U.S. Medical, Dental, Vision, Pharmacy Specialist

2 sequenced courses

GH 101
Benefits and Pricing ▼
  • Plan & Product Provisions: Understand how to describe plan provisions typically offered under short-duration contracts (medical, dental, vision, prescription drug, group life).
  • Manual Rates: Calculate and recommend a manual rate for each of the contracts described in Learning Objective 1.
  • Underwriting & Funding: Apply principles of pricing, risk assessment, and funding to an underwriting situation.
  • Employee Benefits: Evaluate and recommend an employee benefit strategy.
  • View course page to access the syllabus and see the enhancements.
GH 201-U
Valuation and Regulation, U.S. ▼
  • Reserving: Apply valuation principles for short duration group and health insurance contracts.
  • Financial Statements: How to prepare and interpret insurance company financial statements in accordance with Statutory Accounting Standards and GAAP.
  • Regulation: Evaluate the impact of regulation on insurance companies and plan sponsors in the U.S.
  • Government Programs: Describe government programs providing health benefits in the U.S.
  • Flow of Funds: Describe the flow of funds in the health care system and the role of providers in the system.
  • View course page to access the syllabus and see the enhancements.

2 additional courses

GH 301
Health Analytics and Management ▼
  • Provider Contracting and Reimbursement: Evaluate the effectiveness of provider reimbursement methods from both a cost and quality viewpoint.
  • Disease Management: Evaluate health care intervention programs.
  • Health Care Risk Adjustment: Apply risk adjustment in actuarial work.
  • Social Determinants of Health: Explain the determinants of health (SDOH) and their impact on health care costs and policy.
  • Medical Data: Describe medical coding, sources of data, and data quality.
  • Predictive Analytics: Apply the framework of predictive analytics to health care data and business applications.
  • View course page to access they syllabus and see the enhancements.
CFE 101
Enterprise Risk Management ▼
  • Enterprise Risk Management Foundations: Understand the fundamentals of ERM and be able to apply them to organizations.
  • Risk Analysis and Evaluation: Understand the types of risks faced by an entity and be able to identify and analyze these risks.
  • Embedding ERM into Decision Making: How an organization can articulate its approach to risk and how to assess risk and return trade-offs. The candidate will understand the approaches for managing risk. The candidate will understand different concepts of risk capital, risk measures in capital assessment and techniques to allocate risk capital once aggregated.
  • View course page to access the syllabus and see the enhancements.
or
CP 321
Disability, Long-Term Care, and Long-Duration Health Contracts ▼
  • Plan & Product Provisions: Describe benefits typically offered under long-duration contracts (disability income, long-term care, critical illness, Medicare Supplement).
  • Manual Rating: Calculate rates for each of the contracts described in Learning Objective 1.
  • Reserving: Apply valuation principles for long-duration contracts.
  • Financial Statements: Prepare and interpret insurance company financial statements for long duration contracts.
  • Retiree Group Benefits: Design and perform valuations of Retiree Group Benefits.
  • Asset Adequacy: Apply asset matching and asset adequacy standards as they apply to long duration contracts.
  • View course page to access the syllabus and see the enhancements.