Modelling Health Status and Long Term Care Insurance

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Health and Business Workshop 30 November 2017, UNSW Sydney Modelling Health Status and Long Term Care Insurance Michael Sherris Professor of Actuarial Studies, School of Risk and Actuarial Studies, UNSW Sydney Chief Investigator, CEPAR

Coverage Projects Focus is Post Retirement and Older Ages Health Status and Retirement Income Streams Life Annuities, Pooled Annuities Long Term Care Insurance Modelling Functional Disability Risks, LTCI Product design, Insurer Pricing and Capital Housing and Long Term Care Insurance Individual retirement Financing, Reverse Mortgages, Life annuities Industry Partners and Collaborators

Health Status and Retirement Income Streams Life Annuities, Pooled Annuities Models for health status and mortality heterogeneity and implications for retirement income stream products Frailty and Markov Ageing Models calibration to population mortality data Markov ageing models calibrated to cross sectional health status data and longitudinal population mortality data applied to annuity pricing, adverse selection and tail risks of life insurers GLMM for health risk factors using individual level HRS data pricing underwritten life annuities, risks and capital requirements for life insurers Mortality heterogeneity and health status and impact on mutual risk pooling products GSA s, pooled annuities equitable methods of determining annuity payments

Frailty and Markov Physiological Ageing Models Life insurers select lives using underwriting allowing for heterogeneity in individual mortality Frailty Model 1945 Australian Male Cohort with varying levels of frailty Markov Physiological Age Model Distribution of Physiological Ages for a 65 year old Australian male Su, S. and Sherris, M. (2012), Heterogeneity of Australian Population Mortality and Implications for a Viable Life Annuity Market, Insurance: Mathematics and Economics, 51, 2, 322 332 Source: Shu and Sherris (2010)

Life Annuity Portfolio Mix Writing a portfolio representative of the population less profitable and more risky Annuity Portfolio 2,000 1,500 1,000 500 0-500 -1,000 Mixed -1,500 25 30 years since start 35 of contract 40 45 mean ±1 standard deviation 5th percentile Annuity Portfolio 2,000 1,500 1,000 500 0-500 -1,000 Best Health Only -1,500 25 30 years since start 35 of contract 40 45 mean ±1 standard deviation 5th percentile Markov ageing model Le Bras model lower mean and less volatility Sherris, M. and Q. Zhou (2014). Model Risk, Mortality Heterogeneity, and Implications for Solvency and Tail Risk, in P. B. Hammond, R. Maurer, and O. S. Mitchell, eds., Recreating Sustainable Retirement: Resilience, Solvency, and Tail Risk. Oxford, U.K.: Oxford University Press, pp. 113 133.

Models of Mortality Heterogeneity Annuity Pricing allowing for Risk Factors GLMM can allow for both underwriting risk factors and residual variability (frailty) Heterogeneity still significant after underwriting Insurer can adjust annuity prices by pricing using adjusted mortality reflecting risk profiles and a frailty factor Meyricke, R., and Sherris, M. (2013), The determinants of mortality heterogeneity and implications for pricing annuities. Insurance: Mathematics and Economics, 53, 2, 379 387.

Long Term Care Insurance Modelling Functional Disability Risks, LTCI Product design, Insurer Pricing and Capital Models for functional disability, LTC insurance products Multiple state models for functional disability and mortality - calibrated to HRS data Incorporating systematic trends and uncertainty into multiple state models and implications for healthy life expectancy calibrated using HRS data International comparison of functional disability and long term trends in disability LTC product design, pricing and capital Models and product innovations using Australian individual data

Multi-State Life Tables for Functional Disability Disability & recovery transition Intensities Males on left, Females on right U.S. HRS (Health and Retirement Study) data: - Rates of becoming LTC disabled are significantly higher for women than men. - Force of disability > mortality hazard for females of all ages. - Distinct age patterns of recovery. - Used to produce life tables by health state Fong, H. Y., Shao W., and Sherris, M. (2015), Multi-State Actuarial Models of Functional Disability, North American Actuarial Journal, 19:1, 41-59.

Multi-State Life Tables for Functional Disability Mortality transition Intensities Males on left and Females on right US Mortality rates from HRS data Higher male mortality Higher disabled mortality Fong, H. Y., Shao W., and Sherris, M. (2015), Multi-State Actuarial Models of Functional Disability, North American Actuarial Journal, 19:1, 41-59.

Multi-State Life Tables for Functional Disability Male transition rates by age HRS data Female transition rates by age HRS data Fong, H. Y., Shao W., and Sherris, M. (2015), Multi-State Actuarial Models of Functional Disability, North American Actuarial Journal, 19:1, 41-59.

Functional Disability Life Table and LTC Insurance - Disability (functional) free life expectancy - Estimated from HRS data Fong, H. Y., Shao W., and Sherris, M. (2015), Multi-State Actuarial Models of Functional Disability, North American Actuarial Journal, 19:1, 41-59.

LTC Insurance Liabilities and Capital Shao A. W., Sherris, M and Fong, H. Y., (2017), Product Pricing and Solvency Capital Requirements for Long-Term Care Insurance, Scandinavian Actuarial Journal, Vol 2017, Issue 2, 175-208. http://dx.doi.org/10.1080/03461238.2015.1095793

Distribution of Functional Disability including Trends and Uncertainty Li, Z., Shao, W. A., and Sherris, M. (2017), The Impact of Systematic Trend and Uncertainty on Mortality and Disability in a Multistate Latent Factor Model for Transition Rates, North American Actuarial Journal, 2017, 1-17, doi: 10.1080/10920277.2017.1330157

Housing and Long Term Care Insurance Individual Retirement Financing, Reverse Mortgages, Life annuities Individual retirement planning incorporating life annuities, long term care insurance and housing Long term care insurance impact on demand for life annuities, role of reverse mortgages in unlocking illiquid housing equity Bequest motive reduces demand for life annuities but what about impact of bequest on long tem are insurance demand? To what extent does housing crowd out demand for long term care insurance? Impact of lack of liquidity, asset rich cash flow poor retirees because of house equity, on demand for annuities and long term care insurance? Role for reverse mortgages? Product innovations combining reverse mortgage with LTCI, combining life annuity with LTCI

LTC Insurance and Reverse Mortgages Demand for reverse mortgages in presence of illiquid housing and LTCI Shao, W. A., Chen, H. and Sherris, M. (2017), To Borrow or Insure? Long Term Care Costs and the Impact of Housing. Working Paper under Review

LTC Insurance and Reverse Mortgages Shao, W. A., Chen, H. and Sherris, M. (2017), To Borrow or Insure? Long Term Care Costs and the Impact of Housing. Working Paper under Review

LTC Insurance and Demand for Life Annuities Xu, M., Alonso-Garcia, J., Shao, W. A. and Sherris, M. (2017), Demand for Annuities and Long-term Care Insurance with Recursive Utility: Impact of Housing, Unpublished Working Paper.

Industry Partners and Collaborators Industry Partners in CEPAR and on Linkage Grants PwC APRA AMP World Bank Netspar SOA Collaborators Prof Annamaria Olivieri (University of Parma), Prof Ermanno Pitacco (University of Trieste), Dr Adam Shao (Milliman), Dr Hua Chen (Temple University), Dr Ramona Meyricke (Suncorp) Research students and postdocs at UNSW

Michael Sherris CEPAR, Risk and Actuarial Studies UNSW Business School UNSW http://papers.ssrn.com/author=410919 m.sherris@unsw.edu.au http://www.cepar.edu.au/

References Su, S. and Sherris, M. (2012), Heterogeneity of Australian Population Mortality and Implications for a Viable Life Annuity Market, Insurance: Mathematics and Economics, 51, 2, 322 332. Meyricke, R., and Sherris, M. (2013), The determinants of mortality heterogeneity and implications for pricing annuities. Insurance: Mathematics and Economics, 53, 2, 379 387. Sherris, M. and Q. Zhou (2014). Model Risk, Mortality Heterogeneity, and Implications for Solvency and Tail Risk, in P. B. Hammond, R. Maurer, and O. S. Mitchell, eds., Recreating Sustainable Retirement: Resilience, Solvency, and Tail Risk. Oxford, U.K.: Oxford University Press, pp. 113 133. Fong, H. Y., Shao W., and Sherris, M. (2015), Multi-State Actuarial Models of Functional Disability, North American Actuarial Journal, 19:1, 41-59. Fong, J.HY, Sherris, M. and Yap, J., (2017), Forecasting Disability: Application of a Frailty Model, Scandinavian Actuarial Journal, Vol 2017, Issue 2, 125-147. http://dx.doi.org/10.1080/03461238.2015.1092168

References Shao A. W., Sherris, M and Fong, H. Y., (2017), Product Pricing and Solvency Capital Requirements for Long-Term Care Insurance, Scandinavian Actuarial Journal, Vol 2017, Issue 2, 175-208. http://dx.doi.org/10.1080/03461238.2015.1095793 Li, Z., Shao, W. A., and Sherris, M. (2017), The Impact of Systematic Trend and Uncertainty on Mortality and Disability in a Multistate Latent Factor Model for Transition Rates, North American Actuarial Journal, 2017, 1-17, doi: 10.1080/10920277.2017.1330157 Xu, M., Sherris, M. and Meyricke, R., (2017), Systematic Mortality Improvement Trends and Mortality Heterogeneity: Insights from Individual Level HRS data Working Paper under Review. Shao, W. A., Chen, H. and Sherris, M. (2017), To Borrow or Insure? Long Term Care Costs and the Impact of Housing. Working Paper under Review. Xu, M., Alonso-Garcia, J., Shao, W. A. and Sherris, M. (2017), Demand for Annuities and Long-term Care Insurance with Recursive Utility: Impact of Housing, Unpublished Working Paper.

Questions and Discussion