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Regulators closer to replacing 1985 cancer claim tables

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Regulators are getting closer to replacing cancer insurance claim cost tables that were adopted when Ronald Reagan had just started his second term as president of the United States.

The Health Actuarial Task Force, part of the Kansas City, Missouri-based National Association of Insurance Commissioners, has a cancer claim cost valuation tables project proposal on its agenda for the NAIC’s upcoming fall meeting.

Related: Regulators post cancer table update drafts

The NAIC is set to start its meeting in Miami tomorrow. The Health Actuarial Task Force has scheduled a session for 3 p.m. tomorrow.

Members of the task force plan to talk about topics such as actuarial professionalism, long-term care insurance and the struggling Affordable Care Act insurer risk management programs as well as cancer insurance.

Issuers of cancer insurance are using official cost tables adopted in 1985 and based on cancer claims filed through 1978 through 1980.

Actuaries at the Washington-based American Academy of Actuaries and the Schaumburg, Illinois-based Society of Actuaries recently created a new cancer insurance experience study by collecting data from 15 cancer issuers. The issuers provided information about claims filed from 2001 through 2010.

The actuaries who analyzed the data found that, possibly because screening programs are catching cancer when it is easier to treat and patients are spending less time in the hospital, typical claimants in their 40s are now filing only about $5 in claims per $100 in daily hospitalization benefits, down from about $20 to $30 per $100 of daily benefits in the late 1970s.

The study team looked only at the cost of the first occurrence of cancer and hospitalization, and not of providing benefits such as radiation or chemotherapy.

Tomasz Serbinowski of Utah, the regulator who chairs the actuarial task force Cancer Claims Cost Table Subgroup, reported in a memo included in the task force meeting packet that the Washington-based America’s Health Insurance Plans and Colonial Life & Accident Insurance Co., a unit of Chattanooga, Tennessee-based Unum Group Inc. that sells cancer insurance, have supported the idea of developing new cancer insurance cost tables based on the new study.

Colonial Life and some other interested parties would like to get more guidelines about how to use the new data, Serbinowski wrote in the memo.

Colonial Life suggested, for example, that regulators should give insurers guidelines on how to apply the new tables to family coverage.

Colonial Life also recommended that regulations and guidelines take a careful approach to applying the data, in case various risk factors, such as the possibility that the people who buy cancer insurance might be at an especially high risk of developing cancer, throw off efforts to develop adequate claim cost reserves for the first occurrence of cancer and hospitalization.

Commenters noted that the new tables will probably cut cancer insurance reserving requirements for first occurrence and hospitalization benefits. That could help issuers cut premiums on cancer insurance while earning higher profits. 

Subgroup members said in comments that insurance company actuaries will have to use their own data and judgment to establish reserves for benefits related to radiation treatment, chemotherapy, and surgical procedures that fall outside the scope of the new cancer insurance experience study.


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