?ddelWj l[ FheZkYj :[i ]d · 2019. 7. 31. · k $hwqd qf w } ] Ç $jhqgd 3urgxfw /lihf\foh 7kh 5roh...

1©2019 Aetna Inc.

Proprietary

Innovative Product Design

August 2, 2019

How Actuaries Influence The Process

2©2019 Aetna Inc.

Proprietary

Agenda

Product Lifecycle

The Role of the Actuary

Innovation in Health Insurance

3©2019 Aetna Inc.

Proprietary

Product Lifecycle – The Actuary’s View

Price / Size

ImplementMaintain Relativities

4©2019 Aetna Inc.

Proprietary

5©2019 Aetna Inc.

Proprietary

Product Lifecycle – What Really Happens

Ideation

Generate and pursue product concepts

1 2 3 4 7

Nitty Gritty

Nail down details - from target customer to IT requirements

Reality Check

Establish business case, product “story”, go-to-market plan, and

operational readiness

Go / No-Go

Confirm readiness across operations, sales & marketing,

and leadership approval

Calibration

Evaluate within broader product portfolio – retain, modify, sunset

A B

Product Launch

A) Launch date

B) Effective date

5

Real Life Review

Review product performance against target metrics, define

needed modifications

6

Maintenance

Monitor and adjust for compliance, market position,

and customer needs

6©2019 Aetna Inc.

Proprietary

6

The Actuary’s Role

Technical

• Build, maintain and utilize actuarial models that support product design and maintenance

• Calculate benefit relativities for entire portfolios

• Price new concepts

• Determine applicability across funding types

Business

• Consider impact of key features

• Partner with business partners to define and assess risks

• Project financial impact

• Weigh in on business case

Go Beyond

It is often the work we do outside of our

models that delivers the greatest value to the

business

7©2019 Aetna Inc.

Proprietary

An Example – Ultra Lean Plans

1 2 3 5Evaluate existing plans against external market

and plan sponsor selections

Size the opportunity and the risks

Modify models to accommodate and measure changes

Monitor results against targets and overall market response

Innovation

9©2019 Aetna Inc.

Proprietary

©2019 Aetna Inc.

Innovation is more than the big idea.

It is the execution of a new, creative idea into something of value.

What Is Innovation?

10©2019 Aetna Inc.

Proprietary

We Know It When We See It

11©2019 Aetna Inc.

Proprietary

11

Fostering Innovation

• Ask the right questions- What if?- How could we?- What would it take?

• Focus on trade-offs, not cost- What’s it worth to you?- Where can I find a pay-for?

• Collaborate with business partners

• Trust the process

Creativity

is just as important in the execution of a

great idea as it is in the generation

of the idea

12©2019 Aetna Inc.

Proprietary

©2019 Aetna Inc.

Practicing Innovation

• Closed or narrow provider networks

• Diminishing deductible

• Accident forgiveness

• No deductible health plan

• Insurance for gig workers

13©2019 Aetna Inc.

Proprietary

Actuaries belong at the heart of product innovation. Invite yourself to the party!

What Does It Take?

• An open, curious mind

• Freedom from models

• Nimble data analytic skills (or friends with mad skills)

• Partnership across the organization

• Ability to see things through multiple lenses

• Willingness to challenge norms

• Market perspective

• Peer review

Questions?