CUMMING: Our topic is gross premium valuations for health business. We
have three presenters today. Our first presenter will be Peggy Hauser. She is with the Long Term
Care Group, which is a long-term-care managed care company. It provides administrative services
and reinsurance services for blocks of long-term-care business. Peggy's role at the Long Term Care
Group is to provide product design, pricing, and financial analysis. She is going to be talking about
a case study on long-term-care gross premium valuations.
Our second presenter will be Ross Bagshaw. Ross is with the Provident Companies. Ross is going
to talk about gross premium valuations from an individual disability income (IDI) perspective. Ross
is in charge of individual DI valuation at Provident, which is one of the biggest carriers in the
individual DI business. It has over $7 billion of reserves for individual DI business. I'm going to
wrap up the talk by going through a case study from a client project we did for a medical gross
premium valuation.
MS. PEGGY L. HAUSER: The health insurance reserves model regulation gives a definition of
what a gross premium valuation is. It is the ultimate test of reserve adequacy, and it needs to take
into account all expected benefits that are unpaid, and all expected, unearned or expected premiums.
When is it important to do a gross premium valuation? Again, that same model regulation says it's
important to do a gross premium valuation whenever a significant doubt exists as to reserve
adequacy. The keynote speaker at the general session said that the NAIC is also contemplating
requiring a gross premium valuation whenever you're doing a Section 7 opinion. A Section 7
opinion now includes language that says: The reserves and related actuarial items are computed
according to standard actuarial practice and are at least as great as the actuarial present value of the
difference between future cash-flow disbursements and future cash-flow receipts calculated using
best-estimate assumptions.