Chapter 000 Course Overview Flashcards
List the key areas that the coursework has been split into (10)
- Intro to healthcare
- Products
- Product design
- Healthcare operating environment
- Data, Assumptions, Pricing
- Modelling
- Reserving
- Nature of risks
- Risk management
- Investment
- Monitoring
What topics are covered in terms of introducing healthcare and the various healthcare products?
(1,2)
(2,4)
(3,1)
- Healthcare overview
- Intro to healthcare
- Principle concepts and terms specific to healthcare
- Core products
- Critical illness (CI)
- Long term care insurance (LTCI)
- Private medical insurance (PMI)
- H&C insurance products - group products
- Additional products
- Health cash plans
- Variations of the main example products listed above
What ares are covered in F101 w.r.t. to the environment that healthcare contracts operate in (7)
-
Environment that healthcare operates in
- Distribution Channels
- The general business environment
- regulatory and taxation regimes
- professional guidance
- economic and political influences
- Risk adjustment (?)
- State healthcare provision
What key aspects does subject F101 consider in terms of the components of a well-functioning healthcare system?
(1,3)
(1)
(1)
(1)
- Classification of care into
- primary,
- secondary, and
- tertiary care
- Key supply-side providers
- Main funders of healthcare
- Main funding models of healthcare
What key aspects are covered in the F101 syllabus in terms of the role of the State?
(1,2)
(2,4)
Consider the role of the State in the provision of
- alternative or
- complementary
…health and care protection in terms of
- objectives of State healthcare provision
- methods of State healthcare provision
- funding approaches
- impact of different approaches on society
What key mechanics are analysed in subject F101 between funding of healthcare and supply of healthcare? (3)
- risks and risk sharing between funders and providers
- role and functions of managed care organisations
- reimbursement methods of suppliers.
What ares are covered in F101 w.r.t. to
- contract design (2)
-
Contract design
- Key principles by which healthcare products are designed
- Stakeholder interests in contract design
What key topics are covered in subject F101 in relation to pricing of health and care insurance products? (9)
- Data availability
- Assumptions used
- Pricing approaches
- Equation of value and formula approach
- Cashflow techniques
- Group risk assessments
- Options
- Guarantees
- External influences
What aspects related to assumptions crucial for pricing/valutions of healthcare contracts are covered in subject F101? (11)
-
General considerations
- Purpose, consistency, suitability for task, significance, etc
-
Demographic
- Morbidity
- Mortality
- Persistency
-
Financial
- Claim amount
- Expenses
- Inflation
- Investment return
- Taxes
-
Other
- Solvency margins
- Profit requirements.
What principle modelling techniques are described in subject F101? (9)
- Objectives and basic features of a health insurance model
- How modelling might be done
- Comparison of formula and cashflow approach
- Outstanding claim provision
- Uses of models
- Asset-liability modelling
- Pricing
- Reserving, etc
- Different types of modelling
- Multi-state modelling
- Deterministic and stochastic models
- Generalised linear models
- Sensitivity analysis of modelling done
- Risk mechanics
In subject F101, what key concepts are described for reserving?
(9)
Key reserving concepts
- Purposes of reserves
- Methodologies for calculating reserves
- Role of statistical and individual case estimates
- Setting assumptions, including comparison with pricing reserves
- Market consistent valuation
- Comparison of passive and active valuation approaches
- Solvency capital requirements and embedded values
- Interplay between the strength of the supervisory reserves and the level of solvency capital required
- Value at Risk (VaR) capital assessment
What concepts are covered in subject F101 in relation to the principles and practices of supervisory reporting? (7)
- Principles of setting statutory reserves
- Difference in assumptions between supervisory reserves from pricing
- Strength of basis
- Valuation of assets and consistency
- Solvency margins and solvency assessment
- Sensitivity analysis
- Risk-based capital (requirements)
What are some of the key risks faced by insurers providing healtcare products which are covered in subject F101?
-
Business risks
- Non-disclosure and anti-selection
- Data
- Claim rates
- Claim amounts
- Expenses and inflation
- Persistency
- Mix of new business
- Volume of new business
- Competition
- Guarantees and options
- Legal, regulatory and tax developments
- Reputational risks
- Aggregation and concentration of risk
-
Credit risk
- Counterparties
-
Market risk
- Investment performance
-
Operational risk
- Actions of management
- Internal audit failures/fraud
- Catastrophes
- hysical risks
What key risk management techniques are used by insurers providing health care products?
(9 total unique points, 1 of which has 4 points)
- Reinsurance, in particulare we consider
- reasons for reinsurance
- types of reinsurance
- determining retention levels
- individual vs accumulated risks
- Data checks
- Product design
- Underwriting
- Managing the distribution process and customer relationship
- Managing other counterparties
- Claims Management
- Managed care
- Other internal processes
What key outcome(s) do(es) the section(s) on ‘investment’ cover in subject F101?
F101 describes the principles of investment underpinning health and care insurance.
