Predictive Analytics in Life Insurance. ACLI Annual Conference Sam Nandi, FSA, MAAA October 9, 2017

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Predictive Analytics in Life Insurance ACLI Annual Conference Sam Nandi, FSA, MAAA October 9, 2017

Predictive Analytics and Big Data Actuaries have been analyzing data and making predictions for centuries. so what s new? Availability of Data Computational Power New Approaches to Analyzing Data Technology to Automate Processes Cultural Shifts 2

DATA! Without data, nothing is possible! Companies need to: Capture Digitize Organize Acquire Store and Manage Cultivate a Data Culture 3

Data management platforms used across different industries Client Data Activation Reach Reson. Reaction CRM/Sales Web sites Direct Mail Marketing Data TV, Mobile, OOH, Radio Brand metrics, segmentation MMM, household sales data 3rd Party Data ID Demos Media Sales 1 2 3 Calibrati on DMP MTA Hygiene Analysis Segmentation & Targeting Personalization Search Mobile Video Display Experian, Acxiom, etc ROI Measurement & Optimization TV

Life Insurance Data Enrichment and Organization Framework Underwriting 5

Life Insurance Applications We have observed companies use Predictive Analytics for the following: Predictive Underwriting Sales/Marketing Customer segmentation Cross and up-selling Propensity to buy Lead generation Retention/Proactive Lapse Management Fraud Detection Distribution Management Assumption Setting Customer Value Analysis 6

Assumption Setting Example: VALUES Industry Utilization Study 2016 Study covered 7 companies, 2 million policies, $200bn AV Studied both timing of first WB withdrawal and amount of withdrawals relative to MAWA using experience data from 2007 to 2015 Impact of drivers and predicted behavior are analyzed by applying advanced statistical modeling. Study showed that policyholders who are older at issue tend to utilize their policies sooner Policyholders with rollup feature wait longer to utilize the GLWB. Less than half of all policyholders currently taking GLWB withdrawals utilize their GLWB benefit with 100% efficiency. 7

VA Data Enrichment Study (1) 1. Enrich with external data 2. Use analytical tools to develop customer segmentation 8

VA Data Enrichment Study (2) 3. Use Predictive Modeling to develop distinct behavioral profiles 4. Visualize results of customer profitability individually and by segment 9

VA Data Enrichment Study (3) Potential applications Retrospective pricing review Distribution strategy Targeted retention and buyout Targeted M&A Product strategy Improvement of assumptions for reserving, capital, hedging 10

Product Development Example: Vitality Vitality is a leading company in integrating wellness benefits in life insurance products, and has partnered to launch life insurance products in different countries John Hancock has launched a UL product in partnership with Vitality Customers accumulate points and rewards for maintaining a healthy lifestyle (diet, exercise, health screenings) Points status is used to determine discounts for each year s premium The product proposition is empowered by Predictive Analytics and new data Steady stream of data is captured from customer Historical dataset used to analyze impact of various lifestyle indicators on mortality rates Presented as a win-win proposition to customer Data from customer can be used for other purposes (cross-sell/up-sell) 11

Predictive Modeling with Prescription Histories ACLI Annual Conference Eric Carlson, FSA, MAAA October 9, 2017

Agenda Milliman IntelliScript Big Data and Underwriting Big Data from an Rx Perspective Predictive Modeling using Rx Case Studies Proprietary and Confidential for Client. Not for distribution. 13

IntelliScript History 2005 Acquired by Milliman 3 clients / 3 employees 2009 RxRules launched 2014 PopulationRx launched 2017 200 clients / 70 employees Medical Data launched 2001 Founded as IntelRx 2008 1 million transactions processed 2010 GRx launched 2016 8 million transactions processed Risk Score launched 14

Why is Big Data important? The Future of Underwriting Increasing Decreasing Electronic requirements (Rx, MIB, MVR, Medical, Credit ) Decision engines driven by data Predictive Models Automation APS, Labs Cycle times Costs Better Customer Experience 15

Big Data Milliman Perspective Access (with authorization) to Rx Histories on more than 200 million Americans. Milliman has accumulated a large Rx and mortality data set. Health Plan PBM Clearing House Retail Pharmacy 2015 Milliman mortality study 53M exposure years 13M lives 231,000 deaths Created Milliman Risk Score 16

Rx Histories 1 2 3 4 5 Prescription Brand and generic name Dosage and quantity Date of fill Physician Specialty Contact information Pharmacy Contact information Dates of eligibility With or without prescriptions Underwriting significance indicator Red, yellow, green 17

RxRules interprets big data. Data Input Rx data Application data MIB / MVR Medical data RxRules UW Guidance Conditions Severity Decisions Rule Variables Indication / Therapeutic class Drug combinations Fill timing(date or duration ranges) Fill counts / patterns Dosage / quantity Physician specialty / count Gender / Age Other variables 18

RxRules Timing and Duration Matter Corticosteroids 105% relative mortality Low Frequency / Duration High Frequency / Duration 99% 201% Corticosteroids are very common among insurance applicants 19

RxRules Dosage Matters Trazodone 147% relative mortality Low Dose High Dose 132% 224% 20

RxRules Drug Combinations Matter Spironolactone 209% relative mortality With 2 out of 3 of: Thiazide Diuretics (102%) Ace / Angio II (ARBS) (116%) Beta Blocker (122%) 328% Without 2 out of 3 of: Thiazide Diuretics (102%) Ace / Angio II (ARBS) (116%) Beta Blocker (122%) 166% 21

RxRules Morphine Equivalence Matters Opioids 156% relative mortality Low MED* High MED* 135% 322% * MED = Morphine equivalent dosage 22

Predictive Modeling: Milliman Risk Score RxRules-driven Predictive Model Predicts relative mortality of a life or group of lives Multi-variate Rx based score 23

The Milliman Risk Score is built on RxRules. 7,500 GPI codes Hundreds of RxRules 1.27 Milliman Risk Score 250,000 NDC codes 24

Milliman s Risk Score effectively predicts mortality. 25

What s so great about this predictive model? Evidence based and data driven Stratify risk within a given medical condition Detect unintuitive patterns Quickly and consistently interpret large amounts of data Relatively easy to test, implement, use, and update 26

Risk Score stratifies platelet inhibitor risk. Very Serious Platelet Inhibitor (Plavix) 120,000 400% 105,000 350% 90,000 300% 75,000 250% 60,000 45,000 200% 150% Lives Relative Mortality 30,000 100% 15,000 50% 0 x < 1 1 x < 1.5 1.5 x < 2 2 x Risk Score Range 0% 27

Risk Score stratifies insulin risk. Diabetes Third Line with Insulin 50,000 450% 45,000 400% 40,000 35,000 30,000 25,000 20,000 15,000 10,000 350% 300% 250% 200% 150% 100% Lives Relative Mortality 5,000 50% 0 x < 1 1 x < 1.5 1.5 x < 2 2 x Risk Score Range 0% 28

Predictive Model Applications 1 Individual Underwriting 2 Group Underwriting 3 Inforce Analysis 4 Market Segmentation 5 Pension Risk Transfer 29

SI Case Study Background Mostly auto-decision via RxRules Risk Score as of time of underwriting Have deaths on issued and declined cases 30

SI Case Study #1 Distribution of Lives Risk Score Distribution by UW Decision SI Case Study #1 Hits Only 16,000 14,000 12,000 10,000 Issue Average Score (Hits Only) Issue 0.96 Decline 1.52 # of Lives 8,000 6,000 4,000 2,000 0 Decline 0.2 0.4 0.6 0.8 1.0 1.2 1.4 1.6 1.8 2.0 2.2 2.4 2.6 2.8 3.0 3.2 3.4 3.6 3.8 > 4.0 Risk Score Lives Issue Lives Decline 31

SI Case Study #1 - Relative Mortality 600% Relative Mortality by Risk Score and UW Decision SI Case Study #1 (Hits Only) 500% Decline Relative Mortality 400% 300% 200% Issue 100% 0% 0.00 x < 1.00 1.00 x < 1.50 1.50 x < 2.00 2.00 x < 3.00 3.00 x Risk Score Range Issue Decline 32

Thresholds can be adjusted to achieve desired business results. 16,000 Low Threshold High Threshold 14,000 12,000 10,000 # of Lives 8,000 6,000 4,000 2,000 0 0.2 0.4 0.6 0.8 1.0 1.2 1.4 1.6 1.8 2.0 2.2 2.4 2.6 2.8 3.0 3.2 3.4 3.6 3.8 > 4.0 Risk Score Lives Issue Lives Decline 33

Set Risk Score threshold to issue the same amount of business. Some issued premium now gets declined Equal amount of declined premium now gets issued # of Apps 18,000 16,000 14,000 12,000 10,000 8,000 6,000 4,000 2,000 0 Threshold 0.4 0.6 0.8 1.0 1.2 1.4 1.6 1.8 2.0 2.2 2.4 2.6 2.8 3.0 3.2 3.4 3.6 3.8 > 4.0 Lives New - Issues New Lives Declines - Decline Issued Cases Relative A/E Before Risk Score After Risk Score 83% 75% Same amount of business issued 9% Mortality improvement $4 Million increase in profit 34

Set Risk Score threshold to maintain the same mortality A/E. Some issued premium now gets declined More declined premium now gets issued # of Apps 18,000 16,000 14,000 12,000 10,000 8,000 6,000 4,000 2,000 0 Threshold 0.4 0.6 0.8 1.0 1.2 1.4 1.6 1.8 2.0 2.2 2.4 2.6 2.8 3.0 3.2 3.4 3.6 3.8 > 4.0 Lives New - Issues New Lives Declines - Decline Premium Issued Before Risk Score After Risk Score $56.1 M $66.0 M Same mortality A/E 18% More issued business $2.9 Million increase in profit 35

Risk Score adds value to fully underwritten policies. Declined Issued 36

Questions?

Thank you Eric Carlson, Life Actuary eric.carlson@milliman.com 262-641-3537 Sam Nandi, Principal and Consulting Actuary sam.nandi@milliman.com 312-499-5652