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Post by Admin on Jan 4, 2017 23:04:50 GMT -8
Feel free to ask any questions, we will try to answer all of them. However, please be aware that some questions might not be answered. Best of luck!
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Post by Hi on Jan 11, 2017 18:15:54 GMT -8
Is the "Amt Allowed" described in the claims data sheet the amount allowed PER utilization or the total amount allowed? Thanks Does the "Amt Allowed" mean for example, $0.01 is the max amount an insurer will pay? thank you!
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Post by Admin on Jan 11, 2017 20:46:27 GMT -8
Hi. I am a freshman FAM student and I just had a glance on the case competition's outline. I find that my knowledge is too limited to help my teammates do the project or even just understand the materials because I did not take any actuarial related courses yet and I did not take any actuarial exam. I am willing to put effort on this project but it seems that one week is not enough to learn what suffices to know to do the project. How can I help my teammates? Any advice? Hello, Don't be intimidated by the case; it's normal for everyone to experience a very steep learning curve when it comes to case competitions, and it's good that you're willing to put in effort in order to contribute. While you might not be as experienced as your teammates when it comes to performing actuarial calculations, you can always contribute by looking for relevant background information about the health insurance field and helping with the construction of your group's presentation. The most important thing to keep in mind as you're looking for ways to contribute is to make sure that you and your teammates are always on the same page and aware of what everyone else is doing, so don't be afraid to reach out and communicate with them regardless of whether or not they might be older than you. Good luck!
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Post by Stephanie@Molina on Jan 12, 2017 8:57:24 GMT -8
Is the "Amt Allowed" described in the claims data sheet the amount allowed PER utilization or the total amount allowed? Thanks Hi Brian! The 'Amt Allowed' column in the claims data sheet provides total allowed amount incurred for the claim, not per utilization.
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Post by Admin on Jan 12, 2017 11:05:57 GMT -8
Hi, I'm a senior and I have no actuarial background. I was wondering if this is still something that I will be able to do or is this not right for me? Hi, you do not need to have an actuarial background to do this case. It is designed to be a great opportunity for you to learn and experience the real-life problem an actuary might face at work. Good luck, and we are sure that you can do it!
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Post by Admin on Jan 12, 2017 11:06:42 GMT -8
Can a team still compete if one of its members drops out? Hi! Please contact us bruinactuaries@gmail.com directly for team member issue.
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Post by disaalda on Jan 12, 2017 12:23:52 GMT -8
Hello, I was wondering if the Total Member Months is the total Months all enrolled members are for the year, or is it specific to each category we are calculating?
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Post by disaalda on Jan 12, 2017 17:24:17 GMT -8
We would like to know why are we supposed to calculate the claims(PMPM) for individual age-gender group and then calculate the total cost PMPM? Should they be the same?
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Post by Meet on Jan 12, 2017 19:05:58 GMT -8
I found that we have more members than 5000 in the Member data. A100001-A105000 and B103751-B105000 (there might be some missing in B). Are we supposed to only consider the first 5000 member because the question says 5000 or should we adjust to 6240 members.
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Post by disaalda on Jan 12, 2017 19:12:21 GMT -8
In the demographics projections and adjustment part of the guide, "The state is redrawing the lines.... that will increase total census population in region 1 by 2%, in region 2 by 3% and decrease total census population in region 3 by 5%", we realize that the increase in region 1&2 do not offset the decrease in region 3. The sentence does not make sense if the total population stays the same. Does the population actually increase due to the redrawing of lines? Thanks.
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Post by Guest on Jan 12, 2017 21:09:21 GMT -8
I'm wondering about the sentence "...U.S. Care, your largest competitor with 35% market share in region 3, to shift to other regions, leaving some of their members to potentially choose coverage with your company"
Does this mean that after the region lines re-drawed, US Care will have market share too at other regions? Or does it mean some of the US Care members will shift to other regions and will thus choose coverage with our company (Bruin Care), but US Care will still remain only in region 3?
Thank you!
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Post by Inconito on Jan 12, 2017 22:46:59 GMT -8
How long should we expect to get an answer before concluding it is one of the questions that won't be answered?
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Post by Stephanie @ Molina on Jan 13, 2017 9:22:55 GMT -8
Is it reasonable to assume that the members that are joining in 2018 will have the same age distribution as the existing members? And how would the addition of members affect unit cost adjustment and PMPM? And is there any advice on calculating trends? Thanks These are excellent questions to ask and which are designed to be up to you to answer as part of the case. There is no right or wrong answer, and as actuaries, we make reasonable and justifiable assumptions given the all information we have. I recommend you look at historical data and all the information given on population and membership changes in the case to base your assumptions.
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Post by Stephanie @ Molina on Jan 13, 2017 9:44:41 GMT -8
Hi, I will like to know if it's correct for the number of members per region calculated using the member data to be slightly different than the number of members per region calculated using the membership marketshare on the key worksheet. If they are meant to be different which one should take precedent over the other. Thanks Great catch! We will be sending out a correction on the marketshare percentages to reflect what is in the member data. For now, please use the regional member breakdown over the marketshare information provided in the key.
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Post by MonteMash@Molina on Jan 13, 2017 9:50:24 GMT -8
I am confused about the "Rate Dev" page on the spreadsheet. Are cells B10 and B11 meant to designate the category that the rest of the cells are filled by? (i.e. should we be considering a CHOOSE function or scenario layout for this sheet?) No these are not meant to be used for a dropdown list but instead are just headers to denote how the total data was rolled up. That being said it may be useful to implement these type of functions or tools to better understand the underlying data.
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Post by Anonymous on Jan 13, 2017 11:57:36 GMT -8
What's the difference between "Area Calibration" and "Area Factors"? Is the "Area Calibration" supposed to be representative of the impact that the three distinct regions have on the Base PMPM in total? Also, is the "Age Calibration" the inverse of the "weighted average premium ratio"? After we've obtained the calibrations, are we supposed to multiply them with the Base PMPM?
What is the "Base PMPM" referring to in the "Final Premium" tab? Is it before or after we apply the separate calibrations? Is it supposed to be the "Revised PMPM" obtained from the "Unit Cost & Area" tab?
Thanks!
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Post by Anonymous on Jan 13, 2017 12:14:51 GMT -8
Do the premium ratios in the age curve indicate a strict premium ratio, or a ceiling? As in, say the premium for 21 year olds is 1,000. Does the premium for 64+ year olds have to be 3,000 or is it at a maximum of 3,000?
Thanks!
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Post by Brian on Jan 13, 2017 14:36:49 GMT -8
Hi on the sheet "Rate Dev" is there a difference between 6,7 and rows 21,22? Additionally, could you please define Experience Allowed Cost?
Thank you!
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Post by MonteMash@Molina on Jan 13, 2017 14:39:40 GMT -8
Do the premium ratios in the age curve indicate a strict premium ratio, or a ceiling? As in, say the premium for 21 year olds is 1,000. Does the premium for 64+ year olds have to be 3,000 or is it at a maximum of 3,000? Thanks! Yes the age curve is strict. An age 64+ year old premium must be 3 times the age 21 year old premium. Please strictly use the age curve factors when calculating your final premiums by age and region.
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Post by MonteMash@Molina on Jan 13, 2017 14:46:46 GMT -8
Hi on the sheet "Rate Dev" is there a difference between 6,7 and rows 21,22? Additionally, could you please define Experience Allowed Cost? Thank you! Yes, consider rows 6 and 7 as your annual trend summary table. rows 21 and 22 is where you appropriately apply the trends you are considering.
Experience Allowed Cost is a PMPM value. This is the result of applying the trend & demo/age factors to your base claims PMPM.
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