Description: 2021 Life Meeting - Session 5F: Premium Leakage - How Outdated Claims Systems are Losing You Money 8.31.21 Recording

Description: Familiarize yourself with Precision Medicine Diagnostics and Prescription Digital Therapeutics. The innovation in these markets has the potential to improve clinical outcomes across a range of mental health and physical conditions. Market growth will be associated with potentially important PMPM cost impacts as utilization increases and benefit designs evolve. Experience with existing and new technologies will enable a better understanding of possible financial efficiencies related to their use. One category of Precision Medicine Diagnostics includes genetic diagnostics, which are analyses of DNA and genetic material. The resulting genetic insights are to predict disease or enhance response to treatment. The U.S. market is expected to grow from about $5 billion to approximately $8 billion in 2025. Prescription digital therapeutics (PDTs) are software-based interventions intended to prevent, manage or treat disease. PDTs are prescribed by physicians alongside prescription drugs, supported by clinical data, and regulated by the Food & Drug Administration. PDTs enable collection of real-world data for use by prescribing clinicians and other health care stakeholders. To date, the FDA has authorized just nine PDTs, but the annual global growth is expected to grow from about 19 percent to 26 percent, resulting in an estimated $10 billion market in 2025. After the session, you will be able to describe how the two markets are defined and articulate the current and projected market sizes. You will also be encouraged to increase attention to the forecasting challenges that these developing areas pose and incorporate respective considerations into financial modeling.

Description: Learn the roles and responsibilities of a valuation actuary to help health actuaries learn best practices, technical considerations, and professionalism issues surrounding the calculation and reporting of health liabilities and reserves. Focus on key actuarial liability and reserve provisions, including Claims Unpaid and Premium Deficiency Reserves. Explore new ideas about calculation methods and the importance of the underlying assumptions. Examples will be provided to present best practices and practical applications concerning reserve calculation. A discussion of best practices regarding the preparation of an actuarial memorandum supporting a Health Annual Statement will be included to focus on key considerations from the American Academy of Actuaries’ Practice Note about documenting and supporting the actuarial calculations. The discussion will feature views and considerations from both the insurer’s and the regulator’s perspectives. By attending this session, you will be able to: • Understand the roles and responsibilities of the appointed actuary. • Identify what’s in scope for the actuarial opinion. • Understand actuarial qualification requirements. • Learn the statutory rules for establishing key actuarial liability provisions. • Understand the general purpose of financial reporting. • Understand best practices with reserve calculations and resources available, including relevant practice notes and Actuarial Standards of Practice. • Understand the sufficient documentation needed to support valuation work. • Understand the critical elements sought by regulators, auditors and other users of an actuarial memorandum.

Description: Health care has changed rapidly over the past couple of years. The pandemic has shifted consumer behavior in how and where they receive health care as well as consumer attitudes toward health care. Payers continue to design innovative solutions in responses to their patient’s needs and expectations. These changes in consumer behaviors and the responses by payers are expected to impact both health care cost and utilization. Discuss changes in health care that have emerged due to the pandemic and how they are expected to influence actuarial assumptions. Explore epidemiological models commonly used in the industry, the considerations when using these models, as well as the challenges with regards to gathering and interpreting relevant experience data. By attending this session, you will be able to: Identify shifts in consumer behavior that have emerged from the pandemic and describe how payers are responding to new patient expectations. Discuss how these post-pandemic changes by consumers and payers influence medical spending. Determine which actuarial assumptions are impacted and how and if the impact is expected to be temporary or permanent. Discuss considerations taken by actuaries and challenges faced when modelling actuarial assumptions post pandemic.

Description: This session series is sponsored by Hannover Re Session 1 - COVID-19: Past, Present and Future and Its Impact on Health Products COVID-19 has had an unprecedented impact on the health industry, forcing insurance companies and other risk-sharing entities to re-assess how to write and manage its business going forward. This first of two sessions in the special COVID-19 series will review the impact the pandemic has had on the development, pricing and risk management of health products. The speakers will review COVID-19 mortality and morbidity trends, share possible outlooks for the future of the virus, and analyze how COVID-19 has impacted the pricing strategies and risk management of health business across various markets (e.g., the ACA marketplace, Group Commercial and Medicare). By attending this session, you will be able to explain the latest COVID-19 trends in the US and globally and the resulting impact on mortality and morbidity experience. Attendees will develop a clearer understanding of how the pandemic has impacted the pricing and risk management of health products.

Description: The past couple years during the pandemic have had a tremendous and costly impact on society’s collective mental health. What’s next? Examine patterns of MH/SA needs identified from living with COVID-19 for two years and discuss what MH/SA needs to expect in the future. Across society, mental health has been one of the most impacted areas of total health and wellness and has been highly publicized. What’s here to stay, and how does that impact how we think about mental health going forward? With increased publicity and campaigns to normalize MH/SA needs, what are the supply-side and demand-side limits? By attending this session, you will be able to: • Identify drivers of MH/SA services in the pandemic. • Understand future expectations of MH/SA needs, with population specific considerations (ex. gender, business type, etc.). • Analyze impact of increased awareness of MH/SA needs and reduced stigma.

Description: This session will kick off the key National Association of Insurance Commissioners (NAIC) activities, with a primary focus on updates to principle-based reserve valuations and appointed actuary topics. Discover insights into the current set of activities and initiatives being considered and/or adopted by the NAIC Life Actuarial Task Force (LATF) and the NAIC Risk Based Capital Working Group as well as Actuarial Standards Board. Discuss actuarial practice issues and other appointed actuary and opinion topics relevant to life insurance, variable annuities and fixed annuities. By attending this session, you will: - Understand what changes are being made to reserves, RBC, PBR and Actuarial Standards and related topics and the anticipated timing of such emerging changes.

Description: Telehealth continues to be a story of unrealized potential than realized success. Find out what's pushing telehealth forward as a means of remote healthcare and the challenges its facing. Discuss questions, including: - Telehealth's role in expanding access to mental healthcare is clear, but what about other conditions? - Was access expanded for all patients or do modern delivery methods leave some patients behind - How do telehealth costs compare to in-person costs? - What happens to the value proposition if unit cost savings is off the table?

Description: Burnout is impacting the business world now, and even prior to the pandemic. Burnout is a state in which motivation declines markedly, leading to stress, increased use of sick leave, potential illness and lowered work performance. To be effective people leaders, or to simply manage one’s own situation, it is important to gain insight into the symptoms of burnout, the causes, prevention and how to effectively deal with it. By attending this session, you will gain understanding of employee burnout, how to help yourself and your team members effectively deal with it, and how to refresh.

Description: Award-winning keynote speaker Rachel Sheerin will discuss burnout, harnessing her signature blend of positive energy and authentic engagement. With her viral TEDx Talk on burnout, Rachel delivers audiences from fatigued to FIRED UP with truth and humor.