Description: This research report examines the potential implications of the risk mitigation programs – risk adjustment, reinsurance, and risk corridors – established under The Patient Protection and Affordable Care Act.

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: 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.

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: This session will discuss the role of actuaries under national health insurance, role of the Canadian health actuaries under that national program and how actuaries can shape the health-care environment in the U.S.. From Record of Society of Actuaries Vol. 18, No. 4B.

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 article provides an overview of the key provisions and impacts of the Affordable Care Act's Cadillac Plan Excise Tax.

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: 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.