Health Maintenance Organization

Information concerning how our work-products might be of interest to a Health Maintenance Organization is given below.

Interest in Work-Products

The HMO might have either a general or a specific interest in Work-Products.

General Interest

By being an Eligible User of Work-Products, the HMO will, in effect, have its own staff actuary and be able to offer the same full range of services that are offered by some of the larger competitor HMOs..  Being shut out of a bidding opportunity should not be common. There are, however, several additional and significant advantages in using Work-Products: (a) the HMO has no actuary salary or upkeep expenses and (b) there are no potential E & O liability issues associated with Work-Products. Also, the Eligible User will have ready access to the full reservoir or data, experience and knowledge of Actuarial Work-Products, Inc. The Actuary is engaged by the HMO (Eligible User) and has no relationship with the End User (plan sponsor, e.g.); as such, the HMO has the fee-payment responsibility. The HMO will be able to use the Menu of Work-Products to either supplement, complement or replace many of the services that the HMO obtains from outside sources (typically actuarial consulting firms).

Specific Interest

Each of the principal officers of the HMO (actuary, risk manager, financial and accounting officer or human resource director) will have an active interest in one or more all the Work-Products.  The responsibility of each officer will determine such interest. The financial and accounting officer will have in interest in claim reserves; the actuary will have an interest in nearly all of the Menu and the human resource director will have  an interest in the simulations designed to measure benefit content.

Associations

The Health Maintenance Organization (HMO) might be a member of any of the following risk assuming related professional or trade associations:

          American Association of Health Plans
          American Council of Life Insurance
          America’s Health Insurance Plans
          Insurance Institute of America
          International Foundation of Employee Benefit Plans
          American Council of Life Insurance
          American Insurance Association
          Insurance Institute of America
          Risk Management Association.

Journals

Other than Association-sponsored Journals, the HMO might subscribe to these Journals:

          Risk Management.

Magazines

Periodicals that accept advertising that might be subscribed to by the HMO might include the following:         

          Risk and Insurance
          Business Insurance
          National Underwriter
          Best Review(s)
          Insurance Journal
          Rough Notes
         Computer World