Description: Panelists discuss HMO open access plans [in-network-only coverage, but no referral requirements] and the provider contracts and administrative systems that are needed to support them in a cost-effective way. From the Record of the Society of Actuaries, Vol. 25, No. 2.

Description: Presented at October 1985 Annual Meeting. This session discussion is about marketing opportunities, marketing techniques, product selection and design.

Description: This article contains excerpts from the first three articles that were released through the strategic initiative - Commercial Health Care: What’s Next?

Description: The medical scheme approach adopted by several African countries has failed to meet the needs of those in informal employment and rural communities. This is partly due to affordability amongst these individuals as well as a lack of awareness of how healthcare financing products work. Community based healthcare organisations have achieved greater levels of success in this regard by carefully incorporating the peculiarities of communities in benefit design and involving community members in the management of these healthcare solutions. There are lessons to be garnered from the countries where these have been implemented with some level of success. Even as countries aim towards universal health coverage, observing the unique needs of different communities within a country is essential to ensure resources are utilised efficiently and that healthcare needs are targeted effectively.

Description: This purpose of this session is to discuss strategies used by health insuring organizations and their likelihood for success. Topics include alternate delivery systems and managed care. From Record of the Society of Actuaries 1988 Vol. 14, No. 1.

Description: The winner's curse, applied to Affordable Care Act plan pricing.

Description: This session is about regulatory constraints and the role the NAIC is playing to help facilitate 24-hour programs, plan design issues, the use of managed care, coverage as part of a workers' compensation plan versus coverage of health care outside of the workers' compensation system. From Record of Society of Actuaries Vol. 18, No. 4A.

Description: This session discussion is about PPOs' types of sponsors, structures, effectiveness and regulation. Includes a discussion on PPOs in the UK. From Record of the Society of Actuaries 1987 Vol. 13, No. 1.

Description: This article compares the Prescription Drug Plan (PDP) market to the commercial individual market exchanges included in the Affordable Care Act. PDP carrier actions to date could help predict certain aspects of the exchange market.

Description: Mental health spending has reached $147 billion in the United States with demand only increasing greatly impacting society as nearly 1 in 5 experience these issues. There are even more indirect costs associated with mental health causing a national crisis surpassing 1 percent of the GDP. These costs coupled with the severe lack of licensed clinicians calls for an innovative solution. Through years of development and completion of a randomized controlled trial, Prevail has built and validated a low-cost, scalable solution. Prevail's clinically proven digital mental health treatment provides increased access to care while reducing overall health costs. Private and public payors should being reimbursing this model and offering it to their members.