Description: The Society of Actuaries' health leadership met earlier this year for an all-day meeting in Chicago. A significant portion of that meeting was spent discussing current challenges facing the U.S. health care system and how the SOA can best serve its members by addressing top priority issues. The Actuary Magazine, April/May 2005

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

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: 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: 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: Developing a formal strategy to guide the SOA’s activities with respect to public policy-related topics is underway. Recent experience shows that non-partisan contributions through the SOA’s research are already adding value to important public policy discussions.

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: Updates on the efforts of the Academy’s health practice council. its work groups and task forces, to educate health care policymakers on issues including health care reform, Medicare, loss ratios, premium review, reinsurance, benefit and eligibility changes, exchanges, and risk based capital.

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: 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.