Description: Health care reform will require health insurers to change the way they make decisions on what to sell while remaining financially sound. The new regulatory reality of expanded access to coverage leaves insurers with fewer options for managing costs and business risk. With the introduction of risk adjustment mechanisms in the exchanges, the most profitable members will not necessarily be the lowest cost ones, but rather, the members which the health plan is relatively more effective at servicing. While Patient Protection and Affordable Care Act 'PPACA' prohibits underwriting and using any health status information for denying coverage or varying the premium rates, this article describes how the use of consumer data will affect the way health insurers make decisions on what products to sell.

Description: The Society of Actuaries, the SOA Pension Section, the Conference of Consulting Actuaries and the American Society of Pension Actuaries are contributing funds in support of efforts to get the actuarial profession more involved in modeling that addresses national retirement income policy and health care reform. The first project will be a feasibility study to analyze each major existing database/model and investigate whether it would be practical to access it or to extend it into a new macrodemographic model.

Description: Reviews the book, HMOs and the Politics of Health System Reform, by Joseph Falkson which discusses HMOs' legislative and regulatory structuring.

Description: This article is about individual insurance policy. HIPAA and COBRA allows someone who has lost access to employer-based insurance to purchase an individual insurance policy. HIPAA has been approval in 49 states. From The Actuary Vol. 31, No. 9

Description: This articles describes how actuaries can contribute to the understanding of the financing of Medicare and the urgency of its problems.

Description: This article provides a brief summary of the health insurance bill introduced in the New York legislature on February 22, 1967 which proposes mandatory heath insurance.