Actuarial Crossword

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Across
  1. 1. - A fixed amount one pays for a covered health care service after the insured pays the deductible
  2. 3. Care Organization (MCO) - The entity contracting with the state Medicaid agency to provide health care services for selected subsets of the Medicaid population.
  3. 4. - The rate of disease in a population.
  4. 6. Communication - A written, electronic, or oral communication issued by an actuary with respect to actuarial services
  5. 8. - The incidence of death in a population.
  6. 11. But Not Reported Reserve Provision (IBNR) - Amount owed by an insurer to all valid claimants who have had a covered loss but have not yet reported it.
  7. 12. Assessment - is the quantification of actuarial risk
  8. 13. Value - a numerical value assigned to a given set of actuarial risks that is determined using an actuarial model of those risks
  9. 14. - Portion of the insured loss (in dollars) paid out of pocket by the policy holder before an insurance provider pays any expenses
  10. 15. razor - Also known as the law of parsimony
  11. 18. - Percentage of capitation held back pending performance
  12. 19. - Liability set aside to pay future claims
  13. 20. - a person who applies mathematical approaches to anticipate, measure and manage risk.
  14. 21. Corridor - Shared gain/loss arrangement between state and plan
Down
  1. 1. - A measure of the extent to which a change in one random variable occurs simultaneously with a change in another random variable.
  2. 2. - A measure that takes on values from zero to one and gives the likelihood of occurrence of an event.
  3. 5. - A transaction between a primary insurer and another licensed (re)insurer where the reinsurer agrees to cover all or part of the losses and/or loss adjustment expenses of the primary insurer, for a premium.
  4. 7. - A document or request filed by a policyholder, beneficiary or other stakeholder stating that an insured event has occurred and that the insurance company should provide coverage.
  5. 9. Withhold—An amount included in the capitation rates that is paid if the MCO meets certain state requirements that may be related to quality or operational metrics
  6. 10. Adjustment—The process by which relative risk factors are assigned to individuals or groups based on expected resource use and by which those factors are taken into consideration and applied
  7. 13. - General term for smoothing numerical information using a set of data points to arrive at a single value (measure of central tendency) to represent those data points.
  8. 16. - The greater tendency of people with a more than average likelihood of loss to apply for or continue insurance, when compared with other people.
  9. 17. Amount - The maximum amount a plan will pay for a covered health care service.