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The recent changes and regulations have affected the way actuaries price commercial products, specifically in the individual and small group market. Actuaries will have to consider what was done prior to the Affordable Care Act (ACA) in recent years since the start of most provisions, and then how to use this recent experience to project premiums into future periods. New approaches and tools are needed to price policies in this new environment. Pricing will need to consider risk adjustment, guaranteed issue, risk selection and limitations on factors allowed in pricing. Rate filing requirements are different as well; this session will also discuss recent changes in the marketplace, solvency requirements, recent changes in regulation, including the potential impact of Short Term Medical (STM) products and changes in the availability of Association Health Plans (AHP).
For large group ratings, we 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. We will also compare and contrast fully insured, self-funded, and level funded coverage. Furthermore, 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.