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Agenda Day 2 and Presentations

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Wednesday, June 15
5:45 a.m. – 7:15 a.m.

Don't miss this annual networking opportunity. Relax, mingle and build professional connections and new friendships. Share your professional experiences with your peers and meet potential clients at this fun and useful event. Meeting badges are required for attendees and registered guests. 

Session Coordinator(s)

Facilitator(s)

7:00 a.m. – 5:00 p.m.
7:00 a.m. – 7:45 a.m.
8:00 a.m. – 9:30 a.m.

Barbara Corcoran Keynote Speaker: Barbara Corcoran

Self-Made Business Baroness and Author

Barbara Corcoran's credentials include straight D's in high school and college and twenty jobs by the time she turned twenty-three. It was her next job, however, that would make her one of the most successful entrepreneurs in the country, when she borrowed $1,000 from her boyfriend and quit her job as a waitress to start a tiny real estate company in New York City. Over the next twenty-five years, she'd parlay that $1,000 loan into a five-billion-dollar real estate business named The Corcoran Group. She sold the business in 2001 for seventy million dollars.

Barbara is the author of If You Don't Have Big Breasts, Put Ribbons on Your Pigtails , an unlikely business book and a national best-seller. In it, Barbara credits her struggles in school and her mother's kitchen-table wisdom for her success in the business world. The book is a fresh, frank look at how to succeed in life and business and is as heartwarming as it is smart and motivating. Her second book, Nextville, Amazing Places to Live the Rest of Your Life, is fast becoming another best-seller.

Barbara is a 'shark' on ABC's Shark Tank and the real estate contributor to the NBC Today Show. She is also a columnist for the New York Daily News and MORE Magazine, and appears on HGTV's Top Ten and Price Fix on LXTV.

As a speaker, Barbara brings her front-lines experience and infectious energy to every audience she addresses. Motivational, inspirational, and sometimes outrageous, Barbara Corcoran's tell-it-like-it-is attitude is a refreshing approach to success.

Session Coordinator(s)

Facilitator(s)

10:00 a.m. – 11:30 a.m.

Credits: 1.80 CPD

Session Sponsor(s): Health Section

Competency: External Forces & Industry Knowledge

Moderator(s): Courtney R. White, FSA, MAAA

Presenter(s): Jill Van Den Bos, ASA, MAAA; Stacy Koron, JD, FLMI; Courtney R. White, FSA, MAAA; Casey Word, FSA, MAAA

Experience Level: Intermediate

This session will discuss some of the lesser known provisions of the ACA that affect actuaries. Presenters will focus on ACA provisions such as uniform modification, non-discrimination, summary of benefit and coverage, and network adequacy.

At the conclusion of the session, attendees will be able to better understand all aspects of the ACA and how they affect actuaries.

Country Relevance : USA

Session Coordinator(s) Josh Anton Hammerquist, ASA, MAAA

Facilitator(s)

Presentation(s): View Presentation

Credits: 1.80 CPD

Session Sponsor(s): Health Section

Competency: Professional Values

Moderator(s): David M. Dillon, FSA, MAAA

Presenter(s): David M. Dillon, FSA, MAAA; Jan Graeber, ASA, MAAA; Annette V. James, FSA, EA, FCA, MAAA; Steven L. Ostlund, FSA, MAAA

Experience Level: All Levels

Ever wish you had a chance to talk directly to regulators about professionalism topics? Are you curious about what they expect from you? In this session you will get a chance to hear directly from regulators and ask them your questions.

At the conclusion of the session, attendees will be able to interpret feedback from regulators about professionalism concepts, apply lessons learned to their own interactions with regulators (rate filings, etc.) and describe the expectations of regulators.

Country Relevance: USA

Session Coordinator(s) Joe Wurzburger, FSA, MAAA

Facilitator(s)

Presentation(s): View Presentation

Credits: 1.80 CPD

Session Sponsor(s): Health Section

Competency: Results-Oriented Solutions

Moderator(s): Sabrina H. Gibson, FSA, MAAA

Presenter(s): Dawna Nibert; Lawrence R. Smart, FSA, MAAA

Experience Level: Intermediate

Hospital cost control is the number one goal of every health plan and as hospital billing practices become more complex, the health plan's job of controlling these costs becomes more difficult. Presenters for this session will discuss some of the most common ways hospitals increase revenue through billing practices and how the health plan can implement strategies to manage these practices. Some topics of discussion will be:

  • Short stays;
  • Upcoding;
  • Hospital affiliated physician billing;
  • Chargemaster increases; and
  • Readmission billing techniques.

Attendees should leave the session armed with insight into hospital billing practices that increase costs and strategies to mitigate the impact of these practices for a health plan.

At the conclusion of the session, attendees will be able to: Identify common hospital billing practices that increase costs; design medical expense initiatives that mitigate the increased costs due to certain hospital billing practices; and apply the information from the session to improve their health plans hospital cost trends.

Country Relevance: USA

Session Coordinator(s) Sabrina H. Gibson, FSA, MAAA

Facilitator(s)

Presentation(s): View Presentation

Credits: 1.80 CPD

Session Sponsor(s): Reinsurance Section

Competency: External Forces & Industry Knowledge

Moderator(s): Kevin James Trapp, FSA, FCIA, MAAA

Presenter(s): Kathryn Bronstein, Ph.D., RN; MAAA; Patrick Gallagher, FSA, FCAS; Kevin James Trapp, FSA, FCIA, MAAA

Experience Level: All levels

The evolving specialty pharmacy environment has created difficulties for actuaries pricing and forecasting pharmacy coverage. Unpredictable specialty pharmacy trends have increase insurers' earnings volatility, negatively affecting their capital position. This session will explain how reinsurance can be an efficient tool to help health insurers manage pharmacy trend risk. Presenters with different viewpoints will discuss both the financial impact of unpredictable pharmacy trends and reinsurance structures that can mitigate this risk.

At the conclusion of the session, attendees will be able to:

  1. Explain the impact specialty drugs trends have had on earnings volatility 
  2. Explain how reinsurance can be used to reduce this risk
  3. Compare the different reinsurance structures available
  4. Evaluate the risks and benefits associated with each structure

Country Relevance: USA

Session Coordinator(s) John S. Cathcart, FSA, MAAA

Facilitator(s)

Presentation(s): View Presentation

Credits: 1.80 CPD

Session Sponsor(s): Actuary of the Future Section; Predictive Analytics and Futurism Section; Technology Section

Competency: Technical Skills & Analytical Problem Solving

Moderator(s): David L. Snell, ASA, MAAA

Presenter(s): Dihui Lai, Ph.D.; David L. Snell, ASA, MAAA

Experience Level: All levels

Let's face it. The Actuary of the Future, which might mean tomorrow or next week, is comfortable speaking a different language from the actuary of the past. Likewise, she or he will likely be employing a different programming language. A message of less than 140 characters might be immediately read by millions of people, and it may change public opinion around the world. Like tweets, the language R is terse, powerful, free, and able to run on several different machine platforms and operating systems. Fluency in R may soon become a selection factor in getting your next job. This session will show you some of the predictive power you can have beyond spreadsheets. It will teach you how to get started so U B K in the new world of predictive analytics.

At the conclusion of the session, attendees will be able to evaluate whether R may be the preferred tool for a problem. Get started in programming with R.

Country Relevance : International

Session Coordinator(s) David L. Snell, ASA, MAAA

Facilitator(s)

Presentation(s): View Presentation

Credits: 1.80 CPD

Session Sponsor(s): Education & Research Section

Competency: Results-Oriented Solutions

Moderator(s): John D. Dawson, FSA, MAAA

Presenter(s): Eric Bour; Natalie Heidrich; Anuprita Patkar

Experience Level: Intermediate

U.S. obesity rates are continuing to rise and obesity treatments are under scrutiny. Attendees will learn how the treatment of the severely obese population is clinically and economically justified. One treatment, bariatric surgery is considered a safe and effective procedure to assist in significant weight loss. It also helps improve obesity-related diseases among severely obese persons leading to improved health and lower costs. However, coverage is not universal. Some health plans currently exclude or restrict bariatric surgery.

This session will address the clinical and economic impacts of bariatric surgery on the treatment of obesity, regarding the management of cardiovascular disease risk factors (i.e., type 2 diabetes, hypertension and dyslipidemia), as well as management of non-alcoholic fatty liver disease and chronic kidney disease, for up to five years post-surgery. An economic analysis detailing the cost savings that occur as a result of treating obesity in this population compared to those that don't have surgery will be explored.

 

At the conclusion of the session, attendees will be able to 

  1. Compare clinical outcomes of severely obese persons who undergo bariatric surgery vs. those who do not
  2. Describe the economic impact of surgical treatment of obesity
  3. Assess the role of a real-world claims database approach as a means for monitoring disease progression, as well as costs to help improve population health by providing real-world scenarios when surgical treatment for obesity is appropriate

Country Relevance : USA

Session Coordinator(s) Jay Lin

Facilitator(s)

Presentation(s): View Presentation

Credits: 1.80 CPD

Session Sponsor(s): Health Section

Competency: Strategic Insight and Integration

Moderator(s): Greg Vincent Sgrosso, FSA, MAAA

Presenter(s): Donna McDonald; Greg Vincent Sgrosso, FSA, MAAA

Experience Level: Intermediate

As insurers are constrained with their Medicare Advantage rates provided by CMS, the additional bonuses achieved through a favorable STAR rating have become even more important. This session will delve into the accomplishments of a successful 5.0 STAR plan in addition to cases of excellence in moving plans from a 3.0 STAR rating to a 4.0 STAR rating. Topics relevant to traditional insurers will be discussed. Impacts of ever-evolving regulations will be explored with the intent of bringing even more clarity to the STAR calculation. Experts will discuss techniques that can be used in various scenarios through real-life examples. Future opportunities and challenges will be highlighted. Opportunities will be given for the audience to ask questions.

At the conclusion of the session, attendees will be able to identify areas of improvement in their own or client's STAR rating, describe key levers to the STAR rating, and understand what goes into improving and/or maintaining a STAR rating.

Country Relevance : USA

Session Coordinator(s) Greg Vincent Sgrosso, FSA, MAAA

Facilitator(s)

Presentation(s): View Presentation

Credits: 1.80 CPD

Session Sponsor(s): Health Section

Competency: Technical Skills & Analytical Problem Solving

Moderator(s): Tasha S. Khan, FSA, MAAA

Presenter(s): Jeff Babino; Curt Zepeda

Experience Level: Intermediate

Many disability insurers use reinsurance to help address a variety of issues, from claim volatility to capital management to risk management expertise. This session explores the range of reinsurance offerings that are available in the disability insurance market.

At the conclusion of the session, attendees will be able to identify the ways that reinsurance can be used to help manage disability insurance business and describe the types of reinsurance offerings that are available.

Country Relevance : Non-Nation-Specific

Session Coordinator(s) Daniel D. Skwire, FSA, MAAA

Facilitator(s)

Presentation(s): View Presentation

Credits: 1.80 CPD

Session Sponsor(s): Education & Research Section

Competency: Technical Skills & Analytical Problem Solving

Moderator(s): Ian G. Duncan, FSA, FCA, FCIA, FIA, MAAA

Presenter(s): Joan C. Barrett, FSA,MAAA; Ian G. Duncan, FSA, FCA, FCIA, FIA, MAAA; Michael S. Miele, FSA,MAAA

Experience Level: All levels

Tomorrow's health actuary will need to be part risk manager, part clinician, part predictive modeler and part epidemiologist. The Health Section recently completed a review of the health actuarial curriculum. This session is designed to seek input from practicing actuaries. In addition, we will discuss ways to ensure that today's university students are exposed to health actuarial techniques.

At the conclusion of the session, attendees will be able to understand what education and training they will need for their future careers.

Country Relevance: USA and Canada

Session Coordinator(s) Ian G. Duncan, FSA, FCA, FCIA, FIA, MAAA

Facilitator(s)

Presentation(s): View Presentation

Credits: 1.80 CPD

Session Sponsor(s): American Academy of Actuaries

Competency: External Forces & Industry Knowledge

Moderator(s): Cori E. Uccello, FSA, FCA, MAAA

Presenter(s): Catherine M. Murphy-Barron, FSA, MAAA; Cori E. Uccello, FSA, FCA, MAAA; Thomas F. Wildsmith IV, FSA, MAAA

Experience Level: All levels

Academy volunteers will present examples of past and ongoing efforts to be a resource to legislative and regulatory policymakers, with a focus on the upcoming presidential election. These will include published issue briefs, comment letters, hearing testimony, hill briefings and meetings with staff. Panelists will also discuss behind the scenes activities and will comment on how the Academy's work has influenced public policy.

At the conclusion of the session, attendees will be able to: develop a better understanding of the ins/outs of working with policymakers and regulators to advance public policy initiatives; describe Academy efforts to inform various constituencies about the key issues in the 2016 election; and access Academy policy work.

Country Relevance : USA

Session Coordinator(s) Heather Jerbi

Facilitator(s)

Presentation(s): View Presentation

Credits: 1.80 CPD

Session Sponsor(s): Society of Actuaries

Competency: Technical Skills & Analytical Problem Solving

Moderator(s): Marjorie A. Rosenberg, FSA

Presenter(s): Brandon Barber; Geoffrey R. Hileman, FSA, MAAA; Marjorie A. Rosenberg, FSA

Experience Level: Intermediate

This session will present the update to the SOA study that compared several risk adjustment models-including the ACA model. This will be followed by two presentations discussing two of the models-CDPS and the HHS model-in more detail.

At the conclusion of the session, attendees will be able to identify which models might suit their needs, as well as evaluate how some of the specific characteristics of the model might need to be modified.

Country Relevance : USA

Session Coordinator(s) Rebecca Owen, FSA, MAAA

Facilitator(s)

11:45 a.m. – 1:45 p.m.

Join your fellow meeting attendees at this networking lunch. Catch-up with colleagues and friends, discuss previous sessions and make new acquaintances.

The luncheon is included in your registration fee. You may register your guest(s) for the luncheon by including $75 per person with your registration fee. Admission tickets are available for purchase at the meeting as space permits. Refunds will not be given.

Session Coordinator(s)

Facilitator(s)

2:00 p.m. – 3:30 p.m.

Presentation(s): View Presentation

Credits: 1.80 CPD

Session Sponsor(s): Health Section

Competency: Strategic Insight and Integration

Moderator(s): Greger J. Vigen, FSA

Presenter(s): Adam Ryan Singleton; FSA, MAAA

Experience Level: Intermediate and advanced

Networks are becoming more important in many parts of the country. In fact, in some locations, the right hospitals and physicians already offer a big difference in performance on quality and affordability. The Society of Actuaries has conducted a research project on networks. We will discuss networks in exchanges, network modeling analytic methods, case studies, and key elements that drive higher performance in some of the most successful networks across the country.

At the conclusion of the session, attendees will be able to understand some of the success stories across the industry and be able to monitor and strengthen the programs they are developing.

Country Relevance: USA

Session Coordinator(s) Greger J. Vigen, FSA

Facilitator(s)

Presentation(s): View Presentation

Credits: 1.80 CPD

Session Sponsor(s): Health and Long Term Care sections

Competency: Results-Oriented Solutions

Moderator(s): Caroline Humer, Correspondent, Reuters

Presenter(s): Roy Beveridge, MD; Vincent L. Bodnar, ASA, MAAA; Patricia Danzon, Ph.D.; Robyn Stone, Ph.D.

Experience Level: All Levels

This panel discussion will focus on the potential effects of Alzheimer's and dementia on the health and long-term care industries. According to the World Health Organization, worldwide, 47.5 million people have dementia and there are 7.7 million new cases every year, with Alzheimer's disease as the most common cause of dementia. And, treating and caring for people with dementia currently costs the world more than $604 billion per year. However, with drug companies touting a robust research pipeline and reporting developments that could slow the disease, it's evident that an effective treatment may soon be within reach. This multidisciplinary panel will explore:

  • The effects of this rampant disease on the financial health of the health care and long-term care industries;
  • How advances made to combat the disease will improve the financial health of these industries;
  • How the disease affects the way actuaries set rates for health plans;
  • What fluctuations in projected longevity mean for private and public pension plan funding; and
  • New models for drug pricing.

At the conclusion of the session, attendees will be able to understand:

  • The effects of this rampant disease on the financial health of the health care and long-term care industries;
  • How advancements in care and treatment of the disease may not improve the financial health of these industries;
  • How the disease affects how actuaries set rates for health plans;
  • Cost effective ways to manage care in the early stages of the disease; and,
  • New models for drug pricing.

Country Relevance : International

Session Coordinator(s) Deborah Wallace

Facilitator(s)

Presentation(s): View Presentation

Credits: 1.80 CPD

Session Sponsor(s): Health Section

Competency: External Forces & Industry Knowledge

Moderator(s): Samuel C. Vorderstrasse, FSA, MAAA

Presenter(s): Armen Garnikovich Akopyan, ASA, MAAA; Samuel C. Vorderstrasse, FSA, MAAA

Experience Level: Advanced

The panel will focus on transition risks and the significant impact on financial reporting and surplus monitoring as companies and regulators learn to cope with implementation of the Affordable Care Act. Transition risks include estimating the impact of adverse selection, obtaining adequate pricing, and the effectiveness of premium stabilization programs (the 3-Rs), among others.

At the conclusion of the session, attendees will be able to understand the implications of the changes to the 3R programs on financial reporting and pricing.

Country Relevance: USA

Session Coordinator(s) Jackie Lee

Facilitator(s)

Presentation(s): View Presentation

Credits: 1.80 CPD

Session Sponsor(s): Health Section

Competency: External Forces & Industry Knowledge

Moderator(s): Jennifer L. Gerstorff, FSA, MAAA

Presenter(s): Jeremy D. Palmer, FSA, MAAA; Christopher John Truffer, FSA, MAAA

Experience Level: All levels

Recent federal guidelines have been released to further regulate capitation rate setting for Medicaid managed care programs. Our panel includes a representative from the Centers for Medicare and Medicaid Services and a consulting actuary with years of experience setting rates on behalf of state agencies. The panel will discuss how the regulatory environment has changed in recent years, expectations of future changes, and how that will impact actuaries working in Medicaid managed care.

At the conclusion of the session, attendees will be able to identify new guidelines and regulations for Medicaid managed care rate setting.

Country Relevance : USA

Session Coordinator(s) Jennifer L. Gerstorff, FSA, MAAA

Facilitator(s)

Presentation(s): View Presentation

Credits: 1.80 CPD

Session Sponsor(s): Health Section

Competency: Technical Skills & Analytical Problem Solving

Moderator(s): Christopher James Coulter, FSA, CERA, MAAA

Presenter(s): Chris G. Gross, ACAS, MAAA; Sheamus Kee Parkes, FSA, MAAA

Experience Level: Intermediate

Where is the largest concentration of risk in the IBNR triangle? How much information is lost when aggregating information into an IBNR triangle? In this session, we will attempt to provide answers to these questions: with an exploration of risk through visual representations, and with an application of predictive modeling with reserves from a casualty actuary perspective.

At the conclusion of the session, attendees will be able to discuss where the distribution of uncertainty in an IBNR triangle. They will also understand the benefits that a predictive modeling approach brings to the reserving process. 

Country Relevance : USA

Session Coordinator(s) Christopher James Coulter, FSA, CERA, MAAA

Facilitator(s)

Presentation(s): View Presentation

Credits: 1.80 CPD

Session Sponsor(s): Health Section

Competency: External Forces & Industry Knowledge

Moderator(s): Robert W. Beal, FSA, MAAA

Presenter(s): Robert W. Beal, FSA, MAAA; Mark S. Seliber, FSA, MAAA

Experience Level: Intermediate

For many years, the 1985 CIDA table has been the only benchmark for individual disability experience. Following the development of a new industry table, however, companies have an improved ability to study and assess the trends in their business. This session explores recent trends and how they compare to the new industry table.

At the conclusion of the session, attendees will be able to understand how industry trends are emerging relative to the new tables and steps that companies are taking for monitoring their own business.

Country Relevance : Non-Nation-Specific

Session Coordinator(s) Robert W. Beal, FSA, MAAA

Facilitator(s)

Presentation(s): View Presentation

Credits: 1.80 CPD

Session Sponsor(s): Health and Joint Risk Management (CAS, CIA, SOA) sections

Competency: External Forces & Industry Knowledge

Moderator(s): Richard C. Tash, FSA, MAAA

Presenter(s): Rhonda Kay Ahrens, FSA, MAAA; Matthew Kramer, FSA, CERA, MAAA

Experience Level: All levels

With 2015 being the first year for health insurance ORSA filings, this session will provide regulator feedback on completeness of ORSA reports and what is expected in the future. They can describe what they liked and disliked in the reports to help the industry improve reporting in the future.

At the conclusion of the session, attendees will be able to understand regulator expectations regarding ORSA to improve their ORSA filings for the following year and improve their stakeholder management around ORSA.

Country Relevance : USA

Session Coordinator(s) Richard C. Tash, FSA, MAAA

Facilitator(s)

Presentation(s): View Presentation

Credits: 1.80 CPD

Session Sponsor(s): Health Section

Competency: Strategic Insight and Integration

Moderator(s): John Patrick Kinney III, FSA, MAAA

Presenter(s): Dorothy L. Andrews, ASA, MAAA; Soojin Jang, ASA, MAAA; John Patrick Kinney III, FSA, MAAA

Experience Level: All levels

This session is geared towards those that haven't had much exposure to behavioral economics or those that haven't thought about it much in the recent years. It'll be a beginner session aimed at helping people see the relevance of this work to the future of the health actuary.

At the conclusion of the session, attendees will be able to understand basic concepts of behavioral economics.

Country Relevance : USA

Session Coordinator(s) Soojin Jang, ASA, MAAA

Facilitator(s)

Presentation(s): View Presentation

Credits: 1.80 CPD

Session Sponsor(s): Health Section

Competency: External Forces & Industry Knowledge

Moderator(s): Jennifer O'Brien Howard, FSA, MAAA

Presenter(s): Stephanie Atkins, ASA, CERA, MAAA; Richard F. Hartman, FSA, MAAA; Jennifer O'Brien Howard, FSA, MAAA; Stacey Sanders Hunter, FSA, MAAA

Experience Level: Beginner

With changes in the health world due to ACA, carriers are diversifying their risks and exploring new avenues of business, including supplemental health products. This session will discuss the various types of products carriers are exploring, what carriers should consider in the development of these products, and new trends we are seeing in the worksite market as a result of this expansion. We will discuss marketing, actuarial, and systems concerns from a product development perspective.

At the conclusion of the session, attendees will be able to understand the current status of the product development process for supplemental health products in the worksite.

Country Relevance: USA

Session Coordinator(s) Ashlee Mouton Borcan, FSA, MAAA

Facilitator(s)

Presentation(s): View Presentation

Credits: 1.80 CPD

Session Sponsor(s): Health Section

Competency: External Forces & Industry Knowledge

Moderator(s): Susan R. Sames, FSA, MAAA

Presenter(s): Amy Suzanne Whinnett, FSA ,MAAA

Experience Level: Intermediate

This session provides an update on mortality research performed by the Group Life Experience Committee of the Society of Actuaries. Specific considerations may include items such as overall mortality, waiver incidence, mortality improvement, and supplemental life experience.

At the conclusion of the session, attendees will be able to understand recent mortality trends in the group life business.

Country Relevance : USA

Session Coordinator(s) Cynthia MacDonald, FSA, MAAA

Facilitator(s)

Presentation(s): View Presentation

Credits: 1.80 CPD

Session Sponsor(s): Health Section

Competency: Technical Skills & Analytical Problem Solving

Moderator(s): Brian Edward Pauley, FSA, MAAA

Presenter(s): Christopher Lynn Andrews, FSA, MAAA; Adam J. Barnhart, FSA, MAAA; Tyler Laughlin, ASA, MAAA

Experience Level: Advanced

In an environment of funding reductions and growingly complex Bid Pricing Tool (BPT) requirements, MA-PD bid actuaries are faced with more challenges than ever in completing their bids and developing subsequent financial forecasts for clients and organizations. This session explores all of the challenges and complexities facing actuaries pricing plans with downside risk arrangements.

At the conclusion of the session, attendees will be able to understand techniques actuaries use, variables to consider and associated challenges in projecting medical claims costs for the Medicare Advantage population.

Country Relevance : USA

Session Coordinator(s) Brian Edward Pauley, FSA, MAAA

Facilitator(s)

3:30 p.m. – 4:00 p.m.

Session Coordinator(s)

Facilitator(s)

4:00 p.m. – 5:30 p.m.

Presentation(s): View Presentation

Credits: 1.80 CPD

Session Sponsor(s): Health Section

Competency: External Forces & Industry Knowledge

Moderator(s): Joseph P. Slater, FSA, MAAA

Presenter(s): Bethany McAleer, FSA, MAAA; Anthony W. Piscione, FSA, MAAA; Joseph P. Slater, FSA, MAAA; Joshua Ryan Strupcewski, ASA, MAAA

Experience Level: All Levels

Under the Affordable Care Act (ACA), all individuals and groups with 50 or fewer subscribers will eventually be subject to the ACA's modified community rating rules. While some individuals and small groups have benefited financially from ACA's rating rules, a significant number have avoided the ACA's pools due to the expectation of significantly higher premiums. To date the most popular ACA avoidance tactic has been the use of transitional relief or "grand-mothering" in states with that option available. With the transitional relief window scheduled to close in 2017, many health insurers will need to invest a large amount of time and effort into determining how the end of transitional relief will impact their ACA business. A large part of this task will be modeling individual and group decision making in light of the options available to them. Some will move to an ACA pool. Others will drop coverage. And some will seek other alternatives.

At the conclusion of the session, attendees will be able to:

  1. Apply the ACA's rating rules to develop prospective premium rates for individuals and groups that are currently utilizing transitional relief.
  2. Develop an understanding of how individual and group migration will impact the rates that an insurer can offer its ACA pools.
  3. Design a migration model to anticipate the rate morbidity and rate impacts of the end of transiliional relief.

Country Relevance: USA

Session Coordinator(s) Joseph P. Slater, FSA, MAAA

Facilitator(s)

Presentation(s): View Presentation

Credits: 1.80 CPD

Session Sponsor(s): Health and Social Insurance & Public Finance sections

Competency: External Forces & Industry Knowledge

Moderator(s): Rebecca Owen, FSA, MAAA

Presenter(s): Zack Cooper, Ph.D.; James Patrick Hazelrigs, ASA, MAAA

Experience Level: All levels

There has been a general assumption both by policy-makers and in the literature that what we observe for Medicare broadly applies to spending on the privately insured. Health care cost varies significantly by region and the relationship can be very different between Medicare and private insurance. Differences in the ways that providers are paid play a crucial role here.

At the conclusion of the session, attendees will be able to understand the cost variation and findings from some recent studies to help in their work and analysis on this topic.

Country Relevance: USA

Session Coordinator(s) Rebecca Owen, FSA, MAAA

Facilitator(s)

Presentation(s): View Presentation

Credits: 1.80 CPD

Session Sponsor(s): Health Section

Competency: External Forces & Industry Knowledge

Moderator(s): Stephen P. Melek, FSA, MAAA

Presenter(s): Stephen P. Melek, FSA, MAAA; Jordan Paulus, FSA, MAAA; Daniel J. Perlman, FSA, MAAA

Experience Level: All levels

This session will provide an overview of the requirements of the Mental Health Parity and Addiction Equity Act. Large employer plans and (since 2014) individual and small group plans must comply with quantitative and nonquantitative requirements to ensure parity between medical/surgical and behavioral health care benefits. While the concept seems straightforward, the regulations include some specific mathematical tests that can give rise to counter-intuitive requirements for compliance. The session will also discuss nonquantitative treatment limitation requirements, which have gotten less attention but are equally important for compliance.

At the conclusion of the session, attendees will be able to:

  1. Evaluate a health benefit plan for compliance with quantitative parity requirements.
  2. Identify broad categories of non-quantitative treatment limitations.
  3. Design parity-compliant health benefits.

Country Relevance : USA

Session Coordinator(s) Daniel J. Perlman, ASA, MAAA

Facilitator(s)

Presentation(s): View Presentation

Credits: 1.80 CPD

Session Sponsor(s): Predictive Analytics and Futurism Section

Competency: Technical Skills & Analytical Problem Solving

Moderator(s): Andrew John Mackenzie, ASA, MAAA

Presenter(s): Vincent J. Granieri, FSA, MAAA, EA; Norman M. Storwick, FSA, MAAA

Experience Level: All levels

This session will feature speakers sharing cutting-edge techniques and data sources for predictive analytics applications. The session will include presentation of the results of sophisticated modeling efforts and a discussion of non-traditional sources.

Gain an appreciation for practical applications of emerging analytical techniques. Understand how new techniques are being applied to solve actuarial and related problems.

Country Relevance: Non-Nation-Specific

Session Coordinator(s) Geofffrey R. Hileman, FSA, MAAA

Facilitator(s)

Presentation(s): View Presentation

Credits: 1.80 CPD

Session Sponsor(s): Health and Joint Risk Management (CAS, CIA, SOA) sections

Competency: Strategic Insight and Integration

Moderator(s): Thomas Edward Weist, CERA, FCAS, MAAA

Presenter(s): Mario E. DiCaro, FCAS, MAAA; Marcus Andrew Such, ASA, MAAA

Experience Level: All levels

This session will focus on the ERM best practices that apply to health insurance. From the strategic M&A decision to risk measuring and monitoring and proper governance, this session will focus on how to best implement an ERM program to gain a competitive advantage

At the conclusion of the session, attendees will be able to:

  1. Understand ERM best practices
  2. Apply these best practices to the health industry
  3. Obtain a competitive advantage with the ERM program

Country Relevance: Non-Nation-Specific

Session Coordinator(s) Thomas Edward Weist, CERA, FCAS, MAAA

Facilitator(s)

Presentation(s): View Presentation

Credits: 1.80 CPD

Session Sponsor(s): Health Section

Competency: Professional Values

Moderator(s): Clay Farris

Presenter(s): Zachary Christian Aters, ASA, MAAA; Clay Farris; Sabrina H. Gibson, FSA, MAAA; Ernest Gerald Jaramillo III, ASA, FCA, MAAA

Experience Level: All levels

Ethical challenges arise in all actuarial disciplines, and Medicaid is no exception. Our panel of experts will discuss examples of ethical situations that they or their colleagues have encountered during their time practicing in the Medicaid area. These examples will be discussed with audience participation to obtain opinions on how they could be best handled. The panel will also advise how they tackled the issues in the real-world.

At the conclusion of the session, attendees will be familiar with some common ethical and professionalism challenges in Medicaid actuarial work and understand tactics for overcoming these challenges in a manner that meets the high ethical standards required of the profession.

Country Relevance : USA

Session Coordinator(s) Jennifer L. Gerstorff, FSA, MAAA

Facilitator(s)

Presentation(s): View Presentation

Credits: 1.80 CPD

Session Sponsor(s): Predictive Analytics and Futurism Section

Competency: Technical Skills & Analytical Problem Solving

Moderator(s): Douglas T. Norris, FSA, MAAA

Presenter(s): Joan C. Barrett, FSA, MAAA; Geoffrey R. Hileman, FSA, MAAA

Experience Level: All levels

This session will focus on key conceptual principles in building and explaining actuarial models. We will discuss the importance of explaining potential uncertainties, approaches for properly communicating results, the importance of a priori assumptions, and the essential importance of driving stakeholders to key underlying questions rather than simply presenting data and model results. A second presentation will propose ten questions that should be asked about any analysis. We will also cover the importance of data governance as a component of model-building.

At the conclusion of the session, attendees will be able to: evaluate existing models and modeling practices against recommendations in presentation. Identify key questions to ask in any modeling exercise. Demonstrate added value to stakeholders in the execution of modeling exercises.

Country Relevance: Non-Nation-Specific

Session Coordinator(s) Geoffrey R. Hileman, FSA, MAAA

Facilitator(s)

Presentation(s): View Presentation

Credits: 1.80 CPD

Session Sponsor(s): Health Section

Competency: External Forces & Industry Knowledge

Moderator(s): Gregory L. Warren, FSA, FCA, MAAA

Presenter(s): Ira Klein, MD, MBA, FACP; Newell McElwee, PharmD, MSPH; Whitney Schwark Pratt, FSA, MAAA, CERA

Experience Level: All levels

This session will explore pharmaceutical manufacturer perspectives on economic value and how the health economic and outcomes research and actuarial professions can work together to bridge understandings of economic value between the payer and manufacturer industries.

At the conclusion of the session, attendees will be able to:

  1. Understand pharmaceutical manufacturer perspectives on economic value definitions.
  2. Evaluate the comprehensive economic value specific prescription drugs provide relative to their       competitors or treatment alternatives.
  3. Develop strategies to optimize the overall economic value of prescription formulary designs.

Country Relevance : USA

Session Coordinator(s) Gregory L. Warren, FSA, FCA, MAAA

Facilitator(s)

Presentation(s): View Presentation

Credits: 1.80 CPD

Session Sponsor(s): Social Insurance & Public Finance Section

Competency: External Forces & Industry Knowledge

Moderator(s): Ali Zaker-Shahrak, FSA, MAAA, Ph.D.

Presenter(s): Stephen Goss, ASA, MAAA; Doug Vrooman, FSA, MAAA

Experience Level: Intermediate

In this session we review disability insurance that is provided by public (government) and private insurance companies. Topics covered will include:

  • History
  • Coverage
  • Funding
  • Market size
  • Product Types
  • Coordination of products offered by public and private sector
  • Gaps in coverage
  • Challenges facing public sector funding
  • Likely changes coming to the market in the coming years

At the conclusion of the session, attendees will be able to:

  • Explain the current state-coverage and funding-of Social Security and private sector Disability Insurance.
  • Discuss some emerging changes that are taking place due to the effects of the Budget Deal passing.
  • Evaluate possible private insurers' responses to emerging changes to in SSDI.

Country Relevance : USA

Session Coordinator(s) Douglas Ryan Vrooman, FSA, MAAA

Facilitator(s)

Presentation(s): View Presentation

Credits: 1.80 CPD

Session Sponsor(s): Health Section

Competency: Professional Values

Moderator(s): Joe Wurzburger, FSA, MAAA

Presenter(s): Pedro Luis Alcocer, FSA, MAAA; Joe Wurzburger, FSA, MAAA

Experience Level: All levels

Never has professionalism been more important for health actuaries than during this period of high visibility and nearly constant change. Join a panel of experts in reviewing professionalism standards and expectations to make sure that you are up to the challenge.

At the conclusion of the session, attendees will be able to:

  • Identify Actuarial Standards of Practice that are relevant to them.
  • Describe the following: ASOPs, practice notes, and the Code of Professional Conduct.
  • Demonstrate understanding of professionalism concepts through the consideration of realistic scenarios.

Note: This session will be repeated on Friday, June 17, 10:30 a.m. - Noon - Session 134 PD.

Country Relevance: Non-Nation-Specific

Session Coordinator(s) Joe Wurzburger, FSA, MAAA

Facilitator(s)

Presentation(s): View Presentation View Handout

Credits: 1.80 CPD

Session Sponsor(s): Leadership and Development Section

Competency: Leadership

Moderator(s): Joanne Ryan, FSA, MAAA

Presenter(s): Jennifer Barley, PCC; Karen Sullivan, PCC, MA

Experience Level: All levels

Everything is a choice. And when people choose to be a version of them that is bold, passionate, boundless and fulfilled, they rattle all the right cages that produce results. Individuals who have a clear grasp on who they are, plus what they want out of life (and how to get it!) are able to identify opportunity, engage with focus and act with intentional purpose. With Get REAL Leadership we help awaken those kinds of leaders. We start with them being a person first. The challenge comes down to perspective. Are you at the effect of what happens or at the cause of what happens? We have the ability to create all our experiences and that in turn determines how we show up as a leader. Are you reacting or are you responding? There are five choices that we have for every situation that is draining us, frustrating, irritating, annoying and just down right seems unfair at time. Learning these five choices helps you to stay in the cause mode. And then imagine leading others to do the same…well, that might just get a positivity and engagement explosion.

At the conclusion of the session, attendees will be able to At the conclusion of the session, attendees will be able to:

  1. Clearly identify what situations they are at the effect of and at the cause of and what is the difference.
  2. Earn and apply the Power of Choice through understanding the five choices for every situation.
  3. Determine what is keeping them in reaction mode and techniques on how to shift to response mode.

Country Relevance : Non-Nation-Specific

Session Coordinator(s) Joanne Ryan, FSA, MAAA

Facilitator(s)

Presentation(s): View Presentation

Credits: 1.80 CPD

Session Sponsor(s): Health Section

Competency: Strategic Insight and Integration

Moderator(s): James F Walbridge, FSA, MAAA

Presenter(s): Julia S. Lambert, FSA, MAAA; Richard Lieberman

Experience Level: Intermediate

This session will discuss Medicare Advantage risk adjustment topics-where we've been, where are we now and where are we going-with the focus of the session dedicated to the encounter data usage in risk adjustment. We will identify the systems CMS is using to incorporate encounter data, how the new scores will be calculated and some live data showing impacts of the new filtering logic.

At the conclusion of the session, attendees will be able to understand how encounter data is currently and will be applied to the Medicare risk adjustment system, pitfalls and what plans should be doing now to ensure they are not at risk for revenue shortfalls.

Country Relevance : USA

Session Coordinator(s) Julia S. Lambert, FSA, MAAA

Facilitator(s)

Presentation(s): View Presentation

Credits: 1.80 CPD

Session Sponsor(s): Health Section

Competency: External Forces & Industry Knowledge

Moderator(s): Timothy Willard Smith, ASA, MAAA

Presenter(s): Ian G. Duncan, FSA, FCA, FCIA, FIA, MAAA; Ann Marks, RN; Timothy Willard Smith, ASA, MAAA

Experience Level: All levels

Population health is a new way to organize health care motivated by concerns that the health care system provides inadequate value to society. However, the role for health actuaries as part of the population health "mandate" may be unclear to those within the actuarial profession and to population health professionals. This session is intended to serve as a primer for health actuaries interested in becoming more involved in population health efforts. It is also focused on assisting health actuaries communicate their role as part of ongoing and future population health efforts.

At the conclusion of the session, attendees will be able to define population health as a new model for health care delivery, determine the population health initiatives that would benefit from an actuarial skill set and identify new business opportunities in the area of population health management.

Country Relevance : USA

Session Coordinator(s) Robert D. Lieberthal, Ph.D.

Facilitator(s)

7:30 p.m. – 9:30 p.m.

Session Sponsor(s): Entrepreneurial & Innovation Section

Join us for a fun and exciting reception open to all attendees with make-your-own sundaes and a top-rated comedy improv group (featuring a guest appearance from a surprise actuarial improvisationalist). Network, improvise, laugh and enjoy dessert! 

We hope you will join us!

This networking reception is open to all meeting attendees. There is a nonrefundable fee of $10 per person for Entrepreneurial & Innovation Section members and $20 per person for all others. Please include the additional fee with your registration. 

Session Coordinator(s) Pauline Reimer, ASA, MAAA

Facilitator(s)

10:00 p.m. – 1:00 p.m.

Presentation(s): View Presentation

Credits: 1.80 CPD

Session Sponsor(s): Health and Leadership & Development sections

Competency: Leadership

Moderator(s): Olga T. Jacobs, FSA, MAAA; Margaret Resce Milkint

Presenter(s): Yvette D. Bright, MBA; Lucinda M. Lewis, FSA, MAAA; Sarah C. Osborne, FSA, FCA, MAAA; Randy Termeer; Mary Kindel Van der Heijde, FSA, MAAA; Linda L. Williams

Experience Level: All levels

Description:

The Health and Leadership & Development sections, in affiliation with the Women's Insurance Networking Group (WING), presents the Second Annual Women's Leadership Forum & Lunch.

This forum will focus on female leadership and diversity topics including authentic leadership, next stage diversity initiatives, the new face of diversity and empowerment, as well as current challenges and insider perspectives on diversity and inclusion. It will feature a keynote presenter, as well as a panel of female and enlightened male leaders. This will be followed by a roundtable discussion and structured networking to round out your personal and professional enrichment. The forum will conclude with a lightning round of key takeaways and lessons learned. Lunch will be provided.

We welcome all genders to join us for this engaging, thought-provoking forum.

This session includes lunch and is open to all meeting attendees free of charge. If you plan to attend you must register in advance to obtain a ticket.  Attendance is limited to 100 people.

Country Relevance: Non-Nation Specific

Session Coordinator(s) Sarah C. Osborne, FSA, FCA, MAAA

Facilitator(s)