IFoA SA1 study plan

Map the main ways health and care systems are financed (tax-funded, social insurance, voluntary private insurance, out-of-pocket) and explain the incentive each creates for insurers and providers

Build a one-page comparison of how regulation of health insurance differs from regulation of life insurance in at least two markets you know well

Derive the relationships between central death rates, force of mortality and survival probabilities under constant-force and uniform-distribution assumptions, and state when each is appropriate

Calculate crude and standardised mortality and morbidity rates from a small dataset and interpret the effect of age standardisation

Distinguish mortality, morbidity, recovery, disability-inception and lapse as competing decrements and sketch a multi-state model for a critical illness product

Fit and compare mortality models (Gompertz, Makeham, Heligman-Pollard, Lee-Carter style) to a small dataset and justify the choice for pricing a specified product

Quantify the impact of mortality improvement, selection effects and anti-selection on a term assurance and a critical illness price

Explain the roles of underwriting, waiting periods, survival periods and exclusions in controlling morbidity risk, and price each into a product

Compare morbidity bases (incidence-based versus recovery-based) and show how the choice changes reserves and profit signature

Prepare a short note on how morbidity assumptions for a health insurance product should be set and monitored

Design the benefit structure of a private medical insurance product, specifying excesses, co-payment, limits, exclusions and provider network restrictions

Contrast indemnity, preferred-provider and managed-care arrangements and assess the effect of each on claims cost and member behaviour

Model how deductibles, co-insurance and annual limits change expected claim cost and the distribution of member out-of-pocket spend

Explain capitation, diagnosis-related groups, per-diem, fee-for-service and shared-savings reimbursement and derive the provider incentive each creates

Assess the insurer and provider risks created by a capitation or shared-savings contract and propose contract terms that align incentives

Calculate gross premium reserves and claim reserves for a health insurance portfolio using both a seriatim and an approximate method

Build an incurred-but-not-reported (IBNR) estimate using a development-factor approach and test its sensitivity to the assumed development pattern

Explain how reserving for long-term health and care business differs from reserving for short-term medical business, including the treatment of future premiums and renewals

Determine the capital requirement for morbidity, mortality and lapse risk under a principles-based regime and explain how each is aggregated

Evaluate the effect of reinsurance and of a change in the morbidity basis on the solvency position

Match assets to health and care liabilities by duration, currency and inflation linkage, and identify the mismatches that matter most

Explain why medical inflation and claim-cost inflation create a liability that is hard to hedge with fixed-interest assets

Assess the suitability of government bonds, index-linked bonds, corporate credit, equities and infrastructure for backing long-duration care liabilities

Quantify the effect of an interest-rate and a credit-spread shock on the insurer's surplus and on the solvency ratio

Explain the role of the ORSA and the own-risk assessment in linking asset strategy to the business plan

Identify and rank the principal risks of a health and care insurer using a risk register with likelihood, impact and mitigation for each

Compare quota-share, surplus, excess-of-loss and stop-loss reinsurance for a medical portfolio and quantify the cost and risk transfer of each

Design a reinsurance programme for a specified portfolio and justify the retentions and limits chosen

Allocate capital to business lines using at least two methods and reconcile the results

Explain how the risk-management framework feeds into pricing, reserving and capital decisions

Analyse a regulatory change (for example a price-cap, a risk-equalisation scheme or a mandatory-benefit rule) and quantify its effect on an insurer's pricing and profitability

Explain risk equalisation and community rating and show how they redistribute cost between insurers and between members

Evaluate the effect of provider consolidation and vertical integration on an insurer's bargaining position and claims cost

Assess the actuarial and commercial implications of moving from fee-for-service to bundled or outcome-based payment

Prepare a recommendation to a board on whether to enter or exit a specified health insurance market

Apply the actuarial profession's ethical and professional standards to a scenario involving conflicting duties to policyholders, the insurer and the regulator

Draft advice that distinguishes clearly between data, assumptions, judgement and recommendation, and state the limitations and uncertainties

Present technical results to a non-technical audience and defend the key assumptions under challenge

Review a piece of actuarial advice against professional standards and identify the deficiencies

Consolidate the eight weeks into a personal exam-preparation plan with a list of remaining weak areas