Definitions and Abbreviations

Actuarial Science means the science of projecting a future economic value using appropriate past experience.

Actuary means a Member of the American Academy of Actuaries.

AICPA means American Institute of Certified Public Accountants.

ASO means administrative services only.

Census means the enumerated and summarized count of participants and covered persons.

Claim means the amount of the benefit to be paid by the Plan.

Claim Reserve means incurred and unpaid claims on the valuation Date for the designated benefits and may include or exclude claims above the special stop-loss limit.  Such claim reserve may or may not include a margin of error.  Such claims reserves may or may not make an allowance for claims processing expenses or for lawsuits.

Claims Administrator means the TPA.

Conflicted Interest means the financial motivation that precludes a professional from being unbiased.

Covered Person means the participant and all covered dependents.

Cybernetics means computer science.

Database is the reservoir of data of a permanent and descriptive nature as respects the Plan, Plan Sponsor, and Eligible Users.

Distributions of the Certification means how the System will distribute the Work-Product among the multiple parties – Eligible User, Plan Sponsor (Contact Person), Plan Accountant, e.g.

DOL means Department of Labor.

Due Diligence means the process of determining that the established rules and protocol are, or will be followed.

Eligible User means an individual, approved by Actuarial Work-Products, Inc. to enter the Model and use it to obtain Work-Products.

Facsimile Signature means a computer-prepared signature as opposed to an non-facsimile signature (inked).

FASB means Financial Accounting Standards Board of the AICPA.

FSA means Fellow of the Society of Actuaries.

GASB means Government Accounting Standard Board of the AICPA.

GDP means Gross Domestic Product.

Health Plan means and employee benefit plan offering medical, Rx, dental, vision or short term disability using self-funding, traditional insurance, a prepaid medical service plan or a health maintenance organization.

HMO means Health Maintenance Organization.

HRA means Health Reimbursement Account.

HSA means Health Savings Account.

ID means identification

Inked signature means the traditional form of document-execution

Inputting Data means the entering of requisite data (numerical or alphabetical) on to the Website of the Model.  Such entry is manual but provision can be made for electronic transfer of data or it may be entered manually by Actuarial Work-Products, Inc. for a fee.

IRS means Internal Revenue Service.

Lag Study means the array of claims showing both the date paid  and the date incurred in triangular fashion.

LTD means long term disability.

MAAA means Member of the American Academy of Actuaries.

MEWA means Multiple Employer Welfare Arrangement.

MGU means the, Web-based computer system in its entirety and includes all functions thereof (input, output, data files, accounting, computations, etc.).

Monte Carlo Simulation means the statistical technique of using millions of computer-stored random numbers that are used to generate samples.

Output means the Actuarial Certificaiton or Work-Product including the imputed data and documentation attached thereto as an Appendix.

Parameters and Variables mean those inputted items that determine the output.  A parameter is fixed or static where a variable is changing or dynamic.  Both are essential with model building.

Participant means the employee covered by the Plan.

PEO means Professional Employers Organization.

Plan Sponsor usually means an Employer but it may also mean Trust or a MEWA or a VEBA.

Principal means the entity that engages the Actuary.

Professional liability means the financial risk takes by a professional when offering its services.  It also is known as E & O (or errors and omission) liability.

Risk Manager means the professional who is paid a fee (not a commission) to offer risk-related address or services to a health care plan.

Self-Funded Plans mean those which the Plan Sponsor is ultimately at risk, including ASO but excluding minimum premium arrangements.

SOP means Statement of Position of the AICPA.

Specific Stop-loss limit means that point at which the stop-loss carrier assumes the claims obligation.  With other funding methods, the term would include trigger-point, reinsurance limit, benefit-cap, e.g.

Stop-loss means the insurance protection purchased by the Plan Sponsor to limits its losses with a self-funded health care plan.

STD means Short Term Disability.

Submitted Data means the inputted information and documentation needed to make the mathematical model function.

Third Party Administrator means the professional firm that is paid a fee to supervise a health care plan.  Supervising means recordkeeping and claims processing.

Trade and Commerce Laws are those federal laws codified in 15 USC §§1, et seq., such as the Sherman Antitrust Law, et al.

User means any person who uses this Website.

User Name means the designation of the Eligible User.

User Password means the password assigned to the Eligible User for privacy purposes.

Valuation date means the date at which time the Claim Reserve, liability is measured.

Work-Product means an actuarial certification report or opinion with (a) predetermined and easily accessible inputted data and documentation; (b) fixed-global fee (no billable time); (c) standardized report format; (d) high quality assurance; (e) sometimes dependent on Web-based computational protocol available only to secured users; (f) may use a facsimile signature subject to conservative disciplines and (g) clearly delineated and understood rules of privacy and professional liability.