Description: While intended to assist health plan actuaries responsible for stress testing and ORSA filings, this session will also be informative for actuaries interested in communicating the impact of potential catastrophic events for health plans to their management and board. It will begin with a discussion of event thresholds for stress tests and their impact on capital and financial statements. Presenters will take a detailed look at several catastrophic event case studies (historical and hypothetical) in the following areas: healthcare specific (e.g. pandemic, specialty Rx), financial institution/credit market, operational/business, strategic and multi-event scenarios.</

Description: Telehealth enables the delivery of health care services to patients that are not in the same location as providers. Over the past decade, telehealth has been used increasingly to complement face-to-face patient encounters, and is particularly important to addressing health care needs in rural areas. Recent regulatory catalysts, particularly in the Medicare Advantage program, have served to elevate the visibility and importance of telehealth in the overall health care delivery system. Starting in 2020, Medicare Advantage plans can offer any clinically appropriate physician services through telehealth as part of the standard Medicare benefit. Network adequacy standards can also be met via telehealth providers under certain programs. This presentation will cover the basics of what constitutes telehealth, and provide tangible demonstrations of telehealth technology (simulating variations mediums through which services are delivered). We will cover the what, the why, and the where (anywhere) of telehealth in 2020.

Description: This session at the SOA 1990 Annual Meeting looks at the outlook over the next 10 years of employee benefits. The effect on the role of the actuary is discussed.

Description: This session will address the increased cases of managed care in Medicaid states. This will include some indication of how utilization patterns differ for those populations versus commercial populations. From the Record of the Society of Actuaries, Vol. 21, No. 3b.

Description: MHPAEA prohibits health plans from imposing financial requirements or treatment limitations on behavioral health benefits that are more restrictive than those applied to medical and surgical benefits. MHPAEA's regulations define treatment limitations to include nonquantitative treatment limitations (NQTLs), which are benefit design features that are not numerical, but otherwise limit the scope or duration of benefits.

Description: The presenters will provide updates on research being conducted under SOA sponsorship. This includes projects on the topics of Direct Primary Care and Patient Centered Medical Homes.

Description: This discussion at the SOA 1966 Annual Meeting is about various aspects of group life and health insurance including disclosure forms, interest rates, group life maximums, disability insurance, and Medicare.

Description: This general discussion looks at mortality experience with the advent of CSO tables, annuity premium tax, termination dividends, classes of agents included under Social Security, and conditions affecting companies entering the fields of disability income, accident, health, hospitalization and medical insurance.

Description: A panel of actuaries and clinical consultants at this session of the SOA 2003 Vancouver Spring Meeting provides an assessment of current and future applications of predictive modeling techniques in the health arena. A practical example of risk adjustment, discussion of the clinical use of this technique, and applications in underwriting are discussed.

Description: Presentation at June 1980 SOA meeting. Discussed the responsibility of the actuary on self-funded group insurance plans and how this might differ for consultants as opposed to insurer staff, and provides specific case studies.