the apothegm software experience rating
TRANSCRIPT
Model Rating Strategies
•Experience Rating
•Manual Rating
Compare Enterprise Level Results
•Actual vs. Expected
Primary Deliverables…
Monitor Rating Strategy and impacts to the
distribution of Rate Increases and Loss Ratio by:
Features
•Health Plan
•Business Segment
•Group
•Plan
Test the implications of rating variables across
multiple years and apply different methodologies
by user defined Group Size…
Features
Manage variations in plans from group to group
with Claims Normalization and Adjustment
process…
Features
Experience Period Claims
Remove Experience Period Plan
Factor(s)
NormalizedClaims
Adjust Claims to Current Plan
Factor(s)
AdjustedClaims
Adjust Claims to Current
Enrollment Distribution
Examine and balance Pooling Charges and
Pooling Credits…
ExcessClaims
Total Claims
TrendIndexing
DollarTo
Dollar
Features
Large Claims
Pooling Credit and Charges
Rating Process
10 Stage Actuarial Rating Engine
• Rating data is processed modularly in 10 steps. This provides for:
• Simplification of rating method; greatly reducing the time and effort needed
to update or change components within the rating process.
• Greater flexibility in adapting to new business needs.
• Easy auditing of rating data.
• Rapid recalculation of rates after manipulation of rating variables.
Paid Claims
Large Claims
Claims Normalization
and Adjustment
PoolingExperience
Rate
Summary Data and Extracts
Credibility Blended
Rate
Presentation Rate
Rating Process
RatingProcess
Stages
Manual Rate
Enrollment(Current and Experience
Period)
Rating process
Data extraction flow
Experience Rate
Credibility Blended
Rate
Rating Process
Controls
Set ranges for group Pooling Class…
Set Pooling Point by Class…
Set Pooling Method by Class…
Balance Pooling and
Large Claims
Rating Process
Controls
Set the experience period and contract duration…
Adjust credibility…
Experience Rate
Credibility Blended
Rate