You surprise me Junkman. I had no idea you were a certified actuary.
, unless you are assuming the risk all of your math gyrations are just something to chat about with other number crunchers.
I only spent 20+ years on the carrier side, about half that in stop loss underwriting, ceding coverage and at times acting as an intermediary so I probably don't know as much as you or the carriers you put down. We had groups of 300+ that were regularly experience rated and, depending on the number of months of claim data, could be 100% credible.
At one time Hancock, Confederation and Equitable experience rated groups of 100 - 150 as fully credible. Great West was in the mix too although not as aggressive and I think their entry point was 200 lives.
Three years of data with monthly claim and body counts would get you a quote.
Lloyds would self fund groups down to 5 lives and put them on a manual rate the first year but transition to experience rated over time.
BCBSGA gave stats in a meeting a few years ago supporting they made an offer on 96% of apps submitted.
I took thousands of apps (IFP) over the years and can probably count on one hand the number that were declined.
group plans had conversion plans. I wrote a number of group conversion plans with Celtic before COBRA
Some states had risk pools. Others had carriers of last resort. Some had GI. There were almost always an option for sick people.
Whether they took advantage of those options or not does not diminish the fact they could have had coverage.
Medicare has been "dying" for years. Hasn't happened yet. Won't happen.
Concierge practices are not new nor are they the norm. Doubt they will ever be.
You have a nice day.