Description: This article contains a condensed summary and excerpts from a recent white paper regarding the Individual Mandate.

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

Description: Court cases demonstrating how ERISA Preemption Clause makes it difficult for members to sue Managed Care Organizations MCOs. Issue No. 41.

Description: By rationing health care resources, managed care organizations have raised ethical and legal issues not commonly found under previous financing structures. This session 95PD of the Palm Desert Spring Meeting addresses these issues. From the Record of the Society of Actuaries, Vol. 23, No. 1.

Description: Panel discussion on how insurers can deal with the proliferation of laws, court decisions and regulations, and on the outlook for future developments in health insurance regulatory environment.

Description: CHCS is a nonprofit policy center focused on improving American health outcomes, particularly for low-income people, including payment & delivery system reform.

Description: This analysis provides an overview of the functional components of the managed care system. It discusses the market forces underlying the United States’ system for health care financing and delivery and suggests how market forces impact the health care industry. The analysis focuses on societal goals for health care delivery and on managed care’s effectiveness in enabling achievement of those goals. The analysis develops and uses an innovative model developed to summarize the complex interplay among the many stakeholders, or participants, in the health care system. The model provides a framework for analysis of the many relationships among stakeholders. The analysis also highlights current issues in managed care, particularly the barriers that impede collaboration among stakeholders.

Description: Stakeholders in a specific state (Minnesota) were interviewed about the potential value -- and obstacles -- of a catastrophic backstop program to handle long term care (LTC) financing needs. The design would entail a payroll deduction which would produce a fund to pay LTC expenses once a deductible period (of 1 to 4 years, depending on income) was reached. This design was believed to encourage enrollees to cover the front end better than done today, whether by private insurance or other means.

Description: Panel discussion of varying views on: substandard underwriting with prudent pricing, qualified vs. nonqualified plans and the need for IRS clarifications, rate stabilization and aggressive pricing, noncancellable products and product features.

Description: Panel discussion of national, state, and provincial developments in health care policy and regulation. Presented at the 1975 annual meeting.