GH-Specialty Fall 2020

I keep thinking of things I misinterpreted based on their phrasing - they basically asked for a ton of specific lists in the most obtuse terms they could muster.

  • “return” in ROI vs EHM framework - huh‽
  • EHM financial metrics - come on that list wasn’t anywhere near the most relevant part of that study note.
  • IDI and Group LTD underwriting for reinsurance - what?? I ended up talking about why someone WOULD reinsure those product but I’m now thinking they wanted us to talk through the underwriting factor in H2 for these products despite not mentioning RBC at all.
  • That whole risk transfer question putting the first term as “risk x idf x gcf” - were we supposed to back into the PLRS factor somehow? In retrospect I’m thinking we needed to look at the relative premiums to get the risk score and use that to find the “idf x gcf” component, I definitely didn’t have the time to process that so I just assumed idf and gcf were the same across the whole state.
  • The whole PLRS question asking about how factors and methodology was developed seemed super confusing. I feel like I ended up saying the same things for four different parts of that question.
  • Comparing med and rx grouper models - were they just asking for a discussion of the positives and negatives of inclusion of rx codes ( gaming, etc)?
  • Hurdle rate as a savings target - were they just asking how many reduced admits were needed to cover the admin cost of the program?

Ugh, just so much about that exam I wasn’t happy seeing after cramming so much. Seems like the last few exams were WAY more straightforward and tested much more relevant sections of the readings.

We share a lot of the same frustrations.

maybe only the 3 of us sat for this exam so one of us has to pass.

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I felt pretty good about it overall, but it didn’t feel like they tested the important parts of each objective. Self scoring on the spot was a 25-27, but I (like most, probably) grade myself pretty hard. If I had known what the questions would have been I would have been prepared for sure and not wasted so much time memorizing those lists they didn’t ask about! If only…ha!

I put down a descriptive list for IDI/GLTD U/W and the components of a successful ERM program, but maybe not the one they were fishing for (obtuse is right, @Shanser), so fingers crossed I’ll get enough partial credit for those.

For the PLRS problem, I assumed “idf x gcf” equaled 1, and let the difference in the scores come from PLRS and then used that. I got two amounts that summed to zero, so I think that’s good.

I also liked being able to type in Word, but writing out the formulas so the graders could check my work in Excel was obnoxious. At the 10 minute warning, I was so worried about uploading stuff in time, I was basically done typing anything remotely helpful.

Here’s to hoping the candidates who didn’t pass are the ones not posting on this forum, and we all made it. Now we wait. My favorite part. :face_vomiting:

Yeah I actually treated the PLRS question the same as you did @rocketprius92, basically said “risk x idf x gcf” essentially reduced to just the risk component since all companies being considered had the same gcf and idf. I try to default to the mindset of the exam writers not trying to make things absurdly complicated or tricky, but who even knows at this point.

Writing in excel was awful since I get like I was constantly having to un-wrap cells and I couldn’t shortcut things like Ctrl-B. Word was fine but it got to the point where I was typing so fast/much I would lose my train of thought sometimes. Pen and paper was almost restrictive enough to keep me from rambling.

Only hope is most sitters didn’t get much credit on the questions I struggled with. Paranoid there are a lot of people who failed in Spring that were super prepared this time.

I agree that the stuff that was tested was way off my radar. I hate that they picked little random things from the syllabus end skipped the main topics.

I think having a dedicated time for uploading documents would be awesome.

I also am not feeling great about this and share most of the complaints you all mentioned. My gut feeling is that I got a 5, with a 40/60 chance of passing. I’m particularly annoyed about the question on NAIC bylaws regarding revising ORSA regulations, as that is not something that anyone would ever need to know off the top of their head. (I mentioned in the post-exam SOA survey that I don’t think that particular material is worth testing on even if they feel it has to be on the syllabus, and it would be better for us to see at least one example of an actual ORSA summary report.) I did like the CBT format in general, though I felt crunched trying to upload in the final 2 minutes.

For return in ROI vs EHM, I interpreted that as pointing out that an intervention can have a very high ROI but still not be worthwhile for an EHM if total and/or PMPM savings are small due to a small target population.

For the ACA risk adjustment problem, it really seemed like we needed at least one more key piece of information in order for the problem to be well-defined. I took a slightly different tack than most of you. I assumed that since the two carriers’ AVs matched, their IDFs matched too. Then I assumed that because the ARFs were also the same, differences in initial premium were solely due to differences in GCF (which is probably not true, because who knows how rates were developed), and that the statewide average GCF was 1.0. From there you can back out PLRS relative to statewide average and then do the transfer calculations.

I agree that PLRS question was just incredibly vague.

With regards to the ROI v EHM question I actually took the same approach since it was all I could think about - I think I mentioned ROI was more about relative savings and EHM was more about aggregate savings, but even that felt erroneous. I think what annoys me the most about the subsequent question on “financial metrics” in EHM is just how non-numerical that whole study note is - it’s a long list of comparison populations that doesn’t scream “financial”. Probably just a personal hang up though.

For return in ROI vs EHM, I talked about EHM programs leading to improved employee health outcomes leading to reduced utilization and then to dollar savings.

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@Shanser Not to mention how the EHM article was so poorly organized… :roll_eyes:

one week until I can officially post in the Spring 21’ SPC thread…

Just start posting there! What’s the worst that can happen- you pass the exam?

I think it is a mental hurdle. Like I can finally admit that I am doing this again.

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Getting over bad results mentally and moving forward sometimes is the hardest part.

Passing list up. 130 candidates passed. I failed. I knew I failed, but never fun to get confirmation.

Passing Candidate IDs

40244
40454
40525
40598
40700
40867
40875
40893
40967
41013
41041
41065
41131
41365
41543
41770
42479
42525
42539
42643
42756
42806
42827
43058
43108
43113
43243
43725
43742
43773
43774
43786
43788
43818
43891
43898
44090
44198
44270
44665
44807
44810
44961
45189
45269
45433
45798
46021
46029
46679
47289
47472
48047
48144
48582
48659
48784
48975
49066
50152
50765
51402
51518
51685
52466
53688
53887
54448
54756
54883
54896
55362
56224
56560
56875
57482
58341
58552
58644
58673
58683
58689
58714
58718
58751
58761
58763
58775
58812
58839
58870
58886
58911
58934
58951
58981
58988
58997
59015
59021
59040
59175
59330
59337
59510
59518
59551
59564
59579
59592
59669
59676
59718
59743
59753
59868
59869
59875
59899
59926
60214
60234
60262
60313
60561
60763
61078
61463
61727
62226

also failed, but that was expected. had 5 weeks to prep for that one. Would be happy with a 4.

will hit it again in the spring.

I passed but this was a TOUGH sitting. This was my second attempt and I sunk in 500+ hours between both sittings. Y’all will get it on the next attempt! I genuinely believe you need to create your own note cards or fill in the gaps in some way in order to pass this one.

Congrats on passing!

Congrats! How did you identify the right cards to supplement either MATE or TIA note cards?

I think to some extent, this is subjective. But typically I decided this based on “okay could I see them asking this as a question”. For example, compare/contrasting individual disability income reinsurance vs. group long term disability reinsurance. On TIA and in the text, it seemed like something that was obscure but could be asked as a compare/contrast question so I added a notecard on that. Other notecards I added were where I felt there was a good list in the source material/outline that just didn’t make it to the notecards. Another thing I did was look at past exams and see if there were any lists they asked about in the past that could show up again (especially pertaining to ASOPs).

It isn’t a perfect science, but I think for this exam, better to add MORE notecards than less to be safe. Or if you don’t make a notecard for something, maybe just add more details on an existing notecard. For the Fall exam, I spent a good chunk of time familiarizing myself with details of the different care management methods and because I did that, I had plenty to say for the case management questions. If you just memorizing the MATE or TIA notecards, you probably wouldn’t have gotten those points.

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To those who passed, congratulations!

To those who didn’t, don’t give up! Let me know if there is any way we can help. Although we have recently started the material for GHS, some of the materials have been overlapped with other FSA exams, so we are not completely new to this exam. Besides summary of the study notes, we also provide flash cards. Students that have used them have nothing but good things to say about them. For our sample, please click here.

Should you have any questions, please feel free to email me at francisyung@pakstudymanual.com