The Evolving Role of Underwriters in a Technology-Driven Future: Embracing Change in Medical Underwriting

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Underwriting is an essential process in the insurance industry, and nowhere is this more evident than in medical underwriting. With a total volume of $927.4 billion in global health insurance premiums in 2021 (Swiss Re Institute, 2021), it’s clear that underwriters play a crucial role in ensuring the stability and growth of the industry. As technology continues to advance at an unprecedented pace, underwriters face a challenging future.

This article will explore how the role of underwriters is evolving in a future dominated by technology and provide insights on how they can adapt to thrive in this new landscape.

Harnessing the Power of Emerging Technologies and Trends in Medical Underwriting

As technology continues to influence the medical underwriting process, underwriters must stay ahead of the curve by understanding and leveraging the latest trends and innovations. Blockchain, the Internet of Things (IoT), telemedicine, artificial intelligence (AI), and predictive analytics are just a few examples of groundbreaking technologies that are reshaping the industry. Additionally, the 21st Century Cures Act, signed into law in 2016, aims to accelerate the development of innovative healthcare solutions, which further drives advancements in medical underwriting. Here are some key areas where underwriters can tap into these innovations to stay competitive:

Leveraging AI and predictive analytics for accurate risk assessment:

AI and predictive analytics have the potential to revolutionize medical underwriting by automating complex data analysis and providing faster, more accurate risk assessments. Underwriters can use these tools to analyze vast amounts of data, identify patterns, and make informed decisions about an individual’s risk profile. By incorporating AI and predictive analytics into their workflow, underwriters can improve efficiency and provide better coverage to their clients.

Integrating IoT for data-driven insights:

The Internet of Things (IoT) offers unprecedented access to real-time data from a variety of sources, such as wearable devices and smart home systems. This data can provide valuable insights into an individual’s health and lifestyle habits, enabling underwriters to make more accurate and personalized risk assessments. By staying informed about the latest IoT developments and integrating these insights into their underwriting processes, underwriters can offer tailored policies and more competitive pricing to their clients.

Embracing Telemedicine for remote risk assessments:

Telemedicine has seen a rapid rise in adoption due to the COVID-19 pandemic and is poised to become a lasting trend in healthcare. With telemedicine, underwriters can remotely access medical records and consult with healthcare professionals to evaluate risks more efficiently. This approach can lead to faster policy issuance, improved customer satisfaction, and cost savings for both insurers and clients..

Adapting to the CURES Act:

The 21st Century Cures Act encourages the development of innovative healthcare technologies and practices. Underwriters must stay informed of the latest developments resulting from this legislation and adapt their underwriting processes accordingly. By keeping abreast of new medical technologies, treatment options, and patient outcomes, underwriters can more accurately assess risks and provide suitable coverage for their clients. r medical insurance policies.

One of the key provisions of the CURES Act focuses on the interoperability of health information technology systems and promoting the secure exchange of electronic health information. As a result, underwriters can access more comprehensive, accurate, and up-to-date medical information for risk assessment. This improved access to information will enable them to make more informed decisions and ultimately provide better coverage for clients. Moreover, the CURES Act facilitates the rapid adoption of innovative treatments and technologies, such as personalized medicine and regenerative medicine.

Underwriters need to understand the potential impact of these innovations on the healthcare landscape and their implications for risk assessment. For example, personalized medicine could lead to more effective treatment plans, reducing the risk of complications and improving patient outcomes. Underwriters should consider these factors when assessing risk and setting premiums for medical insurance policies.

Conclusion: Embracing the Future of Medical Underwriting

The future of medical underwriting is undoubtedly technology-driven, and underwriters must be prepared to adapt to these changes. By embracing emerging technologies like blockchain, IoT, telemedicine, AI, and predictive analytics, and staying informed about relevant legislation such as the CURES Act, underwriters can thrive in this new era and continue to provide valuable services to their clients.

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Overview of Association Health Plans

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Association Health Plans (AHPs) are group health insurance plans that allow small businesses to band together and purchase health coverage as a single entity. AHPs can be set up by trade or industry associations, chambers of commerce, or other organizations, and are designed to give small employers the same purchasing power and bargaining leverage as large corporations.

One key benefit of AHPs is that they can offer more affordable health coverage to small businesses and their employees. By pooling together the purchasing power of multiple employers, AHPs can negotiate better rates and access to a wider range of benefits and services than individual businesses would be able to on their own. This can be particularly helpful for small businesses that struggle to provide competitive benefits packages to attract and retain employees.

Setting up an AHP involves several steps, and the process can vary depending on the type of organization that is sponsoring the plan. Generally, the first step is to identify a group of small businesses that are interested in participating in the plan. Once there is enough interest, the sponsoring organization can work with an insurance broker to design a plan that meets the needs of the group.

The next step is to obtain regulatory approval from the state or federal government. AHPs are subject to a number of regulations, and it is important to ensure that the plan is compliant with all applicable laws and regulations. This can involve filing paperwork with state insurance regulators, providing financial and other documentation, and demonstrating that the plan meets certain minimum standards for coverage.

Once the AHP is established, it will need to be administered. Which may include a variety of tasks, such as enrolling new members, processing claims, and managing the plan’s finances. Some AHPs may choose to hire a third-party administrator to handle these tasks, while others may have a dedicated staff member or team to manage the plan.

In order to ensure that the AHP remains financially viable and sustainable over the long term, it is important to carefully manage costs and monitor the plan’s performance. This can involve analyzing claims data to identify trends and potential cost drivers, negotiating with providers to secure better rates, and continually evaluating the plan’s benefits and services to ensure that they meet the needs of the members.

AHPs can be a valuable option for small businesses that are looking to provide quality health coverage to their employees. By banding together and leveraging their collective bargaining power, small businesses can gain access to more affordable and comprehensive health benefits that might otherwise be out of reach. While setting up and administering an AHP can be complex, with the right planning and resources, it is possible to create a successful and sustainable plan.

1. Online enrollment and administration platform: An online platform that allows members to enroll in the AHP, manage their coverage, and view their benefits and claims information is essential. This platform should also provide a secure portal for members to access their personal and sensitive health information.
2. Claims processing and management software: A robust claims processing system can help manage and automate claims processing, adjudication, and payment. This system should be able to integrate with healthcare provider networks, billing systems, and other health insurance data sources to provide real-time updates and accurate claims processing.
3. Electronic health records (EHR) system: An EHR system can help streamline medical records management, improve care coordination, and reduce administrative costs. This system should be designed to meet the specific needs of the AHP, including compliance with HIPAA regulations.
4. Data analytics and reporting tools: An effective AHP should have the ability to track and analyze data on enrollment, utilization, and claims data. Data analytics tools can provide insights into member health trends, identify cost drivers, and enable proactive management of the plan.
5. Cybersecurity and data privacy tools: AHPs handle sensitive health information and must comply with HIPAA and other regulations. Robust cybersecurity and data privacy tools can protect the AHP against cyber threats, data breaches, and unauthorized access to member data.
6. Communication and member engagement tools: Effective communication is key to the success of an AHP. Associations can use a variety of tools to communicate with members including email, text messages, mobile apps, and social media. These tools can be used to inform members of plan updates, changes in benefits or services, and to provide resources and support for members.
Overall, implementing an AHP requires a range of technology solutions that can help streamline administration, improve member engagement, and manage costs. Associations should carefully evaluate their needs and select technology solutions that are flexible, scalable, and tailored to their specific requirements. By leveraging technology effectively, associations can create a successful AHP that meets the needs of its members and provides quality health coverage at an affordable cost.
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AI tools for Home and Community Based Service providers

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As a home and community-based service provider, AI tools can be used in your daily work to help improve productivity. Below, we share different AI tools that you can use as a home and community-based service provider that help with a multitude of client needs. We also discuss a few more practical AI tools that can help streamline your work:

Robotic Pets

The Joy For All Companion Pet or Paro therapeutic robot seal can provide companionship and comfort to clients who may not be able to care for a live pet.

Smart Glasses

Devices like Google Glass or Vuzix Blade can provide hands-free access to information and communication and can be helpful for clients with visual impairments or mobility issues.

Emotion Recognition

Tools like Affectiva or Emotient can analyze facial expressions and voice tone to detect emotions. This can improve communication and empathy with clients.

Augmented Reality (AR)

AR technology can be used to enhance the client experience by overlaying digital information onto the real world. This technology can be helpful for clients with learning disabilities or those who may benefit from visual aids.

Personalized NutritionPersonalized Nutrition

Tools like Viome or Nutrino can analyze genetic and dietary data to provide personalized nutrition recommendations. These tools can be used to improve client health and wellbeing.

Music TherapyMusic Therapy

Music therapy apps like SingFit or MusicGlove can provide therapeutic benefits through music. These apps can be helpful for clients with neurological conditions or those experiencing stress or anxiety.

Chatbots

In addition to these fun AI tools, there are also more practical options that can help streamline your work.
For example:

  • Chatbots can automate tasks like appointment scheduling and FAQs
  • Predictive analytics can help you analyze data to identify patterns and trends
  • Natural language processing can help you automate tasks like data entry or transcription
  • Virtual reality can be used to simulate different environments and situations
  • By incorporating AI tools into your daily work, you can improve productivity and efficiency, while also enhancing the client experience and having fun at the same time!

 

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The Future of API Integration in Associations: Embracing Innovation for a Better Member Experience

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In today’s digital age, APIs (Application Programming Interfaces) have become increasingly popular in various industries, including the association industry. APIs allow organizations to connect and integrate different software systems, automate processes, and enhance member engagement. With the growing demand for more innovative solutions, it’s no surprise that the future of API integration in associations is looking brighter than ever.

 

 

 

 

Increased Automation and Efficiency

One of the primary benefits of API integration is the ability to automate and streamline processes. By integrating APIs, associations can eliminate manual tasks and reduce the risk of human error. This leads to improved efficiency and more accurate data management. Additionally, API integration enables associations to automate processes such as membership management, event registration, and payment processing. This results in a more seamless experience for members and can lead to increased engagement and satisfaction.

 

 

 

 

Enhancing Member Experience

APIs can be used to enhance the member experience by providing members with a more personalized experience. For example, by integrating APIs with social media platforms, associations can offer members a more personalized experience by connecting with them through their preferred channels. Resulting in increased engagement and a stronger sense of community.

Another way that APIs can enhance the member experience is by providing access to real-time data. With API integration associations can access and share data in real time, which enables them to make more informed decisions and provide members with more relevant information.

 

 

 

 

The Rise of Cloud Computing

The rise of cloud computing has further increased the demand for API integration in associations. Cloud computing enables associations to store data and run applications in the cloud, which provides more flexibility and scalability. APIs play a crucial role in integrating cloud-based systems, making it easier for associations to manage and access their data.

 

 

 

 

Improved Security

APIs can also improve security in associations by providing secure and controlled access to data. This reduces the risk of data breaches and protects sensitive information. Furthermore, API integration enables associations to implement security protocols, such as encryption and multi-factor authentication to enhance the security of their systems.

 

 

 

 

The Future of API Integration in Associations

As technology continues to evolve, the use of APIs in the association industry is expected to grow. The future of API integration in associations is promising, as it offers numerous benefits such as increased automation, enhanced member experience, and improved security. By embracing API integration, associations can continue to stay ahead of the curve and provide their members with innovative solutions that meet their changing needs.

In conclusion, the future of API integration in associations looks bright, and organizations should consider embracing this technology to enhance their operations and improve the member experience. By adopting API integration, associations can stay ahead of the curve and continue to deliver innovative solutions that meet the needs of their members.

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Why Actuaries Are Transitioning from Excel

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As an actuary, you know the importance of managing large sets of data and making accurate predictions. Excel has been a valuable tool in this process, but as data sets grow larger and more complex, it can become unwieldy to handle. This is why many actuaries are now transitioning to more advanced technologies that can help streamline their workflow and provide more sophisticated analysis capabilities.

Benefits and Limitations of Excel

Excel has been a reliable tool for many years, offering the ability to organize, analyze and make critical decisions with data. It is user-friendly and widely accessible. However, as data sets become larger and more complex, the limitations of Excel can become more apparent. Excel is prone to errors, with larger and more complex data sets. In addition, Excel has limited data visualization and analysis capabilities, making it difficult to identify patterns and trends in the data.

Challenges of Siloed Data

Siloed data is a significant challenge that many actuaries face when using Excel. Data silos occur when data is stored in separate systems, making it difficult to combine data sets for analysis. For example, actuarial data may be stored in separate Excel spreadsheets or databases, and consolidating this data can be time-consuming and prone to errors. Siloed data can also make it difficult to identify patterns and trends in the data, which can hinder predictive modeling and decision-making.

Benefits and Limitations of Excel

Excel has been a reliable tool for many years, offering the ability to organize, analyze and make critical decisions with data. It is user-friendly and widely accessible. However, as data sets become larger and more complex, the limitations of Excel can become more apparent. Excel is prone to errors, with larger and more complex data sets. In addition, Excel has limited data visualization and analysis capabilities, making it difficult to identify patterns and trends in the data.

Examples of Models That Excel Can’t Handle

There are a few models that Excel can’t handle due to increasing complexity. This model requires large amounts of data and complex algorithms, which can quickly become unwieldy to handle in Excel.

Another example is the Neural Network model, which is used in predictive modeling to simulate the behavior of the human brain. This model requires sophisticated algorithms and large amounts of data, which can be difficult to manage in Excel. With more advanced technologies, actuaries can easily work with these models, providing more accurate predictions and insights.

Pathway to Transition

If you are considering transitioning away from Excel, it is essential to have a plan in place. This plan should include the following steps:

By carefully planning your transition and considering various technology options like R, Python, KNIME, and Power BI, you can confidently move away from Excel and take advantage of more advanced tools to improve your workflow and provide more sophisticated analysis capabilities.

    1. Identify areas where more advanced technologies can help improve your workflow and address the limitations of Excel.
    2. Organize your data to make it easier to transition to new technologies. This may involve consolidating data from different sources and ensuring the data is clean and well-structured.
    3. Research and evaluate technology options that best suit your needs. In addition to R and Python, consider alternatives like KNIME and Power BI. These tools offer advanced data analysis and visualization capabilities and can handle large and complex data sets.
      1. R and Python are widely used programming languages in data analysis, statistical modeling, and machine learning, offering powerful analytical capabilities and extensive libraries.
      2. KNIME is an open-source data analytics platform with a user-friendly, visual interface, enabling users to create data workflows and leverage pre-built nodes for data manipulation, statistical modeling, and machine learning.
      3. Power BI is a business analytics tool that integrates seamlessly with Excel, allowing users to create interactive visualizations and reports from various data sources while enhancing their data analysis and visualization skills.
    4. Invest in training opportunities for you and your team to ensure everyone is prepared for the change. This can include attending workshops, webinars, or enrolling in online courses to learn the new tools and technologies.
    5. Develop a timeline for the transition, including milestones and goals for each stage of the process.

    Conclusion

    Transitioning from Excel to more advanced technologies can help improve your workflow and provide more sophisticated analysis capabilities. With the increasing complexity of actuarial data, it is essential to have the right tools and technologies in place to make accurate predictions and informed decisions. By identifying areas where more advanced technologies can help improve your workflow and organizing your data making it easier to transition, you can confidently move away from Excel and take advantage.

    Ready to take the next step in your actuarial data analysis journey? Contact our team of experts for personalized guidance on transitioning from Excel to advanced tools like R, Python, KNIME, or Power BI. We’re here to help you make an informed decision and ensure a smooth transition for you and your team.

    Only then will the silver linings be visible.

    Questions? Call 719-581-2221 anytime to arrange a consultation with either author. Both have spent a decade or more helping associations grow, can share with you what’s worked, and would love your feedback.

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    Preparing your Association for a recession

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    While the economy has been strong in recent years, many experts believe that a recession is on the horizon.

    Trade associations and professional associations may be impacted differently during an impending economic recession. Trade associations may see a decline in membership as companies struggle to cope financially. Additionally, they may see a decrease in sponsorship and advertising revenue as businesses cut back on their spending.

    Professional associations may also see a decline in membership as individuals lose their jobs or have less disposable income to spend on membership dues. However, professional associations may be less impacted by a decline in sponsorship and advertising revenue, as these organizations typically rely more on membership dues for revenue.
    It follows naturally therefore that during a recession, associations may record a decline in attendance and participation in events and programs as businesses show balance sheets with less disposable income, leaving them no choice but to reduce spending on these activities.
    Professional associations will witness a trend where individuals who have been laid off may seek new avenues to improve their job prospects by obtaining certifications or other credentials. This can lead to an increase in demand for training programs offered by professional associations.

    However, it is also important to note that during a recession, this increased demand is often offset by two mitigating factors. First, individuals may have less disposable income to spend on additional training or certifications.  Understandably, their priorities will be on overhead expenses, such as utilities and other necessary expenses. Second, companies may cut back on their training budgets, making it harder for individuals to access the training they need.

    To mitigate the impact of a recession, trade, and professional associations should focus on increasing membership and engagement by diversifying their revenue streams and reducing expenses. Let’s look at both of these measures individually.

    Navigate Through the Clouds with New Revenue Streams In Your Flight Plan

    New revenue streams can come from developing new products or services and seeking out new sponsors and partners to increase non-dues revenue.

    Associations can provide a number of services to help their members steer through a recession and mitigate its impact. Some examples include:
    • Job boards and networking opportunities: Associations can create online job boards or networking groups to enable their members to connect with potential employers or clients. One of the great, yet often underutilized, strengths of an association is the ability to connect people to expertise, in the form of either specialists or documentation. This is something few other organizations can provide nearly as cost-effectively.
    • Professional development and training: Associations can provide online courses, webinars, and other resources to help members improve their skills and stay marketable during a recession.
    • Business counseling, mentoring, and benchmarking: Associations can lay out resources and mentorship to help members launch or grow their businesses during a recession. One association conducted detailed surveys of its members’ financials, maintaining anonymity, and now provides the resulting benchmark data to both members and non-members, earning a 7-figure non-dues revenue stream.
    • Discounts and member benefits: Associations can negotiate discounted rates on products and services to help members save money during a recession. Costs like health insurance often present an enormous, often untouched, opportunity in this regard.
    • Research and data: Associations can furnish research and data to members on the current state of the market and trends within their respective industries for them to make informed decisions.
    • Legal and financial advice: Associations can provide access to legal and financial experts to assist members with issues related to navigating a recession.
    • Increase sponsorship revenue: When was the last time you reviewed your sponsorship model and opportunities? These tend to evolve over time, so your sponsorship strategy should as well. For example, associations are beginning to sponsor mobile directories that connect members while increasing page views and, therefore, sponsorship dollars.

    Reduce Costs to Get More Mileage From the Same Jet Fuel

    Associations are finding significant cost savings in integrations that connect key systems together. It’s not your grandfather’s cloud anymore, so there are new opportunities through advanced Application Programming Interfaces (APIs) and strategically designed data warehousing to share data and streamline workflows.

    Neither you nor your members can afford double data entry, so ensure data is entered only once and shared where needed. For example, technologies like nightly synchronization routines and Single Sign-On (SSO) can free up resources while improving data integrity.

    Enhanced data visualization and business intelligence software can surface essential trends and insights without having to allocate staff resources to research them.

    A properly configured Association Management System (AMSs) can play a vital role in helping associations weather a recession. By managing operations such as membership, events, and finance. AMSs provide valuable data and insights, such as membership trends and financial reports, which, in turn, can help associations make informed decisions about their scope of work and day-to-day operations.

    AMSs can also facilitate a great deal of automation, alerting, for example, staff to engagement changes prior to the renewal or notifying members of expiring credentials or early-bird registration windows. All of these can boost engagement without the labor needed to monitor these dynamics manually.
    Of course, AMSs’ level of sophistication today typically goes beyond the plug-and-play of a few years ago, so make sure your AMS is fully optimized for your data environment and functionality requirements. A substantial cost to avoid is the effort to replace your AMS when it was actually fully adequate but merely misconfigured.

    Conclusion

    To sum up, while the prospect of a recession can be daunting, associations can take steps to prepare and mitigate its potential impact. By diversifying revenue streams and reducing expenses, associations can position themselves for success in any economic climate, however grim the forecast.

    Key takeaways:

    Diversify revenue streams:

    Develop new products or services, seek out new sponsors and partners and increase non-dues revenue to minimize the impact of a decline in membership or sponsorships.

    Flexibility:

    Be open to new ways of working, new technologies and different ways of engaging with members. This will save costs and increase efficiency.

    Reduce expenses:

    Streamline operations and look for ways to cut costs, such as negotiating better deals with vendors or outsourcing certain tasks.

    Network and Collaborate:

    Build strong relationships and partnerships with other organizations, companies, and associations in order to access new resources, knowledge, and opportunities.

    Increase membership and engagement:

    Offer more value to current members while promoting the benefits of membership to prospects. This will increase membership and participation.

    Only then will the silver linings be visible.

    Questions? Call 719-581-2221 anytime to arrange a consultation with either author. Both have spent a decade or more helping associations grow, can share with you what’s worked and would love your feedback.

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