An actuarial projection is a prediction of monies which the insurance scheme will need to pay out in a following period (next year, next 5 years, etc.) This prediction is based on many factors, some quantitative, some qualitative. A good actuary will attempt to understand the health of the population and the trend in that health status, the costs of medical care (called medical loss ratio) and the trend in those costs, the expectations for services from the population, the introduction of new medical technologies and their impacts, etc.