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The changes required by the Affordable Care Act (ACA) have resulted in updates in the way actuaries have to price, specifically in the individual and small group market. Presenters will discuss what was done prior to the ACA, in the recent years since the start of most provisions and how to use this recent experience to project premiums into the future periods. New approaches and tools are needed to price policies that will be effective in 2017, as well as for those that renew or are effective in 2018 and later. Pricing will need to consider risk adjustment, guaranteed issue, risk selection and limitations on factors allowed in pricing. Rate filing requirements are very different as well. This session will discuss recent changes in the marketplace, solvency requirements and recent changes in regulation.
For large group rating, presenters will review topics such as minimum value, cadillac tax issues, expanding coverage to workers with less than 40 hours, high deductible health plan designs and their impact to selection and cost savings. Presenters will also compare and contrast fully insured, self-funded and level funded coverage. This boot camp will include an hour focused on relevant ASOPs and professionalism issues.
This program will be a technically advanced program, focused specifically on pricing.