Description: Learn about key actuarial and analytic tools and methodologies used by commercial health insurance to identify and quantify drivers of healthcare cost and utilization (including wasteful and low-value ones) and risks. Use case scenarios in which these tools and methodologies apply, such as underwriting, reinsurance, medical management for population health and chronic diseases, managed care contracting, insurance market reform, provider payment reform, etc., will also be covered. Experience from the U.S., China and other parts of the world will be shared.

Description: The prospects for China's health insurance has increased significantly in 2018, incentivized by a series of favorable government policies to support the development of commercial health insurance. However, the market still lacks relatively mature products and services. Overall there is a common understanding in the industry that good coverage plus service is the foundation for health insurance future development, and product innovation plus care management is key for an insurance company to maintain sustainable development in the competition. In this presentation, Dr. Yang will discuss the market trend both at home and abroad with respect to health management as well as its impact on product design, pricing and cost control. With the development of internet and big data, today’s health actuary has a special role in taking advantage of the digital transformation and achieving a high-quality and efficient health care service model.

Description: Predictive Analytics and Epigenetics are two of the most impactful driving forces for the future of healthcare, precision medicine, and insurance. Learn why this is true, how if will change the way our industry operates, and how you can stay viable and contribute to the betterment of humanity while also protecting the actuarial profession from obsolescence. Learn how personalized medicine keying off genetic testing is saving life insurers big dollars. The only limit seems to be testing access for their insureds.

Description: SOA interview with David Axene

Description: The SOA is pleased to make available a research report providing insight and considerations for the actuarial profession in assessing the potential risk and opportunities of MACRA to both provider and payer organizations.

Description: Cost Effectiveness of Tumor Genomic Analysis and Immunotherapy

Description: In April 2018, the Centers for Medicare & Medicaid Services (CMS) published a revised definition of primarily health related (PHR) benefits as applicable to Medicare Advantage (MA) organizations.

Description: Report to give actuaries practical information and guidance on LTD claim credibility for case level pricing and underwriting. Stage 2 of the GLTD Credibility Study, this analysis was expanded using the industry data gathered during Stage 1.

Description: Employers who purchase disability insurance are increasingly interested in obtaining assistance with broader absence management services. At the same time, paid family leave is gaining in popularity both as a government-mandated benefit and in the context of private insurance plans. The speakers in this session review recent developments in the full spectrum of leave programs, including plan design, pricing and administration.

Description: The letter from the editor thanks all of the authors for their contributions and gives a very quick synopsis of what will be appearing in the June issue.