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All of the following are typically the responsibility of a health insurance underwriter except:

a) "Enforce" business objectives for MLR
b) Set "new business" premiums which may include a discount
c) Set reserves and certify reserve calculations
d) Calculate annual premium increases

1 Answer

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Final answer:

The responsibility of "enforcing" business objectives for MLR is not typically a responsibility of a health insurance underwriter.

Step-by-step explanation:

Health insurance underwriters are responsible for various tasks related to determining premiums and managing risk. However, in the options provided, the responsibility of "enforcing" business objectives for Medical Loss Ratio (MLR) is not typically a responsibility of a health insurance underwriter.

The MLR is a financial measurement used by insurance companies to determine the percentage of premium income that is spent on healthcare and healthcare quality improvement activities, as opposed to administrative costs and profits. Underwriters are involved in calculating premiums, setting reserves, and certifying reserve calculations, as well as determining annual premium increases, but enforcing business objectives for MLR is usually not within their scope of responsibility.

For example, underwriters use statistical models and risk assessment tools to analyze data and evaluate risk factors when setting premiums. They also determine reserve amounts based on the potential future claims and expenses of the insured population. Additionally, underwriters analyze past claims experience and market trends to calculate annual premium increases.

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