Description: This session discussion is about a review of experience under PPOs, measuring the success of PPOs, PPOs affect on employer health care expenditures, employee utilization of PPOs, the future of PPOs. From Record of the Society of Actuaries Vol. 11, No. 4A.

Description: On Dec. 29, 1973 President Nixon signed into law the Health Maintenance Organization Act of 1973, which authorizes $375 million to be used by the DHEW to stimulate the establishment and development of HMO's over the next five years. This article describes the status of the regulations and the development of additional HMO's.

Description: A discussion of the future of the Brazilian Health Market with a focus on the legislation which passed in June 1998 to regulate the private health insurance industry

Description: This article explores the changing risk profile between the transitional Affordable Care Act (ACA) period (2014-2016) and under the final ACA period (beyond 2017) for the individual market. Actuaries are in a unique position to help facilitate the change from the current ACA period to the final period when health plans will have to take on substantially more risk.

Description: This essay highlights a view that many have for meeting these goals is one of a two-tiered system. The first tier in this system is a universal one controlled by the federal government, while the second tier is a private sector supplementing the first tier. The remainder of this paper will examine this two-tiered system and how various stakeholders in today’s system will be affected.

Description: Individual Market and ACA Products Actuarial rating principals

Description: Medicaid and the ACA

Description: From the April 1982 Society of Actuaries meeting in Houston. Discussion of how the insurance industries in several countries have dealt with high levels of inflation with respect to the development and marketing of insurance products. Also discussed: I. the overall business and economic environment 2. the taxation structure of insurance companies 3. the availability of suitable investments 4. the insurance regulatory climate and 5. the structure of worldwide capital markets Possible applications to U.S. insurance in the 1980's were explored.

Description: Surplus and the ACA

Description: ACA Impact on Employers