A computer-implemented process of developing a person-level cost model for
forecasting future costs attributable to claims from members of a book of
business, where person-level data are available for a substantial portion
of the members of the book of business for an actual underwriting period,
and the forecast of interest is for a policy period is disclosed. The
process uses development universe data comprising person-level enrollment
data, historical base period health care claims data and historical next
period claim amount data for a statistically meaningful number of
individuals. The process also provides at least one claim-based risk
factor for each historical base period claim based on the claim code
associated with the health care claim and provides at least one
enrollment-based risk factor based on the enrollment data. The process
also develops a cost forecasting model by capturing the predictive
ability of the main effects and interactions of claim based risk factors
and enrollment-based risk factors, with the development universe data
through the application of an interaction capturing technique to the
development universe data.