Description: This session dealt with Regulatory Considerations in Group Insurance. Topics included: 1. National health insurance. 2. Federal hospital cost control programs. 3. Non-discrimination legislation and regulation. 4. Multiple- employer trusts. 5. Impact of recent OASDI financing changes. 6. Changes in mandatory retirement age on group insurance.

Description: A panel of practicing actuaries and policy analysts will discuss the 'big issues' that could affect the actuarial profession in the future, and suggest ideas on how the actuarial profession could adapt to these challenges. This will be an interactive session where attendees can expect to have an opportunity to weigh in through polling questions and discussion. Topics touched will include: socialized medicine, artificial intelligence, the competition from data scientists, data commoditization, disruption from new entrants into the healthcare insurance space, and more.

Description: Why is it that two competent actuaries making reasonable assumptions can arrive at very different conclusions when evaluating the impact of proposed health care reforms? Are the answers really as different as they appear to be on the surface? This presentation from Session 137IF of the SOA 1996 Orlando Annual Meeting outlines and highlights some of the key actuarial issues that arise in the course of these analyses. From the Record of the Society of Actuaries, Vol. 22, No. 3.

Description: The Society of Actuaries, the SOA Pension Section, the Conference of Consulting Actuaries and the American Society of Pension Actuaries are contributing funds in support of efforts to get the actuarial profession more involved in modeling that addresses national retirement income policy and health care reform. The first project will be a feasibility study to analyze each major existing database/model and investigate whether it would be practical to access it or to extend it into a new macrodemographic model.

Description: A summary of concerns about the Community Living Assistance Services and Supports Act, including flaws in the underlying premises, opportunism, inadequate sales incentives, insufficient benefits, adverse selection, and cashflow and solvency issues.

Description: This session discusses health alliances, a central component of the President's proposal. Their structure, operations and effect on the market have numerous actuarial implications. From Record of Society of Actuaries Vol. 20, No. 3B.

Description: This article, an Honorable Mention Essay for the Society of Actuaries' Entrepreneurial Actuaries Section 2010 Papers Competition, is a discussion of the various issues relating to measurement of data in healthcare. The author presents “a light hearted & tongue-in-cheek take on how healthcare is typically measured, and an entrepreneurial vision for a better world.” Noting that typically data is summarized in deterministic models that produce point estimates for analysis and decision making, the author’s vision presented in the paper “is that of a central repository of actuarially modeled distributions that can either be used as benchmarks or adapted to an organization's experience.”

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.

Description: Panelists discuss various legislative activities at the federal and state levels that affect health organizations doing business in the commercial market including: patient protection, uninsured, coverage mandates, genetic testing and mental health parity. Also included are case studies of New Jersey and New York's approach to coverage for the uninsured. From the Record of the Society of Actuaries, Volume 28, No. 3, Session 80

Description: US pharmacy prices have entered a new era of growth driven by Specialty medications. A bevy of state and national regulations have been proposed to address pharmacy pricing, industry structure and transparency.Health actuaries will learn about US pharmacy pricing structure and how proposed legislation could affect future costs. Actuaries that have responsibility for pharmacy rate/budget setting, RFPs or trend projection will benefit from a deeper understanding of the US pharmacy market landscape and gain an international perspective.