Description: Interviews with several actuaries who are subject matter experts in the health field to get their perspectives on implementing the Affordable Care Act (ACA).

Description: This article is about the growth of health actuaries and new opportunities in light of the Health Insurance Portability and Accountability Act of 1996 and the Balanced Budget Amendment of 1997.

Description: Beginning with the 2019 Benefit Year, CMS (the Centers for Medicare and Medicaid Services) has provided guidance that allows Medicare Advantage Plan Sponsors much greater flexibility in tailoring benefits to promote clinical, care management, and financial goals. The guidance allows for a broader menu of supplemental benefits and also enables plans to target benefit enhancements to beneficiaries afflicted with specific disease states. This session explores the ramifications of the policy changes on Plan Sponsors and beneficiaries, and discusses the different ways that Plan Sponsors are taking advantage of the additional flexibility.

Description: HIV is still a big public health concern, but there are therapies available to prevent infection before and immediately after exposure. As legislatures and the USPSTF considers adding these therapies to the list of preventive care covered without cost share, actuaries will need to estimate the impact on their care cost. The presenters will share an actuarial tool kit to estimate the impact of covering PrEP and PEP for different populations. Examples are provided and discussion is welcome.

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: Updates on the efforts of the Academy’s health practice council. its work groups and task forces, to educate health care policymakers on issues including health care reform, Medicare, loss ratios, premium review, reinsurance, benefit and eligibility changes, exchanges, and risk based capital.

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 discussion reviews the effect expected from legislation in the U.S. to finance the cost of medical care of the aged. From Transactions of Society of Actuaries 1961, Vol. 13, Pt. 2.

Description: Praise and critisicm of ERISA. Items affecting ERISA The Patient Access to Responsible Care Act of 1997 PARCA, Consumer Bill of Rights, Expansion of Portability and Health Insurance Coverage Act of 1997 EPHIC. Issue No. 35.

Description: Summary of the National Conference on Group Practice of Medicine, held in Chicago from October 19-21, 1967 to explore means for stimulating the group practice of medicine.