Description: This article contains excerpts from the first three articles that were released through the strategic initiative - Commercial Health Care: What’s Next?

Description: This session is about regulatory constraints and the role the NAIC is playing to help facilitate 24-hour programs, plan design issues, the use of managed care, coverage as part of a workers' compensation plan versus coverage of health care outside of the workers' compensation system. From Record of Society of Actuaries Vol. 18, No. 4A.

Description: Provides a summary of recent proposed regulations for the health insurer fee, section 9010 of the Affordable Care Act (ACA).

Description: Using Healthcare Claims Data to Create Actuarial Models.

Description: Essay states a competing American ideals for the U.S. Health care system include free markets which foster competition, cost effectiveness and quality health care vs.public and private assistance which provides health care independent of a person’s financial means.

Description: This article makes organizations entering the MA market aware of the star rating climate, as well as short- and long-term star rating & revenue considerations.

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: This paper examines the factors affecting claims in a group health insurance plan.

Description: This is a highly interactive role-playing session detailing the actual product development process for a hypothetical health care product. From Record of Society of Actuaries, Vol. 30, No. 3, Session 19