Description: What you need to know about risk scores to be competitive in the Medicare Advantage market.

Description: An analysis of the 1999-2011 experience of all Blues plans of betweeen $1.8 and $3.8 billion in annual revenue in 2010 to determine if there is any empirical evidence of an industry underwriting cycle. The analysis shows there is no such evidence.

Description: Presenter describes many of the desirable characteristics of a health care financing system, and alternative health care financing systems as they are found in other parts of the world. The advantages and disadvantages of each alternative system are also discussed. From the Record of the Society of Actuaries, Vol. 24, No. 2.

Description: This article provides an overview of the key provisions and impacts of the Affordable Care Act's Cadillac Plan Excise Tax.

Description: An update on HMO market trends and reinsurance products, and services supporting them.

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

Description: This article is focused on sustainability concerns in the ACA individual markets and what we can learn from core actuarial principles as discussed in ASOPs.

Description: This research report is sponsored by The Society of Actuaries and the Canadian Institute of Actuaries on the Canadian health care system. Performed by Stéphane Levert, FSA, FCIA, the study (available in French and English) estimated the future costs of the Canadian health care system, assessed the sustainability of the system over a 25-year horizon, and analyzed the implications of the changes to the Canada Health Transfer proposed on Dec. 19, 2011 by the federal government. The report summarizing the findings indicates that, without significant government intervention, the Canadian health care system in its current form is not sustainable.

Description: Panelists report on the status of activities by national associations in regard to risk-based capital requirements for health insurers. From the Record of the Society of Actuaries, Vol. 24, No. 2.

Description: A proposal to reform current health care market, from a 'preferred payer' system, in which Medicare and Medicaid pay less than the true cost while others must then pay more, to a 'value for money' system. This would be achieved by requiring providers to bill all patients the same rate for the same services, with a standard bundling format to make all providers' rate differences transparent. Differences between billed charges and what Medicare pays would be made up by the Medicare patient, rather than subsidized by those outside of Medicare.