Heather McLeod

     

Body, Mind, Soul,

Earth

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Financial Soundness and Solvency of Private Health Insurers in South Africa

Healthcare Financing, Policy and Reform

• Council for Medical Schemes (2005),  Standard Management Accounts.

 

 

 

 

• South African Institute of Chartered Accountants (2003) Audit and Accounting Guide on Medical Funds. Available on http://www.saica.co.za

 

• Marx G. L. (1992) A Report on Risk Management in South Africa’s Private Health Care Industry, Transactions of the Actuarial Society of South Africa, Vol. IX Part II.

 

• Milburn-Pyle P. (1997) Whistle Blowing, Transactions of the Actuarial Society of South Africa, Vol. XI Part III.

 

• McLeod, H.D., Slattery, P.G., & Van den Heever, A.M. (2001). The use and abuse of reinsurance in medical schemes. South African Actuarial Journal, 1, 95-117.

 

 

 

 

• Da Silva, R. (2002) Report to the LOA Health Care Standing Committee on the Medical Scheme Reinsurance Survey, July 2002

 

• Council for Medical Schemes (2002) Guidance to Trustees for submissions in respect of section 20 of the Medical Schemes Act relating to Registrar approval of reinsurance contracts.

 

• Actuarial Society of South Africa (2003), Professional Guidance Note PGN302 : Advice to South African Medical Schemes on Reinsurance. Available on http://www.assa.org.za/

• Guidance Note effective from 1 March 2003.

 

• Council for Medical Schemes (2003),  Review of the Factors that Influence Financial Soundness of Medical Schemes, Discussion Paper, Office of the Registrar of Medical Schemes,  August 2003.

 

• Council for Medical Schemes (2003),  Developing a Risk Based Regulatory Approach for the Council For Medical Schemes. Part 1: Criteria For Allocating Medical Schemes Into Impact Bands, Consultation Paper 2 of 2003, Office of the Registrar of Medical Schemes,  9 April 2003

 

 

 

Initial Research on a Risk-Based Capital Approach

 

• Halvorson A. L and Keizur C. B. (1998). Risk-based Capital Requirements for Managed Care Organizations, Milliman and Robertson Research Report. Available on http://www.milliman.com

 

• Actuarial Society of South Africa Health Committee (undated) Demystifying the US Risk-based Capital formula. Briefing note on http://www.assa.org.za

 

• Kendal J., (edited) McLeod H.. (2004) The Effect of Risk-Based Capital Formulae on South African Medical Scheme Solvency. CARe Discussion Paper prepared for the Council for Medical Schemes. May 2004.

 

• American Academy of Actuaries (1998), HORBC Task Force September 2000 Progress Report. Available on http://www.actuary.org

 

 

Financial Soundness Reporting in Other Countries

 

• Ooi B. (2005) Applying the Actuarial Control Cycle in Private Health Insurance. Presented to the Institute of Actuaries of Australia 2005 Biennial Convention 8 May – 11 May 2005. Available on http://www.actuaries.asn.au/

 

• Institute of Actuaries of Australia (2003). GN660 Financial Projections for Health Insurers. Available on http://www.actuaries.asn.au/

 

• Institute of Actuaries of Australia (2004). GN670 Financial Condition Reports  for Health Insurers. Available on http://www.actuaries.asn.au/

 

• Actuarial Standard of Practice No. 7 : Performing Cash Flow Testing for Insurers, Actuarial Standards Board, July 1991. Available on http://www.actuary.org

 

• Actuarial Standard of Practice No. 14 : When to do Cash Flow Testing for Life and Health Insurance Companies, Actuarial Standards Board, July 1990. Available on http://www.actuary.org

 

• American Academy of Actuaries (1998), Preliminary Recommendations on the Development of a Health Liquidity Test. Available on http://www.actuary.org

 

• Actuarial Standard of Practice No. 11 : The Treatment of Reinsurance Transactions in Life and Health Company Financial Statements, Actuarial Standards Board, July 1989. Available on http://www.actuary.org

 

 

[Please note this list has not been maintained since the last meetings of the Financial Soundness Working Group in 2004 and there will be papers published from 2005 onwards. Initial work was done on the issue of a risk-based capital approach to solvency but further work will be needed if this question arises again.]

Council for Medical Schemes SAAJ 2001 IMSA Policy Briefs

The Annual Reports of the Council for Medical Schemes contain detailed information on the financial status of each medical scheme.

CMS Publications