{"title":"Do pension buyouts help or hurt employees (retirees)?","authors":"Yijia Lin, Richard D. MacMinn, Tianxiang Shi","doi":"10.1111/jori.12423","DOIUrl":"https://doi.org/10.1111/jori.12423","url":null,"abstract":"<p>This article compares expected pension default losses of employees and retirees before and after pension buyouts. The comparisons are made using a stochastic model calibrated with market data. The analysis shows that the lower protection level provided by the State Guarantee Association relative to that of the Pension Benefit Guaranty Corporation (PBGC) is a critical factor that explains the welfare reduction, or equivalently, larger expected pension default losses, of most retirees who become annuity holders in the buyouts. The analysis also shows that the employee welfare, or equivalently expected pension default gains or losses, depends on the continued PBGC protection and, critically, their employers' postbuyout default risk and pension funding status. Moreover, these employee welfare changes are quite different for the corporations included in this analysis. Our results suggest that welfare improvements depend on the PBGC and state insurance regulators' cooperation in protecting pension participants and supervising buyout insurers.</p>","PeriodicalId":51440,"journal":{"name":"Journal of Risk and Insurance","volume":"90 3","pages":"667-702"},"PeriodicalIF":1.9,"publicationDate":"2023-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jori.12423","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50140440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Data Policy","authors":"","doi":"10.1111/jori.12422","DOIUrl":"https://doi.org/10.1111/jori.12422","url":null,"abstract":"","PeriodicalId":51440,"journal":{"name":"Journal of Risk and Insurance","volume":"90 1","pages":"243-244"},"PeriodicalIF":1.9,"publicationDate":"2023-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jori.12422","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50133370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Special issue on health insurer decision-making","authors":"Justin Sydnor","doi":"10.1111/jori.12420","DOIUrl":"10.1111/jori.12420","url":null,"abstract":"","PeriodicalId":51440,"journal":{"name":"Journal of Risk and Insurance","volume":"90 1","pages":"5-8"},"PeriodicalIF":1.9,"publicationDate":"2023-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46332505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Issue Information: Journal of Risk and Insurance 1/2023","authors":"","doi":"10.1111/jori.12387","DOIUrl":"10.1111/jori.12387","url":null,"abstract":"","PeriodicalId":51440,"journal":{"name":"Journal of Risk and Insurance","volume":"90 1","pages":"1-4"},"PeriodicalIF":1.9,"publicationDate":"2023-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jori.12387","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43313022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A common thread linking the design of guarantee and nonescalating payments of public annuities","authors":"Sau-Him Paul Lau, Qilin Zhang","doi":"10.1111/jori.12419","DOIUrl":"https://doi.org/10.1111/jori.12419","url":null,"abstract":"<p>Motivated by recent experiences in economies adopting the defined-contribution pension system, we study public annuities in the presence of survival probability heterogeneity. It is found that the difference of annuitization-weighted and unweighted averages of survival probabilities is a useful measure of the severity of adverse selection. We then examine public annuities with a guarantee feature which bundles annuity income and bequeathable wealth components. We show that when the heterogeneity in survival probability is limited, the magnitude of guarantee proportion is irrelevant. On the other hand, an increase in the guarantee proportion mitigates adverse selection when the extent of heterogeneity is sufficiently large, because the share of annuity purchase by retirees with lower (resp., higher) survival probabilities is increased (resp., decreased). We also obtain a similar set of results for public annuities with nonescalating payments. The results have useful implications regarding the design of public annuities.</p>","PeriodicalId":51440,"journal":{"name":"Journal of Risk and Insurance","volume":"90 3","pages":"703-742"},"PeriodicalIF":1.9,"publicationDate":"2023-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jori.12419","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50132730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Francis Duval, Jean-Philippe Boucher, Mathieu Pigeon
{"title":"Enhancing claim classification with feature extraction from anomaly-detection-derived routine and peculiarity profiles","authors":"Francis Duval, Jean-Philippe Boucher, Mathieu Pigeon","doi":"10.1111/jori.12418","DOIUrl":"https://doi.org/10.1111/jori.12418","url":null,"abstract":"<p>Usage-based insurance is becoming the new standard in vehicle insurance; it is therefore relevant to find efficient ways of using insureds' driving data. Applying anomaly detection (AD) to vehicles' trip summaries, we develop a method allowing to derive a “routine” and a “peculiarity” anomaly profile for each vehicle. To this end, AD algorithms are used to compute a routine and a peculiarity anomaly score for each trip a vehicle makes. The former measures the anomaly degree of the trip compared with the other trips made by the concerned vehicle, while the latter measures its anomaly degree compared with trips made by any vehicle. The resulting anomaly scores vectors are used as routine and peculiarity profiles. Features are then extracted from these profiles, for which we investigate the predictive power in the claim classification framework. Using real data, we find that features extracted from the vehicles' peculiarity profile improve the classification.</p>","PeriodicalId":51440,"journal":{"name":"Journal of Risk and Insurance","volume":"90 2","pages":"421-458"},"PeriodicalIF":1.9,"publicationDate":"2023-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50117546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Benjamin Handel, Nianyi Hong, Lynn M. Hua, Yuki Ito
{"title":"Employer risk-adjustment transitions with inertial consumers: Evidence from CalPERS","authors":"Benjamin Handel, Nianyi Hong, Lynn M. Hua, Yuki Ito","doi":"10.1111/jori.12417","DOIUrl":"10.1111/jori.12417","url":null,"abstract":"<p>Risk-adjustment policies, which transfer money from insurers with healthy consumers to those with sick consumers, are an important tool to contend with adverse selection in health insurance markets. While the steady-state properties of risk-adjustment have been studied extensively, there is less evidence on the transition phase of policy implementation. We study the introduction and removal of risk-adjustment at California Public Employees' Retirement System and show that these changes meaningfully impact premiums via plan differences in enrollee health status. Despite these premium differences, there is limited consumer resorting due to consumer inertia, though new active enrollees respond more fluidly. We show that, with inertial consumers, risk-adjustment changes have substantial distributional consequences, leading to worse outcomes for sicker consumers when removed and vice-versa when implemented. We estimate a model of plan choice with premium sensitivity, brand preferences, and inertia and use these estimates to study the interaction between risk-adjustment policies and the strength of inertia.</p>","PeriodicalId":51440,"journal":{"name":"Journal of Risk and Insurance","volume":"90 1","pages":"93-121"},"PeriodicalIF":1.9,"publicationDate":"2023-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48869668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"How do low-income enrollees in the Affordable Care Act marketplaces respond to cost-sharing?","authors":"Kurt Lavetti, Thomas DeLeire, Nicolas R. Ziebarth","doi":"10.1111/jori.12416","DOIUrl":"10.1111/jori.12416","url":null,"abstract":"<p>The Affordable Care Act requires insurers to offer cost-sharing reductions (CSRs) to low-income consumers on the marketplaces. We link 2013–2015 All-Payer Claims Data to 2004–2013 administrative hospital discharge data from Utah and exploit policy-driven differences in the actuarial value of CSR plans that are solely determined by income. This allows us to examine the effect of cost-sharing on medical spending among low-income individuals. We find that enrollees facing lower levels of cost-sharing have higher levels of healthcare spending, controlling for past healthcare use. We estimate demand elasticities of total health care spending among this low-income population of approximately −0.12, suggesting that demand-side price mechanisms in health insurance design work similarly for low-income and higher-income individuals. We also find that cost-sharing subsidies substantially lower out-of-pocket medical care spending, showing that the CSR program is a key mechanism for making health care affordable to low-income individuals.</p>","PeriodicalId":51440,"journal":{"name":"Journal of Risk and Insurance","volume":"90 1","pages":"155-183"},"PeriodicalIF":1.9,"publicationDate":"2023-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jori.12416","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9767949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Patricia H. Born, E. Tice Sirmans, Petra Steinorth
{"title":"Health insurers' use of quality improvement expenses to achieve a minimum medical loss ratio requirement","authors":"Patricia H. Born, E. Tice Sirmans, Petra Steinorth","doi":"10.1111/jori.12413","DOIUrl":"10.1111/jori.12413","url":null,"abstract":"<p>Health insurer medical loss ratios (MLRs) are the percentage of premium dollar spent on medical claims and healthcare quality improvement expenses (QIEs). QIEs include activities to improve patient health outcomes and safety, reduce medical errors, and prevent hospital readmissions. The Affordable Care Act mandates minimum MLRs in certain health insurance markets lest rebates be paid to policyholders. QIEs are reported in all markets regardless of whether that market is subject to minimum MLR requirements. Using health insurer statutory filings for a sample of group market insurers from 2010 to 2018, we employ a mixed regression discontinuity/regression kink approach to evaluate whether QIEs are used by insurers as a potential strategy for meeting the minimum MLR requirement. We show that health insurers' QIE increase in the loss ratio until meeting the minimum MLR requirement, have a significant discontinuous jump at the threshold, and decrease above the threshold after the introduction of the MLR mandate.</p>","PeriodicalId":51440,"journal":{"name":"Journal of Risk and Insurance","volume":"90 1","pages":"123-154"},"PeriodicalIF":1.9,"publicationDate":"2023-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47199368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Michele Tumminello, Andrea Consiglio, Pietro Vassallo, Riccardo Cesari, Fabio Farabullini
{"title":"Insurance fraud detection: A statistically validated network approach","authors":"Michele Tumminello, Andrea Consiglio, Pietro Vassallo, Riccardo Cesari, Fabio Farabullini","doi":"10.1111/jori.12415","DOIUrl":"https://doi.org/10.1111/jori.12415","url":null,"abstract":"<p>Fraud is a social phenomenon, and fraudsters often collaborate with other fraudsters, taking on different roles. The challenge for insurance companies is to implement claim assessment and improve fraud detection accuracy. We developed an investigative system based on bipartite networks, highlighting the relationships between subjects and accidents or vehicles and accidents. We formalize filtering rules through probability models and test specific methods to assess the existence of communities in extensive networks and propose new alert metrics for suspicious structures. We apply the methodology to a real database—the Italian Antifraud Integrated Archive—and compare the results to out-of-sample fraud scams under investigation by the judicial authorities.</p>","PeriodicalId":51440,"journal":{"name":"Journal of Risk and Insurance","volume":"90 2","pages":"381-419"},"PeriodicalIF":1.9,"publicationDate":"2022-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50118710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}