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Froogle 1.1.1.7
Froogled By:
Elias Makere, FSA, MAAA
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ASOP 5 | Commentary Section 3.2 | COMMENT ON SECTION 3.2

Section 3.2, Considerations for Estimating Incurred Claims
CommentResponse
One commentator suggested changing “management” to “principal.”The reviewers agree that reliable sources of information extend beyond management and changed “management” to “another party.”
Section 3.2.1, Health Benefit Plan Provisions and Business Practices
CommentResponse
One commentator suggested clarifying the relationship between “plan provisions” and “business practices.”The reviewers agree and made a clarifying change by adding the word “related.”
One commentator suggested adding “benefit periods” and “lifetime maximums” to the list.The reviewers believed these items are generically covered by “maximum allowances” and did not include them.
One commentator suggested that a high standard is being set for the actuary regarding identifying differences between business practices and plan provisions.The reviewers removed the language related to identifying differences between business practices and plan provisions, and clarified that “reasonable effort” is the appropriate standard to apply to the understanding of changes in business practices.
Section 3.2.3, Behavior of Claimants
CommentResponse
One commentator suggested recognizing the difference between observed behavior and assumed behavior.The reviewers believe this distinction is covered by “reasonably available information” and made no change.
Section 3.2.4, Organizational Claims Administration
CommentResponse
One commentator suggested changing “electronic submission of claims” to “method of claims submission.”The reviewers believe the specific example is appropriate and made no change.
Section 3.2.8, Legislative Requirements
CommentResponse
One commentator suggested adding “for example” to the beginning of this list.The reviewers agree and made the change.
One commentator suggested referring to developing regulatory provisions regarding estimation of incurred claims for certain long-term products.The reviewers note, as described in section 1.2, that this standard does not address interpretation of statutory or generally accepted accounting principles, and added “methods used to estimate incurred claims” to the list of example influences of government mandates.
Section 3.2.10, Special Considerations for Long-Term Products
CommentResponse
Several commentators suggested reversing the order of the sentences in this section.The reviewers agree and made the change.
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