LOGIC-BASED FORMULA MANAGEMENT STRATEGIES IN AN ACTUARIAL CONSULTING SYSTEM

In many decision support systems, multiple decision methods and models must be combined for solving a complex problem. Expertise is required for selecting, adapting and coordinating appropriate models. This paper describes the design and implementation of a knowledge-based model management system called the Actuarial Consulting System (ACS). The ACS supports actuaries in making pricing decisions in the domain of life insurance. Actuarial knowledge is organized using a graph formalism called Formula Derivation Network (FDN), represented in Prolog as a hierarchy of predicates. On the user level, a Problem Analyzer converts a problem specification by the user into a search problem on the stored collection of FDNs. Using different search strategies, including human expert rules, the Surface Planner generates an efficient solution strategy (sequence of models). At the lowest level, a Plan Executor retrieves or requests model data and issues appropriate function calls to a subroutine library.Information Systems Working Papers Serie

LOGIC-BASED FORMULA MANAGEMENT STRATEGIES IN AN ACTUARIAL CONSULTING SYSTEM

In many decision support systems, multiple decision methods and models must be combined for solving a complex problem. Expertise is required for selecting, adapting and coordinating appropriate models. This paper describes the design and implementation of a knowledge-based model management system called the Actuarial Consulting System (ACS). The ACS supports actuaries in making pricing decisions in the domain of life insurance. Actuarial knowledge is organized using a graph formalism called Formula Derivation Network (FDN), represented in Prolog as a hierarchy of predicates. On the user level, a Problem Analyzer converts a problem specification by the user into a search problem on the stored collection of FDNs. Using different search strategies, including human expert rules, the Surface Planner generates an efficient solution strategy (sequence of models). At the lowest level, a Plan Executor retrieves or requests model data and issues appropriate function calls to a subroutine library.Information Systems Working Papers Serie

Analysis of HHS Final Rules on Reinsurance, Risk Corridors and Risk Adjustment

Summarizes final rules for states and health insurance plans for minimizing adverse selection under federal healthcare reform and highlights changes from proposed rules. Outlines implications for states and plans, as well as outstanding issues

Analysis of HHS Proposed Rules on Reinsurance, Risk Corridors and Risk Adjustment

Offers questions and answers about rules for lessening the financial risk of health insurance issuers and exchanges under healthcare reform. Outlines steps for states and health plans, outstanding issues, and operational impact on states

Addressing the Pension Dilemma in Canada

The purpose of this paper is to advance understanding of defined benefit pension plans in Canada by focusing on important questions related to the funding, accounting and policy aspects of management of defined benefit pension plans. As well, the paper aims to impart a reasonable estimate of the standing of defined benefit pension plans at December 31, 2003 and to explore potential remedies for consideration by stakeholders inclusive of legislators, regulators, standard setters, employers and members. The analysis shows that at December 31, 2003, 59% of Canadian defined benefit pension plans continued to be in deficit. That number rises to 95% if provided for indexation of benefits. It is expected that an additional $160 billion is required to fully fund those deficits (assuming indexation of accrued benefits). Given that the future prospects of equities market performance are relatively conservative, it is unlikely that stock market returns alone will correct the situation; at least in the short term. On a solvency basis,$15 billion per year will need to be injected into defined benefit pension plans over the next five years to make up for the investment losses. Pension regulators must take a more proactive approach and monitor more closely pension plans that are in a deficit position.defined benefit pension plan, funding position of pension plans, household savings, retirement savings, retirement income, household finance, pension accounting

Reinventing the Risk Sharing Mechanism of Defined Benefit Pension Plans

In this paper, I will introduce several new mechanisms of risk sharing regarding occupational retirement provisions, based on the analysis of present risk sharing between sponsoring employers and plan participants, individual participants and participants as a group, active members and beneficiaries (including deferred members), etc. Among others, I will introduce "Ring-fenced" DB (RfDB) plans, which introduce "share" structure into contributions and reserves, prohibit "lending" from active members to beneficiaries when the plan is in an underfunded status (actuarial deficiency), and allow temporary benefit reductions within prescribed ranges according to the funding level. The risk active members bear will be eased in RfDB plans, and market interest risk sponsoring employers bear will also be eased, because some portion of benefits becomes conditional. RfDB plans allow investments with greater risk tolerance, which may benefit both labor and management from a long-term perspective. It will also be possible to ease funding rules substantially for RfDB plans. It is said that DB plans are on the verge of extinction mainly by the threats from accounting standards. Taking this into account, it is necessary to expand the variation of risk sharing mechanisms in occupational retirement provisions."Ring-fenced" DB plan, "Retrospective" DB plan, Sequential plan, Combination plan, Collective DC plan, DC conversion

Sustaining the Medical Home: How PROMETHEUS Payment Can Revitalize Primary Care

Argues for reforming the current fee-for-service payment system on the PROMETHEUS model of budgeting for a comprehensive episode of care for a condition. Analyzes the implications for a sustainable patient-centered medical home model of care delivery

DESIGNING EXPERT SYSTEMS IN A BUSINESS ENVIRONMENT

The integration of an ES into a business environment presents a different set of problems to the designer. First, it can be difficult to isolate and draw boundaries around the domain of the business problem. Second, there is often a need to generate a large number of expert decisions in a short period of time. That is, there can be many transactions requiring some expertise to process, such as applications for life insurance. Finally, there may exist a number of computerized transactions processing systems which interact with very large databases and there may be a need to integrate the ES with these existing systems. This paper discusses these general issues involved in developing expert systems for business applications, with particular examples drawn from the domain of insurance underwriting.Information Systems Working Papers Serie