Description: Panelists discuss key aspects of recent and pending laws and the cost and design implications on group health plans. From the Record of the Society of Actuaries, Vol. 24, No. 2.

Description: This presentation is a Health Section meeting from the 1991 Annual Meeting of the Society of Actuaries, held October 20-23 in Toronto. The session leader, the incoming chair of the section, covers administrative matters, and then the next speaker addresses a newly completed research project, sponsored by the Society and Health Section, on the variation by duration in small group medical insurance claim costs. The speakers then discuss current developments in small group reform, and the various parties involved, including the National Association of Insurance Commissioners [NAIC], and the Health Insurance Association of America [HIAA], and the work that has been done, including modeling to address the impact of a small group reform mechanism. The speakers discuss how the various parties' objectives can differ. Discussion from participants is included. From the Record of Society of Actuaries, Volume 17, No. 4B.

Description: Updates on the efforts of the Academy’s health practice council. its work groups and task forces, to conduct research and educate health care policymakers on issues including principles for market reform, individual insurance, and risk factors.

Description: Reviews the book, HMOs and the Politics of Health System Reform, by Joseph Falkson which discusses HMOs' legislative and regulatory structuring.

Description: The SOA’s research objective is to provide guidance to state exchange officials and administrators, federal officials and administrators, and actuaries assisting states and health plans. The goal of the project is to estimate the morbidity and/or cost for newly insured individuals in the individual market (and to some degree, the small group exchange) relative to the morbidity and/or cost for the current commercially insured population. This analysis will primarily focus on the individual, non-group market. In order to plan for the impact that these currently uninsured individuals will have on the health insurance markets, it will be important to understand their costs relative to the costs for people already enrolled, for whom many health insurers have experience and data.

Description: Part II of a two-part series discussing individual market evolution from before the ACA through President Trump's first term.

Description: A summary of the 14th Monograph “Health Risk Assessment and Health Risk Adjustment: Current Initiatives” published by The American Academy of Actuaries.'The monograph examines the approaches of two states, New York and California, in implementing or considering risk adjustment provisions in recent legislative reforms.'

Description: Summary of results of a 2010 Health Section survey of actuaries and Medicare population, on ways to bend the cost trend curve downward. Issues included transparency, quality measures, fraud and abuse, provider payment, malpractice, medical errors, consumer education, and the pros and cons of employer-sponsored coverage.

Description: There have been a variety of proposals related to expanding eligibility for Medicare, ranging from a publicly funded program to a full buy-in option. This session will explore the actuarial implications of various buy-in proposals and the potential impact that such policy changes could have on the health care market landscape. In particular, we will discuss the ways in which program eligibility requirements, plan designs, provider reimbursement arrangements, network design, rating rules, and subsidies could affect premium levels and membership volume in a Medicare buy-in market, as well as the potential side effects on providers and existing health care markets.

Description: Updates on HPC activities, including new work groups for providing input to key players as health care reform moves on from the legislative phase into the regulatory phase, as well as ongoing activities of existing workgroups in financial reporting, long term care, stop loss, disease management, Medicare SUpplement, sovency, cancer claims experience, and risk adjustment.