 119.63

80.55 113.18 127.45

:z; 143:82 138.55

352

Page 21: MEDICAL INSURANCE CLAIMS - Society of Actuaries

TABLE A2-Continued

Duration 1 2-4

Group Six

I s-9 lo-14 Is-25 All

1 mo 2mo 3 mo 4 mo 5 mo 6mo 7 mo 8 mo 9 mo

10 mo 11 mo 12 mo

13 mo 14 mo 15 mo 16 mo 17 mo 18mo 19 mo 20 mo 21 mo 22 mo 23 mo 24 mo

25 mo 26 mo 27 mo 28 mo 29 mo 30 mo 31 mo 32 mo 33 mo 34 mo 3.5 mo 36 mo

1 yr 2 Yr 3 Yr 4 YT 5 Yr 6 v 7t yr

$ %: 69:71 90.45 79.95 92.11

100.15 88.11

109.09 95.76

115.17 114.93

125.54 137.98

:;:-;i 126:12 124.21 148.42 151.11 137.16 126.11 135.41 163.85

139.87 148.58 189.39

:z 138:40 127.31 196.71 134.85 148.73 132.67 138.09

87.64 135.22 149.11

::Ei 175.71 177.84

Short-F<

sEY 69:50 73.93 79.30 83.60 83.87 91.29 94.57 98.09

104.43 104.05

111.77 109.86 123.03 116.92 119.86 122.37 134.29 120.64 126.22 129.54 124.87 128.48

135.84 143.13 141.20 142.60 145.45 151.57 142.88 124.87 140.21 161.05 137.18 140.47

78.87 121.26 142.10 134.87 152.96 153.50 154.80

and Long-Fom

$ 42.49 57.35

::*:i 79:31

24: 88:23 94.00 92.28 96.41 98.96

:iY3” 113:26 117.81 107.89 109.70 117.72

:tz 120:37 111.15 127.94

125.19 115.61 132.09 122.79

%-E ;g;:;;

126:76 124.40 119.69 131.70

79.06 113.95 125.78 131.13 147.72 153.22 141.74

mmary

% 46.96

E3 85:91 82.14 89.10 94.23

109.83 105.56 106.34 111.45 109.35

108.11 117.25 116.56 131.27 112.62

::%+z ;;;:;;

;:;::X$

122:80

179.61 135.02 160.13 148.39 150.02 117.50 156.92

:;z*:: X&i;;

145:13

86.74

:::*i; 143157 163.00 141.96 154.17

$ 58.35 83.78 98.82 99.46

101.80 98.53

106.08

%Z 116:08 110.90 113.60

$ 43.75 63.50 75.51 81.07 82.84 89.17 92.01 95.50

100.01 99.69

104.71 105.26

112.81 113.80

::‘6-:: p;:;;

99:10 113.95 121.19 136.70 122.68 152.74

111.52 114.71 121.00 120.84 116.29 118.35 127.07 122.51 122.80 126.91 123.43 133.14

::Fi~~ 148:06 173.79 141.31 134.55 198.36

E: g:;;

151:78

137.29 134.88 146.28 140.69 137.56 140.17 143.37 138.04 142.13 147.51 129.59 139.06

98.27 83.39 121.51 120.39 152.03 139.69 173.80 137.95 129.35 152.71 166.02 155.36 169.69 154.43

353

Page 22: MEDICAL INSURANCE CLAIMS - Society of Actuaries

TABLE A2-Continued

Duration 1 2-4

Group Size

5-9 lo-14 E-25 All

1 mo 2 mo 3 mo 4 mo 5 mo 6 mo 7 mo 8 mo 9 mo

10 mo 11 mu 12 m*

13 mo 14 mo 15 mo 16 mo 17 ma 18 mo 19 mo 20 mo 21 mo 22 mo 23 mo 24 mo

25 mo 26 mo 27 mo 28 mo 29 mo 30 mo 31 mo 32 mo

:: :: 35 mo 36 mo

f Yr 2 Yr 3 Yr 4 Yr 2 Yr

:~% 348:55 861.77

0 Yr 7+ yr

1,135.39 379.14 371.4:

~ 237.83 382.65 648.35

Es; 407:48 549.93

1,199.32 401.43 102.07 395.70 978.09

451.04 961.86 398.64 119.59 240.13 210.99 163.23 146.91 714.75 333.90 248.87

4,047.10

590.64 467.17 754.01 489.49 523.30 701.10 546.31

G

% 45.07 136.28 134.18 104.76 103.41 294.57 164.14 57.25 71.68

131.44 174.83 124.80

“W -I-

216.83 185.31 140.21 150.91 306.12 159.14 66.11

144.68 111.23 173.16 106.68 81.50

antcc-Issue suml

$ ZE 82:27 74.58 77.37 84.54 77.99 93.57

129.71 114.18

363s2F .4 1

178.93 150.60 140.53 171.91 178.52 193.90 152.98 159.86 179.23 249.47 425.86 278.19

384.89 159.48 187.48 165.44 117.55 555.01 501.59 512.00 881.52 119.42 127.75 93.28

E*E 124:00 136.35 205.44 230.62 244.41 169.45 98.26

114.35 87.68

122.47

130.51 92.32 155.18 196.47 312.65 150.83 152.34 161.40 206.84 171.02 182.97 126.32 L

170.58 128.47

Y

$ 48.21 54.53 65.95 77.16

;2;: 108:84 84.77

120.08 146.89 90.59

114.86

141.84 p&?

161.84 152.98 161.28 214.57 200.28

:::::i 259.50 161.00

111.94 114.80 155.62

‘%i 141:48 205.44 211.00 140.42 166.62 124.81 113.33

107.09 169.48 142.62 154.00 121.20 125.53 101.66

$ % 63:40 47.76

:E: 61:62

110.87 91.12

159.98 113.31 121.1”

d 66.32 68.41 77.56 73.64

127.81 130.52 90.35 91.64

g;; 111:fIo 111.00

89.97 107.95 313.77 164.34 171.24 111.59 120.46 404.35 232.18 69.76

128.05 105.97

152.16

:%:5 165:30 177.96 163.80 159.99 225.96 170.07 179.23 292.77 198.88

65.42

:2z 217:74 88.25

122.86 167.80 166.76

2:; ;5&

149.15 138.22 153.15 160.37 145.18 238.31 264.89 233.99 246.02 129.82 110.56 179.90

110.57 102.57 170.35 180.68 132.05 176.93 102.07 159.15 137.59 167.70

:;;:i; :E

354

Page 23: MEDICAL INSURANCE CLAIMS - Society of Actuaries

TABLE A2-Continued

I Grouo Size

Duration 1 2-4 5-9 IO-14 15-25 All

1 mo 2 mo 3 mo 4 mo 5 mo 6 mo 1 mo 8 mo 9 mo

10 mo 11 mo 12 mo

13 mo 14 mo 15 mo 16 mo 17 mo 18 mo 19 mo 20 mo 21 mo 22 mo 23 mo 24 mo

25 mo 26 mo 27 mo 28 mo 29 mo 30 mo 31 mo 32 mo 33 mo 34 mo 35 mo 36 mo

1Yr 2 YT 3 YT 4 Y’ 5 yr 6 yr 7-t yr

$ 48.52 97.38 14.43

103.82 87.23 85.20

117.08 184.93 151.44 138.63 131.87 131.53

183.52 127.20 143.64 149.53 180.20 187.20 165.93 223.69 202.85 141.00 143.36 188.29

::Ki :;3&

142:05 393.37 562.58 287.82 243.84 236.17 237.73 377.51

109.M) 167.87 281.50 334.18 220.86 277.35 316.83

No Preexisti

% 34.53 57.49 59.81 79.62 78.90 62.07 68.34 90.35 90.48 94.27

100.84 111.01

Condition Limit: n Summary

% 27.03 $ 21.47 46.42 62.60 53.34 52.14 72.40 70.72 67.44 62.91 68.01 80.34 82.50 112.34

121.17 51.48 102.26 50.98 82.22 55.10

118.75 45.73 107.04 59.62

92.36 84.48 120.88 92.01 173.89 119.84 123.84 137.41 127.50 126.29 98.62

153.05 141.00 109.69

142.94 118.76 142.02 135.29 196.19 171.53 113.20 252.9s 144.16 206.62 322.81 140.81

76.05 126.28 167.93 122.31 127.63 219.76 53.49

102.82 107.80 92.85

112.21

::z H$g 51:18

175.10

204.22 177.0s 72.96 40.98 88.23 64.81 98.06

2-z 151:95

‘:KZ

76.17 59.80 104.75 138.92 105.47 105.65 89.63 122.98 89.78

lj4.03 32.30

f37.56 119.09 123.82 44.92

450.40 358.51 153.07 152.37 77.72

103.48 33.93 47.17

S 33.72 63.04 60.72

lE: 74:08 86.22

113.81 101.04 95.14

105.72 108.37

53.62 139.77 103.52 121.60 46.67 113.19 48.68 45.13 141.07

294.01 56.12 129.40 348.12 69.03 135.89 88.58 76.27 135.45

127.90 65.81 129.65 122.71 105.39 142.90 76.97 65.03 115.18

131.51 26.40 135.05 102.80 36.07 112.63 246.29 201.12 151.17

102.69 67.54 77.78 70.52 68.09

127.43 184.58 87.66

112.81 186.82 70.44

135.71

117.54 62.03 13.03 34.34 57.66

469.07 513.93

E-;: 466177 467.39 102.99

166.47 133.00 131.42 143.30 145.38

Ei 201:14 151.62

:zi~~ 156:36

1,214.56 70.91 0.00

142.45 79.05

245.77 90.72 64.82 79.72 8.12

81.71 127.23 167.76 141.15

:;;2 73123

355

Page 24: MEDICAL INSURANCE CLAIMS - Society of Actuaries

Dudan 1

TABLE A3

MONTHLY EXPOSURE

Group Size

2-4 s-9 lo-14 15-25 All

1 mo 2 mo 3 mo 4 mo S mo 6 mo 7 mo 8 mo 9 mo

10 mu II mo 12 mo

13 mo 14 mo 15 mo

:,“z: 18 mo 19 mo 20 mo 21 mo 22 mo 23 mo 24 mo

25 mo 26 mo 27 mo 28 mo 29 mo 30 mo 31 mo 32 mo 33 mo 34 mo 35 mo 36 mo

1 YT 2 Y’ 3 Yr 4 Yr 5 Yr 6 Y’ 7+ yr

2,633 2,828 3,067 3.247 3,329 3,440 3,462 3,522 3,592

3;472 3,311

z% 21682

2;; 21348

%! 1:988

: % 1:644 1,538 1,504 1,405 1,358 1,248 1,159

40,194 36,799 19,789 11,491 9,202 6,575 3,244

Total 127.294

50,657 50,930 50.967 501378 49,384

2~~~ ‘p;

411948 ;;A;;

7 -

35,935 34,426

%E ;p;

24:738 23,423 21,739 20,391 19,584 18,549

17,209 16,607 15,904 15,334 14,990 14,526 13,804

:32: 121574 12,475 12,405

3::: 172:182 119,488 80,723 47,192 58,873

391,057 115,879 56,493 237,683 76,910 34,401 129,223 28,966 9,844 82.602 13,127 5,167 51,834 8,056 4.59s 32,389 4,200 1,909 47,625 8,013 1,486

1,353,614 972.413 255.151 113,895

Low-Farm Summa

34,794 34,631 35,226

::+:z 331538 32,731 31,978 ;yg

29:03x 28,266

26,204 25,107 23,413 22,170 21,538

%E 17:861 16,531 15,711 15,171 14,531

13,490 13,004 12,107 11,757 11,403 10,858 10,171 9,907 9,404 9,220 9,122 8,780

8,831 9,026 9,470 9,836

10,047 10,018 9,959 9,942 9,938 9,815 9,690 0.307

8,711 8,534 7,792 7,300 7,156 6,758 6,038 5,716 5,131 4.802 4;656 4,316

3,748 3,642 3,016 2,709 2.417 21396 21249 2,077 1,892 1,642 1.584 11594

4,280 4,233 4.575 41806 4,844 4,986 5,081

2;;: 4:74?: 4,581 4,518

4,369 4,035 3,609 3.352 3;157 ;A$

$4;

11988 1,934 1,652

1,407 1,269 1,057

873

% 640 662 585 593 620 579

101,195 101.648 103;305 103,390 102,159 100,234 98,109 95,778 93,139 90,223 87,513 84,929

78,711 7s,545 70,402 66,611 64,262 60,666 55,430 52,426 48,221 45,458 43,822 41,396

38,020 36,585 34,072 32,565 31,471 30,146 2X.402 27,570 26,220

2;:;: 24:517

1,161,622 702,950 360,004 231,875 154,410 92,265

119,241

2,822,367

Page 25: MEDICAL INSURANCE CLAIMS - Society of Actuaries

TABLE Af-Continued

DUallOll 1 2-4

Group Size

5-9 lo-14 B-25 All

1 mo 2 mo 3 mo 4 mo 5 mo 6 mo 7 mo 8 mo 9mo

10 mo 11 mo 12 mo

13 mo 14 mo 15 mo 16 mo 17 mo 18 mo 19 mo 20 mo 21 mo 22 mo 23 mo 24 mo

25 mo 26 mo 27 mo 28 mo 29 mo 30 mo 31 mo 32 mo 33 mo 34 mo 35 mo 36 mo

1 Y’ 2 Yr 3 Yr 4yr 5yr 6 yr 7+ yr

36,886 35,135 33,734

E:: 30:692 29,111

%z 26:670 26,109 25,292

144,945

:‘2%i 121:746 118,058 113,670 108,597 103,066 $69;

91:343 85,958

105,883 97,695 89,649 86.042 81j428 75,988 70,170 65,797 60,705 56,335 51,472 47,052

77,858 73,323

E% 631798 60,584

:8%

:%i 38Z543 34,603

516,603 481,283 449,279 430,896 414,801 395,105 372,327 351,620 331,750 312,812 293,621 273,784

22,241 21,339 20,608 19,668 19,019 18,371 17,279 16,704 16,263 15,555 14,899 14,205

77,510 71,968

:Ei 601762 57,970 53,735

xl: 461709 44.317 42;254

bon-Form Sumn

151,031 140,471

E?:;: ;$;gy

108:521 102,441

227 g:;;;:

,

72,773 67,120 61,757

:xz 491708 45,400

:Gl 36:420

:::;;:

21:76S

27,879 23,197 19,955 17,216

t3% p;

91191 8,509 8,249 7,835

240,545 218,187 200,841 184,680 171,620 161,544 147,080 136,442 128,229 120,347 113,977 108,144

13,176 12,590 12,136 11,481 10,859 10,388 9,886 9,524 9,207 8,876 8,450 7,974

31h68 I ~~ 29,567 28,343 27,549

256t; 241438

29,141 27,063

%Z ;&

19:173 18,006

:i% 15:538 14,808

10,891 10,128 9,591 8,759 8,315 8,015 7,492

6,311 6,104

99,260 93,723 89,910 84,351 79,620 76,317 72,222 68,891 66,320 63,958 61,942 59,443

362,465 216,151 124,457 66,367 31,325 12,610 17,023

1,342,660 686,742 370,839 216,945 l~Op$

491063

1,346,693 590,153 248,734 122,266

ii?E 23:146

888,216 265,996 96,562

x: 141346 24,137

zi: 75:275 51,210 27,428 12,741 24,252

4,623,881 1,931,636

915,957 511,934 257,734 110,979 137,621

Total 830,488 2,819,770 2,416,878 1,375,259 1,047,347 8,489,742

357

Page 26: MEDICAL INSURANCE CLAIMS - Society of Actuaries

TABLE A3-Continued

I 5-9

Group Sire

l&14

1 mo 2 mo 3 mo 4 mo 5 mo 6mo 7 mo 8 mo 9 mo

10 mo 11 mo 12 Ill,>

13 rn” 14 mo 15 mo 16 mo 17 mo 18 mo 19 mo 20 mo 21 mo 22 mo 23 mo 24 mo

f’6 ii: 27 mo 28 mo 29 mo 30 mo 31 mo 32 mo 33 mo 34 mo 35 mo 36 mo

1Yr 2 Yr 3Y 4 Yr 5 yr 6 yr 7+ yr

Total

39,519 37,963 36,801 34,971 34,686 y;;

31:770 31,099 30,320 29,816 29,009

Shon

195,602 185,589 177,660

Z% 1611922 155,473 148,436 142,312 137,180 131,840 125,079

25,733 il3,445 24,782 106,394 24,033 100,119 23,186 94,506 22,491 89,701 21,682 84,969 20,375 78,473 19,673 74,095 18,945 70,393 18,121 67,100 17,376 63,901 16,553 60,803

15,342 14,653 14,124 13,373 12,683 ;y;;

11:028 10,612 ‘$g

91133

56,174 53,494 51,568 49,241 47,312 45,594 43,371 41,763 40,483 39,092 38,086 36,843

402,659 252,950 144,336 77,858

3:;: 20:267

1,900,659 1,737,750 1,004,095 740,340 1,003,899 827,836 342,906 206,995

543,021 377,957 125,528 85,119 336,433 204,868 68,273 56,377 188,999 111,683 38,912 32,023 92,437 58,426 18,546 14,650

107,936 70.771 32,150 25,738

957,782 4,173,384 3,389,291 1,630,410 1,161,242 11,312,109

15-25 All

m and Long-Fo

185,825 175,102 164,791 159,656 154,715 147,709 141,252 134,419 127.855 1221089 rl;.;N:

19,272 74,521 70,291 64,263 59.860 551768 52;ljl 49,054 46,302

42,631 40,067 37,744 35,492 33,279 31,393 29,344 27.913 26;424

f22~ 23:588

Summary

114,714 106,721 99,119 95,878 91,475 86,006 80,129 ;p;

66:150 61 16” 56:3SG

48,853 43,097 38,357 33,759 30,958 28,523 25,177 22,531 20,015 17,956 17,285 16,395

14,639 13,770

::%i 101732

‘8:: 91272 8,687 8,298 8,021 7,882

82,138 77,556 74,213 g5.5

651570 61,009 57,034 52,980 47,296 4.1.124 39.121

ye

:3::6i 20,568 18,211 16,745 14,222 12,709 11,329 10,497 10,183 9,487

8,494

%i 7:342 7,085 7,033 6,744 6,485

2:;: p;

617,798 582,931 552,584 534,286 516,960 495,339 470,436 447,398 424,889 403,035 381,134 358,713

319,256 293,73;1 271,243 251,291 235,882 222,210

:k%~~ 1761450 165,805 157,799 149,540

137,280 130,308

t% 111:091 106,463 100,624 96,461 92,540

8896'2: 83:960

5,785,503 2,634,586 1,275,961

743,809

;;:%i 256:862

358

Page 27: MEDICAL INSURANCE CLAIMS - Society of Actuaries

TABLE A3-Continued

Duration 1 2-4

Group Size

5-9 lo-14 15-25 All

1 mo 2 mo 3 mo

: iii 6 mo 7 mo 8 mo 9 mo

10 mo 11 mo 12 mo

13 mo 14 mo 15 mo 16 mo 17 mo 18 mo 19 mo 20 mo 21 mo 22 mo 23 mo 24 mo

:z zt 27 mo 28 mo 29 mo 30 mo 31 mo 32 mo 33 mo 34 mo 35 mo 36 mo

1 Yr 2 Yr 3yr 4 Yr 5yr 6 Yr 7+ yr

GU

339 433 416 472 465 413 496 498 605

E 749

nrce-luuc sunu

3,930 4,354

2% 41970 5,063

z:: 5:429 5,417

:::;;’

, 2,672 2,923 3,357 3,475 3,666 3,845 3,956 4,078 4,094 4,092 4,065 4,017

94s 1,086 1,274 1,371

:% 11653 1,720 1,775 2,007 2,061 2,096

7,907 8,797 9,776

10,178 10,631 10,986 11,349 11,518 11,931 12,175 12,073 12,072

718 700 715 696 699 659 621 710 667

2:: 650

4,709 4,486 4,143

E 3:539 3,198 3,203 2,968 2,870 2,753 2,629

3,763 3,554 3,364 3,254 3,049 2,745 2,476 2,313 2,093 1,818 1,649 1,501

2,194 2,290 ;,;g

2:146 2,007 1,751 1,658 1,515

:G (088

11,416 11,062 10,454 10,065 9,652 8,984 8,084 7,918 7,274 6,761 6,264 5,901

Ii:: 583 581 589 591 612 631

:: 726 740

2,407 2,323 2,286 2,268 2,193 2,131 1,912 1,893 1,893 1,917

22:K

1,285 1,279 1,109 1,128 1,110 1,061

995

E 894 818 815

919 858 827 768 717 581 423

5,258 5,079 4,839 4,776 4,650 4,400 3,996 3,927

?Zi 31881 3,910

6.284 -n- 8.140 7,599 8,204 5,754 3;014

852

y;

25:242 23,174 16,432 9,267 3,430

44,240 31,579 12,395 8,331 6,834 3,473 1.523

19,106 21,605 6,630

:z!: 21777

872

129,393 103,835 52,473 43,756 33,853 18,775 6,790

Total 2.745 39.847 179.231 108,375 58,677 388,875

359

Page 28: MEDICAL INSURANCE CLAIMS - Society of Actuaries

TABLE A3-Continued

GTOl

Duration I 24 5-9

1 Ill0 2 mo 3 mo 4 mo 5 mo 6 mo 7 mo 8 mo 9 mo

10 mo 11 mu 11 mc:r

13 mu 14 mu 15 mu 16 mo 17 mn 18 mo 19 mo 20 mo 21 mo 22 mo 23 mo 24 mo

25 mo 26 mo 27 mo 28 mo 29 mo 30 mo 31 mo 32 mo 33 mo 34 mo 35 mo 36 mo

1 Yr 2 Yr 3 Y’ 4 5

YT Yr

6 yr 7+ yr

Total

5,224 5,095 4,993 4,592 4,562 4,485 4,140 4,030 3,948 3,819 3,569 1,376

2,4!l4 2,180 2,090 1,884 1,813 1,710 1,489 1,382 1,306 1,218 1,124 1,039

874 800 757 726 679 628 580 556 519 487 482 439

51,833 19,639 7,521 3,168 2,:;;

155

85.330 221.014 137.204 36.745

No Preexisfir

11.326 10;717 10,450 10,187 10,170 10,117 9.911 91759 9;745 9,855 9,167 Y,704

6.972

3;839 3,719 3,409 3,170

2,73 1 2.466 2;289

:2; 11977 1,822 1,743 1,624 1,489 1,442 1,328

120.108 55;919 23,167 10,373 7,730 3,145

572

hdition Limtti

8,398 7,834 7,523 7,150 6,958 6,886 6,678 6,574 6,453 6,366 5,804 5,475

4,033 3,270 2,984 2,781 2,681 2,619 2,314 2,240 2,101 2,017 1,807 1,776

1,435 1,289 1,175 1,182 1,184 1,149

983 894 904 855 817 759

82,099 30,623 12,626 6,104 3,906 1,446

400

308

E 204 201

537 215 494 156 487 238 420 233 423 278 432 243 450 265 459 205 428 195

397 206 322 178 320 138 323 131 292 143 313 153 288 136 236 142 229 141 245 144 239 137 208 124

23,960 4,012 6,404 2,741 3,412 1,773 1,854 1,348

856 1,353 259 606

0 155

la-14 15-25 All

n Summary

351 282 237 271 343 354 345 339 355 378 382 375

27,872 26,241 25,355 24,285 24,039 23,865 23,035 22,614 22,412 22,376

:;::3Rc i

14,696 12,392 11,476 10,698 10,066 9,782 8,668 8,346 7,921 7,669 7,004 6,608

5,643 5,055 4,679 4,551 4,365 4,220 3,809 3,571 3,417 3,220 3,117 2,858

I

282,012 115,326 48,505 22,847 15,861 6,448 1,282

11,988 492,281

360

Page 29: MEDICAL INSURANCE CLAIMS - Society of Actuaries

TABLE A4

INDIVIDUAL CELL DETAIL

Duration

Adjuslcd lncurrcd Claims

Monthly Exposure

Adjusted Monthly

Claim Cost

1 mo 2 mo 3 mo 4 mo 5 mo 6 mo 7 mo 8 mo 9 mo

10 mo 11 mo 12 mo

13 mo 14 mo 15 mo 16 mo 17 mo 18 mo 19 mo 20 mo 21 mo 22 mo 23 mo 24 mo

25 mo 26 mo 27 mo 28 mo 29 mo 30 mo 31 mo 32 mo 33 mo 34 mo 35 mo 36 mo

1Yr 2 yr 3 yr 4P 5yr 6yr 7+ Y

Form: Lang; PICC

$ 113,326.46 237,302.62 343,145.34 317,251.80 273.251.64 298;832.67 288,036.75 377,788.15 365,743.13 418.600.89 464;754.45 434,480.13

543,274.34 669.868.98 546;841.25 653.618.57 430;885.39 502,312.93 815,226.32 583,254.90 565,331.46 463.753.52 575,180.11 697,875.71

524,126.75 343,281.09 473,027.36 437.448.54 3i5;4Oi;j6 340.285.40 304,352.58 376,467.25 331.732.28 381;730.02 306,030.62 357,291.24

3,932,514.03 7,047,423.48 4.551.180.69 2;556;868.01 2,784,690.44 1,448,638.44 1,081,256.66

3;329 3,440

x; 3:592 3,650 3,707 3,717

3,492 3,443 3,425 3,518 3,472 3,311 3,096 2,969 2,682 2,566

% ,

2% ;h;

1:824 1,644 ;s;

1:405 1,358 1,248 1,159

40,194 36,799

x9”; 9:202

?:E A

Tgf 111:ss 97.71 82.08 86.87 83.20

107.27 101.82 114.69 125.37 116.89

155.58 194.56 159.66 185.79 124.10 151.71

:E2 210:79 180.73 232.21 297.22

241.98 166.40 237.94 231.21 205.82

%z

E?: $3;:;;

308:28

97.84 191.51 229.99 222.51 302.62 220.33 333.31

0.225 0.438

E% 0:429 0.454 0.434 0.560 0.532 0.599 0.655 0.610

0.812 1.016

E:;f 0:648 0.792 1.375 1.026 1.101 0.944 1.213 1.552

1.264 0.869

:%: ::;‘8;

1:033 1.307 1.233 1.468 1.280 1.610

0.511 1.000 1.201 1.162 1.580

:% A

361

Page 30: MEDICAL INSURANCE CLAIMS - Society of Actuaries

TABLE A4-Continued

Duration

Adjusted Incurred Claims

Monthly Exposun

Adjusted Monthly

Claim Cast Durational

slope

1 mo 2mo 3 mo 4 mo 5 mo 6 mo 7 mo 8 mo 9 mo

10 mo 11 mo 12 mo

13 mo 14 mo 15 mo 16 mo

;‘,z: 19 mo 20 mo 21 mo 22 mo 23 mo 24 mo

2 1:: 27 mo 28 mo 29 mo 30 mo 31 mo 32 mo 33 mo 34 mo 35 mo 36 mo

1 Yr 2 Yr 3 yr 4 yr 5 yr 6 yr 7+ vr

Form: Long; Pwxir

$ 2,221,156.88 3,472,100.02 4,216,097.02 5,074,228.31 4,331,625.35 4,716,455.84 4,948,649.56 5,053,460.39 5,226,998.29 4,635,583.61 4,653,984.11 4,206,924.43

g: 12 mo.;

50,657 50,930 50,967 50,378 49,384 48,252 46,876

2% 411948 40,497 39,121

up Size: 2-4

$ % 82172

100.72 87.71 97.75

105.57 111.38 119.83 110.51 114.92 107.54

0.302 0.470 0.570 0.694 0.604 0.674 0.727 0.767 0.826 0.761 0.792 0.741

4,664,572.38 4,432,107.11 4,268,218.96 3,856,6?1.68 4,489,362.26 4,109,547.57 3,979,442.70 3,585,139.97 3,262,693.16 3,070,362.37 3,196,816.79 3,114,561.63

35,935

xi; 30:271

%% 24:738 23,423 21,739 20,391 19,584 18,549

129.81 128.74 132.71

:::.s 152:21

:E 150:08 150.57 163.24 167.91

0.894 0.887 0.914 0.878 1.069 1.049 1.108 1.055

:*K 1:125 1.157

3,300,689.52 17,209 191.80 1.322 2,999,072.13 16,607 180.59 1.244 3,001,474.65 15,904 188.72 1.300 2,543,168.84 15,334 165.85 1.143 2,703,345.32 14,990 180.34 1.243 2,830,340.50 14,526 194.85 1.343 2,596,461.51 13,804 188.09 1.296 1,957,483.99 13,420 145.86 1.005 2,028,778.48 12,934 156.86 1.081 2,973,989.20 12,574 236.52 1.630 2,397,380.73 12,475 192.17 1.324 2,329,857.07 12,405 187.82 1.294

52,757,263.81 557,999 94.55 0.651 46,029,496.58 317,157 145.13 1.000 31,662,041.94 172,182 183.89 1.267 18,792,469.70 119,488 157.27 1.084 12,600,758.13 80,723 156.10 1.076 8,099,885.34 47,192 171.64 1.183

10,419,145.44 58,873 176.98 1.219

362

Page 31: MEDICAL INSURANCE CLAIMS - Society of Actuaries

TABLE A4-Continued

Duration

Adjusted lncuncd Claims

Monthly Exporurc

Adjusted Monthly

UaimcQst

1 mo 2 mo 3 mo 4 mo 5 mo 6 mo 7 mo 8 mo 9 mo

10 mo 11 mo 12 mo

13 mo 14 mo 15 mo 16 mo 17 mo 18 mo 19 mo 20 mo 21 mo 22 mo 23 mo 24 mo

25 mo 26 mo 27 mo 28 mo 29 mo 30 mo 31 mo

:: ii: 34 mo 35 mo 36 mo

1 yr 2yr 3 Yr

:; 6 yr I+ yr

Form: lane: Preexi stim P: 12 mo.: Grout Size: S-9

$ y$l& 3:166:464:52 2;848;910.51 3,387,360.25 2,952,989.62 3,858,084.16 3,087,846.45 3,741,247.07 4JKIlJ46.92 3,315,407.56 3,129,967.05

3,247,652.33 3,575,613.11 2,867,697.59 2,732,319.57 2,596,237.12 2,567,541.19 2,456,980.67 2,223,087.56 2,265,844.35 2,119,895.61 2J37.746.37 1,864,391.80

2,041,626.39 1.715,759.52 2,114,561.94 1,715,938.26 1,694,921.50 1,893,545.05 1,436,659.31 1,138,370.69 1,146,667.45 1,244,523.85 1,284,700.97 1,525,310.04

37,158,945.04 30,655.007.27 l&952,584.97 13,528,160.00 9,123,467.64 5,249,202.97 7,319,380.08

- 34,794 34,631 35,226 35,123 34,555

:2*;z 311978

:%i 29:038 28,266

26,204

‘2:*~~~ ;p;

$g

17:861 16,531 15,711 15,171 14,531

;;,g

12:107 11,757

:% 10:171 9,907

%E 91122 8,780

ox% 129:223 82,602

:i% 411625

-T&g 89:89 81.11 98.03 88.05

117.87 96.56

120.26 133.07 114.17 110.73

123.94 142.41 122.48 123.24 120.54 124.74 130.25 124.47 137.07 134.93 140.91 128.30

151.34 131.94 174.66 145.95 148.64 174.39 141.25 114.91 121.93 134.98 140.84 173.73

95.02 128.97 146.67 163.78 176.01 162.07 153.69

0.383 0.431

EE 0:760

i$z 0:749 0.932 1.032 0.885 0.859

0.961 1.104 0.950 0.956 0.935 0.967 1.010

KE l:O46 1.093 0.995

1.173 1.023

:*::i 1:152 1.352 1.095 0.891 0.945

::% 1.347

0.737 1.000 1.137

K: l&7 1.192

363

Page 32: MEDICAL INSURANCE CLAIMS - Society of Actuaries

TABLE A4-Continued

Duration

Adjusted locumd Claims

Monthly Exposure

Adjusted

Monthly Claim Cost

Durational Slope

Form: Long; Preexisting: 12 mo.; Group Size: 10-14

% 406,547.29 8,831 607.558.06 9.026 900,964.21 816,754.02 798,614.56 709.885.29

-I---

9,470 9,836

10,047 1;,;;:

91942 778;815.43

1,066,624.79 804.168.60 1 9:938 1 .~

1,149,181.43 1,093,405.35

p;:, /

1,120,113.37 91307 ;

$ 46.04 67.31 95.14 83.04 79.49 70.86 78.20

107.28 80.92

117.08 112.84 120.35

1 mo 2 mo 3 mo 4 mo 5 mo 6 mo 7 mo 8 mo 9 mo

10 mo 11 mo 12 mo

13 ma 14 mo I5 mo 16 mo 17 mo 18 mo 19 mo 20 mo 21 mo 22 mo 23 mo 24 mo

25 mo 26 mo 27 mo 28 mo 29 mo 30 mo 31 mo 32 mo 33 mo 34 mo 35 mo 36 mo

1 yr 2yr 3yr 4 yr s_yr

I;+yryr I

947,326.8: 8 711 -236.805.40 8:534 :076:338.32 ‘957;831.72 664,207.82 755,707.21 839,122.17

.222,891.97 990,392.85 559.616.50 667;969.33 499,645.02

761,065.26 652,135.13 423.069.73

71792 7,300 7,156 6,758 6,038 5,716 5,131 4,802 4,656 4,316

3,748 3.642 3;016 2.709 5771794.40

334,073.29 2,417 337.951.64 2,396 334,045.58 2,249 gsg;.y; 2,077

299:811:05 1,892

140,295.86 %: 292,071.47 11594

10,252,632.40 115,879 10,417,855.13 76,910

I

108.75 144.93 138.13 131.21 92.82

111.82 138.97 213.94 193.02 116.54 143.46 115.77

203.06 179.06 140.28 213.29 138.22 141.05 148.53 166.86 109.98 182.59 88.57

183.23

88.48 135.46 162.50 156.37 196.54 121.61 198.07

0.340 0.497 0.702 0.613 0.587 0.523 0.577 0.792

%zl 0:833 0.888

0.803 1.0711 1.020 0.969 0.685 0.826 1.026 1.579 1.425

%!i 0:855

1.499 1.322 1.036 1.575 1.020 1.041

:*“u’: 0:812 1.348 0.654 1.353

0.653 1.000 1.200 1.154 1.451 0.898 1.462

364

Page 33: MEDICAL INSURANCE CLAIMS - Society of Actuaries

TABLE A4-Continued

Adjusrcd Incurred Claims

Adjusted Monthly

Claim Cost Durational

Slope

1 mo 2 mo 3 mo 4 mo 5 mo 6 mo 7 mo 8 mo 9 mo

10 mo 11 mo 12 mo

13 mo 14 mo 15 mo 16 mo 17 mo 18 mo 19 mo 20 mo 21 mo 22 mo 23 mo 24 mo

25 mo 26 mo 27 mo 28 mo 29 mo 30 mo 31 mo 32 mo

z: :: 35 mo 36 mo

1 Yr 2yr 3 Y’

;: 6 yr 7+ yr

mn: Lang; Preexisli~

$ 543J83.15 293,782.46 427,670.19 502,202.20 4853644.87 645,915.32 637.304.59 492;831.03 407,311.11 513,847.18 411,611.20 527,846.16

;;;,;g.3”;

602:138:16 728,574.66 386,210.53 392,514.SS 226,820.40 273,501.70 223.743.71 206;412.87 ;;;,;p$

I .

106,761.75 128.326.87 151h77.85 377,003.39 1gp;.;;

97:444:88 96,592.49

191.637.33 991971.31 g>;;;.;;

, *

5,889,149.46 4,407,084.78 1,624,438.94

959,144.Ol 712,212.70 306,474.65 193,820.95

12 ma.; GI

4,280

2:;: p4”:

41986 5,081 4,966 4,881 4,742 4,581 4,518

Size: 15-Z

$126.91 69.40 93.48

104.49 100.26 129.55 125.43 99.24 83.45

108.36 89.85

116.83

4,369 4,035

E; 3:157

%Z ;:;‘g

1:988 1,934 1,652

117.59 93.84

166.84 217.36 122.33 130.19 84.16

111.32 104.65 103.83 116.49 151.02

1,407 1,269 1,;;;

837 722 640 662 585 593 620 579

75.88 101.12 143.40 431.85 194.91 92.45

152.26 145.91 327.59 168.59 137.48 103.62

56,493 104.25 34,401 128.11 9,844 165.02 5,167 185.63 4,595 155.00 1,909 160.54 1,486 130.43

0.991 0.542 0.730 0.816 0.783 1.011 0.979 0.775 0.651 0.846 0.701 0.912

0.918

Ei 1:697 0.955 1.016 0.657

FEZ; 0:810 0.909 1.179

Ei 1:119 3.371 1.521 0.722 1.188 1.139 2.557 1.316 1.073 0.809

K% 1:288 1.449 1.210 1.253 1.018

365

Page 34: MEDICAL INSURANCE CLAIMS - Society of Actuaries

TABLE A4-Continued

Duration

Adjusted lncwrcd claims

Monthly Exposure

Adjusted Monthly

Claim Cost Durational

SlOpC

1 mo

:i:: 4mo 5 mo 6 mo

2: 9 mo

10 mo 11 mo 12 mo

% 2S3.4i1.52 496;151.80 371.633.98 476.722.64 397.946.78 js2;i23.30 484,709.87 745,249.52 597,902.04 529.445.50 470,639.N 444,030.78

13 mo 14 mo 15 mo 16 mo 17 mo 18 mo 19 mo 20 mo 21 mo 22 mo 23 mo 24 mo

441J74.98 277.290.84 300.211.90 281;705.40 326,702.42 320,106.09 247,074.14 309,145.05 264,916.06 171,733.44 161.134.49 195.636.07

25 mo 190,987.42 26 mo 118,467.09 27 mo 177,376.67 28 mo 280,296.32 29 mo 96.449.69 30 mo 247,038.97 31 mo 326,297.86 32 mo 160.029.97 33 mo 126,552.56 34 mo 115,014.34 35 mo 114,587.44 36 mo 165.726.83

1; 3yr 4 Yr 5 yr

5,650,047.54 51,833 109.00 3,296,830.88 19,639 167.87 2,118,825.16 7,527 281.50 1,058,670.94 3,168 334.18

445,249.64 2,016 220.86 2q7;,;;;.;; 992 277.35

, . 155 316.83

Form: Short: Preexistinn: None: t 3n 1

5,224 5,095 4,993 4,592 4,562 4,485 4,140 4,030

it%; 31569 3,376

2.404 2,180 2,090

:CE (710 1,489 1,382 1,306 1,218 1,124 1,039

874 800 757 726 679 628 580

::: 487 482 439

tp Size: 1

$ Ezl 74143

103.82 87.23 85.20

117.08 184.93

::E 131:87 131.53

183.52 127.20 143.64 149.53 180.20 187.20 165.93

:;2.:: 141:oo 143.36 188.29

218.52 148.08 234.32 386.08 142.05 393.37 562.58 287.82

2:2: 237.73 377.51

0.289

8E 0:618

Et: 0:697 1.102

Fl%i 0:786 0.783

3.093 0.758 0.856 0.891 1.073 1.115 0.988 1.333 1.208 0.840 0.854 1.122

1.302 0.882 1.396 2.300 0.846 2.343 3.351 1.715 1.453 1.407 1.416 2.249

0.649 1.000

K 1:316 1.652 1.887

366

Page 35: MEDICAL INSURANCE CLAIMS - Society of Actuaries

TABLE A4-Continued

Duration

Adjusted lncuncd Claims

Monthly Exposure

Adjusted MOMhlY

Claim Cost Durational

Slope

1 mo 2 mo 3 mo 4 mo 5 mo 6 mo 7 mo a mo 9 mo

10 mo 11 mo 12 mo

13 mo 14 mo

:z-E

:;:i 19 mo 20 mo 21 mo 22 mo 23 mo 24 mo

25 mo 26 mo 21 mo 28 mo 29 mo 30 mo 31 mo 32 mo 33 mo 34 mo 35 mo 36 mo

1 Yr 2yr 3Y 4 5

Y’

6 YT Y’

7+ yr

Form: Short; Preexi :: None; C

$ 391,051.78 11,326 616,134.65 10,717 625,041.90 10,450 811,064.87 10,187 802,410.82 10,170 627,970.68 10,117 617,281.78 9,911 881,754.35 9,759 881,770.47 9,745 929,037.81 9,855 924,396.93 9,167 966,230.05 8,704

643,924.19 730,828.75 913,433.98 632,865.51 609,534.95 649,672.56 537,019.56 508,049.47 318,591.77 569,196.24 480,654.30 347,726.17

6,972 6,046

:%Y 41922 4,728

fi9;;: 31839 3,719 3,409 3,170

390,374.65 292,855.25 32.5,092.06 296,148.57 ~~;s~;.~

206:253:55 440,885.52 234,118.14 307,656.33 465,498.67 187,000.64

2,731 2,466 2,289 2,189 2,067 1,977 1,822 1,743

E;: 1:442 1,328

9,134,146.09 120,108 7,061,497.45 55,919 3,890,515.22 23,167 1,268,748.04 10,373

986,558.35 7,730 691,151.41 3,145 30,595.24 572

I Sire: 2-4

s 34.53

E 19162 78.90

Ki 90:35 90.48 94.21

KY:;

92.36 120.88

::Ei 123:84 137.41 127.50 126.29 98.62

153.05 141.00 109.69

142.94 118.76 142.02 135.29 196.19 171.53 113.20 252.95 144.16

%E 140:81

76.05 126.28

:“23z 127:63 219.76 53.49

0.273 0.455 0.474 0.630 0.625 0.492 0.541 0.715 0.717 0.747 0.799 0.879

0.731 0.957 1.377 0.949 0.981 1.088 1.010

GE 1:212 1.117 0.869

1.132 0.940 1.125 1.071

:*::i 0:896 2.003 1.142 1.636 2.556 1.115

0.602 1.000 1.330 0.969 1.011 1.740 0.424

367

Page 36: MEDICAL INSURANCE CLAIMS - Society of Actuaries

TABLE A4-Confinued

Form: Short: Preex

$ 226,982.96 363,649.29 401,311.47 517,679.35 469,256.14 468,344.95 550.94X.87 7951564.56 659,863.26 523,440X 689,201.96 586,027.OO

-

I :istir

T

11 mo 12 mn

13 ,711, 14 mo 15 mo 16 mo 17 mo 18 mo 19 mo 20 mo 21 mo 22 mo 23 mo 24 mo

25 mo 26 mo 27 mo 28 mo 29 mo 30 mo 31 mo 32 mo 33 mo 34 mo 35 mo 36 mo

1 YT 2 Y’ 3 yr 4 yr 5 Yr 6 Y’ 7+ yr

340.726.14 300;887.52 306,820.05 299,790.76 248,939.55 293,889.24 270,672.18 294.229.79 219;747.95 228,576.65 92,481.35

310,972.59

293.057.6s 2281212.54 85,73X72 48.442.83

104,466.05 74,468.91 96.390.75 46;847.49 81,117.45

129,920.30 89,890.OO 53,146.28

6,253,270.63 82,099 3,207,733.77 30,623 1,331,693.97 12,626

547,074.29 6,104 350,674.23 3,906 1g,;;;.;g 1,446

9 . 400

Monthly Adjusted Monthly

~g: None; C

8,398 7,834 7,523 7,150 6,958 6,886 6,678 6,574 6,453 6,366 5.804 5.475

up Six: 5-9

3,033 3,270 2,984 2,781 2,681 2,619

%l 2:101 2,017 1,807 1,776

84.48 0.807 92.01 U.878

102.82 0.982 107.80 1.029 92.85 0.886

112.21 1.071 116.97 1.117 131.35 1.254 104.59 0.999 113.33 1.082 51.18 0.489

175.10 1.672

1,435 204.22 1.950 1,289 177.05 1.690 1,175 72.96 0.697 1,182 40.98 0.391 1,184 88.23 0.842 1,149 64.81 0.619

983 98.06 0.936 894 52.40 0.500 904 89.73 0.857 855 151.95 1.451 817 110.02 1.050 759 70.02 0.668

76.17 104.75 105.47 89.63 89.78

134.03 32.30

0.727 1.000 1.007 0.856 0.857 1.280 0.308

$ 27.03 0.258 46.42 0.443 53.34 0.509 72.40 0.691 67.44 0.644 68.01 0.649 82.50 0.788

121.17 1.157 102.26 0.976 82.22 0.785

118.75 1.134 107.04 I.022

368

Page 37: MEDICAL INSURANCE CLAIMS - Society of Actuaries

TABLE A4-Conrinued

Duration

Adjusted

Incurred Claims

Monthly Exposure

Adjusted Monthly

Claim Cost

1 mo 2 mo 3 mo 4 mo 5 mo 6 mo 7 mo 8 mo 9 mo

10 mo 11 mo 12 mo

13 mo 14 mo 15 mo 16 mo 17 mo 18 mo 19 mo 20 mo 21 mo 22 mo 23 mo 24 mo

25 mo 26 mo 27 mo 28 mo 29 mo 30 mo 31 mo 32 mo 33 mo 34 mo 35 mo 36 mo

1Yr 2yr 3 Yr 4 Yr 5 Y’ 6 yr 7-t Y

Form: Short; Pmcxi

$ 55,231.29 144,799.19 112,205.36 147,461.31 126,191.81 162,529.24 2gpg.;; 97:425:98

107,886.56 73,769.42 86,631.99

52,493.43 84,145.13 29,356.68

157,884.51 171,970.80 43.140.13 53,717.61 51,907.29 33J52.49 59,179.20 47,187.21

105,410.26

40,766.41 21,747.40 24.890.60 y;;.g

. . 391884.47 ;;;;g.;;

25:834:01 45,769.72 16,835.57 28,227.55

1,432,853.94 889,644.74 360,460.81 227,995.13

1,039.661.43 18,364.67

0.00

5: None; G p Size: lo-14

2,573 $ 21.47 2,313 62.60 2,152 52.14 2,085 70.72 2,006 62.91 2,023 80.34 1,961 112.34 1,912 51.48 1,911 50.98 1,958 55.10 1,613 45.73 1,453 59.62

979 692 603 531 494 487 420 423 432 450

:;i

53.62 0.386 121.60 0.875 48.68 0.350

294.01 2.116 348.12 2.506 88.58 0.638

127.90 0.921 122.71 0.883 76.97 0.554

131.51 0.947 102.80 0.740 246.29 1.773

397 102.69 322 67.54 320 77.78 323 70.52 292 68.09 313 127.43 288 184.58 236 87.66 229 112.81 245 186.82 239 70.44 208 135.71

23,960 59.80 6,404 138.92 3,412 105.65 1,;:; 122.98

259 ‘~“:Ei 0 0:oo

0.155 0.451 0.375 0.509 0.453

E6 0:371 0.367 0.397 0.329 0.429

x-:z 0:560 0.508 0.490 0.917 1.329 0.631 0.812 1.345 0.507 0.977

0.430 l.CQO 0.760 0.885 8.743 0.510 0.000

369

Page 38: MEDICAL INSURANCE CLAIMS - Society of Actuaries

TABLE A4-Continued

Duration

Adjusted Incurred claims

Adjusted Monthly

Claim Cost

1 mo 2 mo 3 mo 4 mo 5 mo 6 mo 7 mo 8 mo 9 mo

10 mo 11 mo 12 mo

13 mu 14 ma 15 mo 16 mo 17 mo 18 mo 19 mo 20 mo 21 mo 22 mo 23 mo 24 mo

25 mo 26 mo 27 mo

:i ii: 30 mo 31 mo 32 mo 33 mo 34 mo 35 mo 36 mo

1Yr

;;

z; 6 Y’ 7-k yr

Form: Start; Prccxir

s ;;*;;;.g

29:345:76 12,172.19

154,487.49

43,050.40 9,521.40 9.071.37

12,066.75 10,768.01 18,lSl.lS l&334.32 29.298.76 15,801.56 6.995.97 7;393.77

39,217.58

24,212.87 11,041.59 1,797.98 4,498.59 8,246.OO

71.767.60 69,894.22 49,811.89 50,454.os 67,215.23 64,031.91 12,770.29

571.503.76 216.671.04 435;742.22 122,296.14 y&

1:258:02

:: None; G

351 282 237 271 343 354 34s 339 35s

z. 37s

, size: 15-25

“l:Z; 123:82 44.92

450.40 358.51 153.07 152.37 17.12

103.48 33.93 47.17

308 lW.7’ 204 46.67 201 45.13 21s 56.12 156 69.03 238 76.27 233 65.81 278 105.39 243 65.03 265 26.40 20s 36.07 195 201.12

% 138 131 143 153 136 142 141

:“;: 124

117.54 1.487 62.03 0.785 13.03 0.165 34.34 0.434 57.66 0.729

469.07 5.934 513.93 6.501 350.79 4.438 357.83 4.527 466.77 5.905 467.39 5.913 102.99 1.303

4,012 142.45 2,741 79.05 1,173 245.77 1,348 90.72 1,353 64.82

606 79.72 155 8.12

0.475 1 .so7 1.566 0.568 5.698 4.535 1.936 1.928 0.983 1.309 0.429 0.597

1.768

LEE 0:710 0.873 0.965 0.833 1.333 0.823 0.334 0.456 2.544

370

Page 39: MEDICAL INSURANCE CLAIMS - Society of Actuaries

TABLE A4-Continued

Duration

Adjusted lncuncd Claims

Monthly Exposure

Adjusted Monthly

Claim Cost

1 mo 2 mo 3 mo 4 mo 5 mo 6 mo 7 mo 8 mo 9 mo

10 mo 11 mo 12 mo

13 mo 14 mo 15 mo 16 mo

:;i ::: 19 mo 20 mo 21 mo 22 mo 23 mo 24 mo

25 mo 26 mo 27 mo 28 mo 29 mo 30 mo 31 mo 32 mo 33 mo 34 mo 35 mo 36 mo

1 Yr 2 yr 3 yr 4 Yr 5 6

Y’ yr

yr 7+

Form: Shon; Preex

$ 1,607,998.82 2,530,482.00 2,222,346.43 2,845,800.62 2.499.882.27 218451056.96 2,974,072.48 2,421,364.04 3,026,834.50 2,515,011.43 2,969,186.43 2,899,584.16

2,687,330.74 2,749,641.38 2,594,263.23 2.283,685.98 2,405,772.01 2,190,901.75 2,208,857.90 2,389,562.33 2,033,192.99 1,821,401.71 1.777.688.86 2,014,275.96

1.621.693.93 I~~ I~

1.833.836.39 2,201,865.51 1,653.852.34 1,267,808.26 1.324.919.80 1;150;007.54 1.792.888.06 ~ ,--- -- 1,099,272.22 1,140,410.13

980,568.16 903,875.37

31,357,620.14 362,465 27,156,574.84 216,151 16,970,99?.71 124,547 8,215,650.91 66,367 4,262,369.82 31,325 1,922,306.50 12,610 2.523.017.76 17,023

ng: 12 ma;

36,886 35,135 33,734 31,724 31,357 30,692 29,111 28,248 27,507 26,670 26,109 25,292

22,241 21,339 20,608 19,668

:z% 171279 16,704 16,263 15,555 14,899 14,205

13,176 12,590

:T%t 101859 10,388 9,886 9,524

i%i 8:450 7,974

‘~up Size: 1

$ 43.59 72.02 65.88 89.70 79.72 92.70

102.16 85.72

%% 113:72 114.64

120.83 128.86 125.89 116.11

%2 ;;;:;g

125:02 117.09 119.32 141.80

:i% ;8&

116:75 127.54 116.33 188.25 119.40 128.48 116.04 113.35

86.51 125.64 136.26

0.347 0.573 0.524 0.714 0.635 0.738 0.813

Ez 0:751 0.905 0.913

0.962 1.026 1.002 0.924 1.007 0.949 1.017 1.139 0.995 0.932 0.950 1.129

0.980 1.159 1.444 1.147 0.929 1.015 0.926 1.498 0.950 1.023 0.924 0.902

0.689 1.000 1.085 0.985 1.083 1.213 1.180

371

Page 40: MEDICAL INSURANCE CLAIMS - Society of Actuaries

TABLE A4-Continued - I

1 mo 2 mo 3 mo 4 mo 5 mo 6 mo 7 mo 8 mo 9 mo

10 mo 11 mo 12 mo

13 mtr 14 mo 15 mo 16 mo 17 mo 18 mo 19 mo 20 mo 21 mo 22 mo 23 mo 24 mo

25 mo 26 mo 27 mo

t; FE 30 mo 31 mo 32 mo 33 mo 34 mo 35 mo 36 mo

1 Yr 2 Yr 3 Yr 4 yr 5 yr 6 yr 7+ yr

Form: Short: Prccxi

$ 5.012.738.38 7,034,391 .ss 8,130,654.02 7,650,198.64 8,947,006.46 8.819;680.08 8;091;550.99 8,497,670.00 8,230,887.73 8,819,914.96 9,114,271.22 8,807,843.21

9,015,583.88 7,256,122.41 8,049,384.80 7,192,637.02 6,262,504.55 6,288,528.24 6,558,693.34 5,353,739.77 5,622,041.85 5,621,644.35 4,782,278.49 4,697,541.99

4.329.926.15 ,_- , ~. 4,657,340.58 4,279,752.53 4,478,524.06 4.177.955.33 4:080:423.51 3;600;182.79 3,257,547.03 3,647,330.07 3,321,786.41 2,827,447.06 2,845,376.40

97,156,807.25 75,700,700.69 45,503,591.92 26,580,681.31 16.308.398.48 6:088:881.26 612891792.79

Monthly Adjusted Monthly

EXp& Chm Cost

:: 12 mo.; G 2 Sire: 2-4

144,945 f 34.58

:E% 121:746

Es” 62184

118,058 75.78 113,670 77.59 108,597 74.51 103,066 82.45 98,693 83.40 95,232 92.62 91,343 99.78 85,958 102.47

77,510 11,968 67,956 64,235 60,762 57,970 53,735 50,672

2% 44:317 42,254

103.41 100.82 118.45 111.97 103.07 108.48 122.06 105.65 115.55 120.35 107.91 111.17

38,965 36,887 35,664 33,907

2% 29:567 28,343 21,549 26,518 25,611 24,438

111.12 1.008 126.26 1.145 120.00 1.089 132.08 1.198 129.26 1.173 131.34 1.191 121.76 1.105 114.93 1.043 132.39 1.201 125.27 1.136 110.40 1.002 116.43 1.056

13;,4@$

370:839 216,945 1g,;;;

491063

72.36 0.656 110.23 1.000 122.70 1.113 122.52 1.112 150.62 1.366 134.58 1.221 128.20 1.163

- I

E:: p; 0:688 0.704 0.676 0.748 0.757 0.840 0.905 0.930

0.938 0.915 1.075 1.016 0.935 0.984 1.107

!%: 1:092 0.979 1.009

372

Page 41: MEDICAL INSURANCE CLAIMS - Society of Actuaries

TABLE A4-Continued

Duration

Adjusted Incurred Claims

Adjusted Monthly

Claim Cost

1 mo 2 mo 3 mo 4 mo 5 mo 6 mo 7 mo 8 mo 9 mo

10 mo 11 mo 12 mo

13 mo 14 mo

:2E 17 mo 18 mo 19 mo 20 mo 21 mo 22 mo 23 mo 24 mo

:z ii: 27 mo 28 mo 29 mo 30 mo 31 mo 32 mo 33 mo 34 mo 35 mo 36 mo

1; 3 Yr 4yr 5 yr 6 yr 7+ Y

Form: Shoe Ptecxir

16 6,178,838.45 8,090,013.61 8,559,146.87 9,217,135.02 8,883,616.26

10,412,844.57 9,102,174.16 8,772,612.52 8,276,898.66 7,265,489.82 7,789,907.63 7,671,121.68

7,526,492.28 6,858,278.50 6,778,289.86 6.6063668.27 5;443;590.34 5.143.402.26 5;108;304.39 4,495,356.98 4,185,364.35 4,155,158.39 3,314,459.05 4,059,486.19

3,295,518.06 2,916,577.71 2,870,923.16 2,642,154.38 2,451,017.37 2,283,616.69 2,472,702.97 2,287,005.25 2,202,823.40 1,918,042.58 1,666,975.02 1,581,155.83

100.219.799.2s 63;674;850.86 28,588,512.42 13,335,218.17 7,373,864.66 3,702,667.30 2.711.597.22

g: 12 mo.; G

151,031 140,471 129,565 124,533 120,160 114,171 Kw2;

961746 92,021

%:E

72,773 67,120 61,757

::% 49:708 45,400 41,999 39,237 36,420 33,883 31,771

29,141 27,063

3% 21:876 20,535 19,173 18,006

Ez 151538 14,808

13;g

248:734 122,266 59,849 26,037 23,146

p Sire: S-9

$ 40.91

z;: 74:01 73.93 91.20 83.87

E: 78195 90.42 94.85

103.42 102.18 109.76 115.70 102.74 103.47

EZ

:%I 97182

127.77

%‘: ;;;:;;

112:04 111.21

:fE: 129:43 118.38 107.28 106.78

74.42 107.90 114.94 109.07

:::.t: 117:15

0.379 0.534 0.612 0.686 0.685 0.845 0.777 0.794 0.793 0.732 0.838 0.879

0.959 0.947 1.017 1.072 0.952 0.959 1.043 0.992 0.989 1.057 0.907 1.184

1.048 0.999

:% 1:038 1.031 1.195

:-% 1:097 0.994 0.990

0.690 1.000 1.065 1.011 1.142 1.318 1.086

373

Page 42: MEDICAL INSURANCE CLAIMS - Society of Actuaries

TABLE A4-Continued

Duration

1 mo 2 mo 3 mo 4 mo 5 mo 6 mo 7 ma 8 ma 9 mo

10 mo II mo 12 mo

- I I

1 6;653;051.38 5,885,274.04 5,723,328.28 5,042,557.82

12mo.; (

105,883 97,695

2% 81:428 75,988 70,170 65,797 60,705 :y;s

2 47:0x!

13 mu 14 mo 15 mo 16 mo 17 mo 18 mo 19 mo 20 mo 21 mo 22 mo 23 mo 24 mo

4,334,361.48 3,816,147.61 3,394,565.07 3,473,860.28 2,822,394.29 2,857,943.24 2,357,096.10 1.837.956.39 1;369;670.52 1,796,245.06 1,775,970.63 1,513,599.22

40,142 34,563 30,565 26,459

%“,: 191139 16,815 14,884 13,154 12,629 12,079

25 mo 1,868,272.33 10,891 26 mo 1,207,064.98 10,128 27 mo 1,595,642.10 9,591 28 mo 1,123,928.84 8,759 29 mo 1,275,958.78 8,315 30 mo 885,329.11 8,015 31 mo 1,194,481.08 7,492 32 mo 1,110,951.14 7,195 33 mo 1,306,570.49 6,795 34 mo 1,085,164.42 6,656 35 mo 854,168.73 6,437 36 mo 851,812.32 6,288

76,841,432.98 31.349.809.89 i4;359&4.32 7,749,440.18 4,759,154.80 2,121,942.90 3.369.550.74

888,216 265,996 96,562

:3E 14:346 24,137

374

Ed ;3:;; 96:50

110.21 109.60 104.47 111.19 107.17

107.98 110.41 111.06

t:;z 131:31

:fE 92:02

136.56 140.63 125.31

171.54 119.18 166.37

::.:: ;;g:;;

154:41 192.28

;Ezl 135:47

86.51 117.86 148.71 140.53

:‘6:;;’ 139.60

%z 0:649 0.732 0.700 0.776

i-i:: 0:930 0.886 0.943 0.909

0.916 0.937 0.942 1.114 1.006 1.114 1.045 0.927 0.781 1.159 1.193 1.063

1.456 1.011 1.412

:-2; 0:937 1.353

:*2’: I:383 1.126 1.149

0.734 1.000

Page 43: MEDICAL INSURANCE CLAIMS - Society of Actuaries

TABLE All-Continued

Duration

Adjusted Incurred aaims

Monthly Ibqmsure

Adjusted

Monthly Claim Cm

Durational Slope

1 mo 2 mo 3 mo 4 mo 5 mo 6 mo 7 mo 8 mo 9 mo

10 mo

::z

13 mo 14 mo 15 mo 16 mo 17 mo 18 mo 19 mo 20 mo 21 mo

Ei 24 mo

E: 27 mo

ZEi: 30 mo 31 mo 32 mo 33 mo 34 mo 35 mo 36 mo

:g: 3 yr

g 6yr 7+ yr

:orm: Short; Precxis

$ 4.249,831.42 6,204,150.03 6,906,299.11 6,624,891.83 6,502,150.59 5,814,691.73 5,834,380.67 5,704,280.88 5,759,102.53 4,976,158.00 4,370,872.72 3,916,189.69

3,124,265.07 2.720.418.29 2.641.627.13 1,880,756.77 1,929,095.43 1,491,008.73 1,182,510.94 1,174,670.22 1,149,204.60 1,228,534.53 1,023,912.85 lJ99.523.07

997,720.39 1,122,159.10 1,023,875.30

;;;P;~.;;

879:529:15 1,240,306.67

951,863.57 990,001.86 714,116.37 730,636.22 928,709.41

66,862,999.20 20,745,527.63 11,315,921.38 8,839,048.15 3,429,987.85 2.125.733.78 4;173;5$6.41

: 12 mo.; (

38,543 34,603

27,879

:% 17:216 15,054

1p size: 15-2:

s ‘s::: 99:17 99.10

101.92 95.98

104.32 109.55 119.73

:fE

113:17

112.07

:Ki 109:24 128.15

;iE-:; 114:58 125.04

153:10 :iE

6,311

5,935 156.48

683,847 172,594 75,275 51,210 27,428 12,741 24,252

97.77 120.20 150.33

%z 166:84 172.09

0.454

8% 0:824 0.848 0.798

Ef!i ;:;W& 0:943 0.942

0.932

%T pg 0:903 0.853 0.953

:%! 1:033 1.274

1.171 1.323 1.238 1.156 1.116 1.159 1.691 1.360 1.433 1.041 1.029 1.302

0.813

:E 1:436 1.040 1.388 1.432

375

Page 44: MEDICAL INSURANCE CLAIMS - Society of Actuaries

TABLE A4-Continued

Duration

Adjusted Incurred Claims

Monthly Exposure

Adjusted Monthly

Claim Cost Durational

Slope

1 mo 2 mo 3 mo 4 mo 5 mo 6 mo 7 mo 8 mo 9 mo

10 ma 11 mo 12 mo

13 mo 14 mo 15 mo 16 mo 17 mo 18 mo 19 mo 20 mo 21 mo 22 mo 23 mo 24 mo

25 mo 26 mo 27 mo 28 mo 29 mo 30 mo

z1 iti 33 mo 34 mo 35 mo 36 mo

1 Yr 2 Yr 3 yr 4 yr 5 Yr 6~ 7+r

2;681.28 1.502.48 yyg

241129154 28.384.80 10;995.04 10,771.28

7,610.52 12.251.30 29J75.73 4.230.92 5,141.45

13.854.46 20,897.31 40,776.90 12,444.36 3,164.20

13,453.83 32,277.09

15,335.51 42,321.85 y?;;;.g

p;:;:

8:814:26 10,430.54 42,885.21 23,707.22 16,425.20

263,061.42

100,409.04 195.278.07 457;682.97 350,964.53 249,088.68 1y;.;;

. .

Group Siz .;

s 1;E 3,820:13 1,;;;t.g

214:64 SOS.32 348.55 861.77

1.13s.39 379.14 371.42

237.83 382.85 648.35 108.49 146.90 407.48 549.93

1,199.32 401.43 102.07 395.70 978.09

%Z 398:64 119.59 240.13 210.99 163.23 146.91 714.75 333.90 248.87

4,047.10

590.64 467.17 754.01 489.49 523.30 701.10 546.31

0.026 0.424 8.177 3.005 0.574 0.459 1.082 0.746 1.845 2.430

::% 0.509

L%: 0:232 0.314 0.872 1.177

;*‘Bz 0:218 0.847 2.094

0.965 2.059 0.853 0.256

K; 0:349

t::;: 0:715 0.533 8.663

1.264 1.000 1.614 1.048

:% 1:169

376

Page 45: MEDICAL INSURANCE CLAIMS - Society of Actuaries

TABLE Al-Continued

Duration

Adjusted ItlCUmd aah

Monthly Exposure

Adjusted Monthly

Claim Cost Durational

Slope

h

1 mo 2mo 3 mo 4 mo 5 mo 6 mo

z:: 9 mo

10 mo 11 mo 12 mo

13 mo 14 mo 15 mo 16 mo 17 mo 18 mo 19 mo 20 mo 21 mo 22 mo 23 mo 24 mo

:z Fl: 27 mo 28 mo 29 mo 30 mo 31 mo 32 mo 33 mo 34 mo 35 mo 36 mo

a; 3Y

2; 6yr 7+ yr

491444.81 48;087.45

139,332.35 81,411.77 28,512.16 43,369.32 83,329.90

123.078.03 931474.09

155,687.31 129.714.07 100,252.98 105,030.18 213.975.96 lOQ74.26 41,053.93

102.721.75 74,190.70

113,244.17 69.447.21 521976.56

p&g.;;

323:068:9Q 5ggs;;.3”;

92:746:63 69,030.18

: Guaranteed Issue; Preexisting: 12 n

339 433

820,145.98 1,263,169.08 2,375,852.41 1.249.760.08 1;190;165.56

5S1.478.01 107,627.64 L

416 472 465 473 496 498 605 634

:z

718 700 71.5 696 699 659 621 710 667 654 651 650

613 575 583 581

:i; 612 631 645 713 726 740

6,284 8,140 7,599 8,204 5,754 3,014

852

10. ; Group Sire

a 45.07

::E 104:76 103.41 294.57

‘EZ 71:68

131.44 174.83 124.80

216.83 185.31 140.21 150.91 306.12

‘2:;’ 14i68 111.23 173.16 106.68 81.50

:!E ;&

117:55 555.01

%i? 881:52 119.42 127.75 93.28

130.51 155.18 312.65 152.34

%G 126:32

-4

0.290 0.878 0.865 0.675

%f? 1.058 0.369 0.462 0.847 1.127 0.804

1.397 1.194

i%i 11973 1.026 0.426 0.932 0.717 1.116 0.687 0.525

2.480 1.028 1.208 1.066 0.757 3.577 3.232 3.299 5.681

Eu” 0:601

0.841 1.ooo 2.015 0.982 1.333 1.179 0.814

377

Page 46: MEDICAL INSURANCE CLAIMS - Society of Actuaries

TABLE A4-Continued

Duration

Adjusted lwurrcd ClhllS

Monthly Expaurc

Adjusted Monthly

Claim Cost Durational

SlOpc

Form: Guaranteed Issue; I

‘----pm& 1 mo 2 mo 3 mo 4 mo 5 mo 6 mo 7 mo 8 mo 9 mo

10 mo 11 mo 12 mo

13 mo 14 mo 15 mo 16 mo 17 mo 18 mo 19 mo 20 mo 21 mo 22 mo 23 mo 24 mo

25 mo 26 mo 27 mo 28 mo 29 mo 30 mo 31 mo 32 mo 33 mo 34 mo 35 mo 36 mo

:;: 3 yr

:c f-5~ 7+ Y

362;246.59 384,534.60 Q.;,O@&

487:893:34 704,201.70 618J12.27 611,517.30 520,472.66

842.560.80 675.594.42 582.235.81 egg;

686:209: 18 489,235.40 512,017.96 531,961.30 715,966.80

1,172,389.73 731,368.66

329JN2.09 2,407 327,675.72 2,323 283.460.36 2,286 309,235.76 2,268 450,531.45 2,193 491,444.49 2,131 467,306.30 1,912 320.767.86 1,893 186,013.78 1,893 219,202.94 1,917 175,534.89 2,002 247,012.19 2,017

5,501,387.94 8,269,827.70 3,807,187.83 3,740,261.75 2,810,200.03 1,580,775.65

440,640.10

xisting: 12 ma; Grow Size: S-9

93.57 / 0.476 129.71 j 0.660 114.18 117.28 :

0.581 0.597

100.46 0.511

4,709 4,486 4,143 3,872 3,723 3,539 3,198 3,203 2,968 2,870 2,753 2,629

178.93 150.60

f%: ;7&

152:98 159.86 179.23 249.47 425.86 278.19

136.69 141.06 124.00 136.35 ;g$t 244:4; 169.45 98.26

114.35 87.68

122.47

59,593 42,093

:% 16:432 9,267 3,430

92.32 196.47 150.83 161.40 171.02 170.58 128.47

378

0.911 0.767 0.715 0.875 0.909 0.987 0.779 0.814 0.912 1.270 2.168 1.416

i% 0:631 0.694 1.046 1.174 1.244

Ei 0:582 0.446 0.623

0.470

A%i

EX 0:868 0.654

Page 47: MEDICAL INSURANCE CLAIMS - Society of Actuaries

TAEiLE A4-Continued

Adjusted Incurred Claims

Monthly Exposure

Adjusted Monthly

Claim Cost

WI

1 mo 2mo 3 mo 4 mo 5 mo 6mo 7 mo

E: 10 mo 11 mo 12 mo

13 mo 14 mo 15 mo 16 mo 17 mo 18 mo 19 mo 20 mo 21 mo 22 mo 23 mo 24 mo

25 mo 26 mo 27 mo 28 mo 29 mo 30 mo

:1 rl: 33 mo 34 mo 35 mo 36 mo

;; 3 Yr 4 Yr 5 Y' 6 Y' 7+ yr

Gunrananrccd Issue; PI dsting: 12 m

% 128,814.59 2,672 159,386.75 2,923 221,391.54 3,357 268,122.09 3,475 712,097.45 3,666 549,312.lO 3,845 430,560.50 3,956 345,673.96 4,078 491,600.42 4,094 601.082.08 368;264.76

4,092 4,065

461,398.37 4,017

533,750.94 580,787.37 588,449.38 526.613.46 4661443.81 442,700.58 .531,271.56 463,242.75 266,738.60 282,566.M 427,909.27 241,663.26

143,840.87 146,832.94 172.582.26 189;660.15 82,181.04

150.111.94 204.410.72 $ygg

148:956:20 102;096.93 92,361.67

4,737,704.61 44,240 5,352,137.83 31,579 1,767,733.31 12,395 1,282,940.76 8,331

828,279.43 6,834 435,967.78 3,473 154,828.44 1,523

1,285 1,279 1,109 1,128 1,110 1,061

995

z!

iE 815

Group Sk

S 48.21

t% 77:16

194.24

%-i: 84177

E-i: 90:59

114.86

141.84 163.42 174.93 161.84 152.98 161.28 214.57 200.28

;z-:: 259:50 161.00

111.94 114.80

:E: 74:04

141.48 205.44 211.00 140.42 166.62 124.81 113.33

107.09 169.48 142.62

:I% 125.53 101.66

- I Durafional

Slope

-14

0.284 0.322 0.389 0.455 1.146 0.843 0.642 0.500 0.708 0.867 0.535 0.678

0.837 0.964 1.032 0.955 0.903 0.952 1.266 1.182 0.752 0.917 1.531 0.950

0.660 0.677 0.918 0.992 0.437 0.835 1.212 1.245

8% 0:736 0.669

0.632 1 .ooo 0.841 0.909 0.715 0.741 0.600

379

Page 48: MEDICAL INSURANCE CLAIMS - Society of Actuaries

TABLE A4-Confirmed

Duration

Adjusted Incurred Claims

Momhly F.xposurc

Adjusted Monthly

Claim Cost Durational

Skp

FOll

1 mo 2 mo 3 mo 4 mo 5 mo 6 mo 7 mo 8 mo 9 mo

10 mo 11 mo 12 mo

13 mo 14 mo 15 mo 16 mo 17 mo 18 mo 19 mo 20 mo 21 mo 22 mo 23 mo 24 mo

25 mo 26 mo 27 mo 28 mo 29 mo 30 mo 31 mo 32 mo 33 mo 34 mo 35 mo 36 mo

1 Y’ 2 yr 3Y

if

7+ yr

iuarantced Issue; PI isting: 12 nx

% 93,819.05 945 82.678.21 801769.82

1,086 1,274

65,475.91 1,371 211,322.78 1,520 315,786.52 1,598 101,851.86 1,653 190,688.92 1,720 161,737.03 1,775 321,078.44 2,007 233,537.98 2,061 253,831:10 2,096

197,395.&I 247.198.60 686,204.91 362,208.60 367,486.59 223,962.28 210,933.01 670.408.14 3511749.40 96,832.80

150,718.88 115,299.59

60.118.42 93;471.09

162,214.99 167,222.25 63,274.45 71,382.22 70,979.47 62,035.16 23,472.95 27,079.40 42,279.54 31,934.35

2,112,577.62 19,106 3,680,398.64 21,605

875,464.29 6,630 339,880.48 3,330 599,472.M 4,357 386,177.04 2,777 106,833.62 a72

Gmuo Size: 15-25

-i-g

63:40 47.76

139.03 197.61 61.62

110.87 91.12

159.98 113.31 121.10

0.583 0.447 0.372 0.280 0.816 1.160 0.362 0.651 0.535 0.939

ET?

2,194

z%Y 2:204 2,146 2,007 1,751 1,658 1,515 1,388 1,177 1,088

89.97 107.95 313.77 164.34 171.24 111.59 120.46 404.35 232.18 69.76

128.05 105.97

0.528 0.634 1.842 0.965 1.005 0.655 0.707

:%i 0:410 0.752 0.622

919 65.42 0.384 858 108.94 0.640 827 196.15 1.151 768 217.74 1.278 717 88.25 0.518 581 122.86 0.721 423 167.80 0.985 372 166.76 0.979 335 70.07 0.411 288 94.03 0.552 269 157.17 0.923 273 116.98 0.687

110.57 170.35 132.05

m 139:06 122.52

0.649 1.000 0.775 0.599 0.808 0.816 0.719

380

Page 49: MEDICAL INSURANCE CLAIMS - Society of Actuaries

TASKFORCEREPORTSOFTHE COMMITTEE ON VALUATION AND RELATED AREAS*

PREFACE

This section presents the five task force reports of the Committee on Valuation and Related Areas, as follows:

I. C-l Task Forcet Report: “Bond and Mortgage Loan Default Experi- ence” and “Real Estate Loss Experience,” by Irwin Vanderhoof, Sep- tember 1987

II. C-l Task Force? Report: “A Cash-Flow Scenario Methodology for C-l Risk: Preliminary Report,” by Joseph J. Buff, October 1987

III. C-3 Task Forcej: Report: “Modeling the C-3 Risk,” by Stanley B. Tulin and Peter B. Deakins, September 1987

IV. C-3 Task Force+ Report: “The Impact on the C-3 Risk of Combining Lines of Business,” by Peter B. Deakins, January 25, 1988

V. “Combination of Risks Task Force5 Report,” by Michael E. Mateja, April 1987.

Discussions of these reports as well as of any experience study are encouraged.

*Robert W. Stein (Chairperson), Donald D. Cody, Solomon Goldfinger, James C. Hickman, Robert D. Hogue, Donald M. Keith, W. James MacCinnitie, Michael E. Mateja, Daniel 3. Mc- Carthy, Carl R. Ohman, Robert D. Shapiro, Edward S. Silins, Stanley B. Tulin, and Irwin T. Vanderhoof.

+Irwin T. Vanderhoof (Chairperson), Faye Albert, Aaron Tencnbein, and Ralph F. Vemi. $Stanley B. Tulin (Chairperson), Robert J. Malczak (Vice-Chairperson), Thomas A. Bickerstaff,

Robert P. Clancy, Peter B. Deakins, J. Helmut Engels, James A. Geyer, Paul F. Kolkman, William H. Mawdsley III, Carl R. Ohman, Terrencc M. Owens, James A. Tilley, and Michael R. Tuohy.

§Michael E. Mafcja (Chairperson), William A. Carroll, James A. Geyer, Steven D. Meyers, Stephen L. Smith, and Donald R. Sondergeld.

381

Page 50: MEDICAL INSURANCE CLAIMS - Society of Actuaries