Description: An analysis of prescription drug use in the Kansas individual market

Description: Summary and analysis of the diseases and conditions exhibited in the Medicare Advantage population

Description: Health Watch, Issue 79, December 2015, Health Watch

Description: This article will consider several issues arising from ACO budgeting and pricing of stoploss coverage, including: 1) attribution of members; 2) claim carve outs; 3) ambiguous stoploss terms; 4) providers gaming the system and 5) credibility of data.

Description: This session is about health risk adjustments. Health care reform issues and Society of Actuaries research activities will also be discussed. From Record of Society of Actuaries Vol. 20, No. 3A.

Description: Article provides a market scan of recent state proposals for Medicaid work requirements as well as measures the impact to enrollment in different states.

Description: Chapter 1 presents the background to the current study, followed by the methodology used, and a summary of the findings of the study. From Group Medical Insurance Large Claims Database Collection and Analysis, M-HB97-1.

Description: Chapter 7 analyzes, in table form, the study's claimant counts & charges per claimant in relation to deductible and broken down by diagnosis category. From Group Medical Insurance Large Claims Database Collection and Analysis, M-HB97-1.

Description: Chapter 2 analyzes, in table form, the study's claimant counts and charge totals, broken down by gender, age, diagnosis category, year, and by subscriber vs. dependent status. From Group Medical Insurance Large Claims Database Collection and Analysis, M-HB97-1.

Description: The PPACA imposed a market share-based health insurance provider fee, known as the "Section 9010 Fee", "Health Insurer Fee", or simply the "HIF", on each “covered entity” with net premiums written in excess of $25 million that is engaged in the business of providing health insurance coverage for U.S. health risks. This article provides background information to help unpack the language behind the Section 9010 Fee and highlights a few areas of special interest including merger and acquisition-related issues, application of the Section 9010 fee to expatriate plans, and considerations regarding fee administration.