GH 201-C: Claims lag and benefit changes need different adjustments
Paid experience can be incomplete because claims have not yet emerged. A benefit change alters what is covered. Developing claims for lag does not automatically adjust them to a new benefit design.
Original practice scenario
In an original dataset, recent paid claims are 600 and the assumed completion fraction is .75, suggesting 800 on that simplified basis. Separately assess a new deductible. Explain the assumptions behind the completion fraction and why the design change requires another analysis.
Study check
Write the assumptions, the decision being supported and one limitation. Use the current course syllabus for the required terminology and scope; this introductory guide is not a complete course summary.
Reading sources
ActNet editorial guide · October 1, 2026 · Original illustrative examples.