Description: With there being over 11 million undocumented immigrants in the United States, some states are considering or have expanded Medicaid-like coverage to this population. Healthier Oregon launched in July 2022 to provide such benefits, and now covers more than 20,000 Oregonians. Hear about the structure of the program, along with its capitation rate build (which integrates federal participation for emergency and pregnancy-related services), risk corridor design, and related policy and implementation considerations. After attending this session, you will gain an understanding of the actuarial, regulatory and practical considerations for covering this population through managed care.

Description: A diverse panel of health actuaries will be available to answer any attendee questions. An ACA question, we have it covered! A valuation question, we will find a solution. A professionalism issue, we will make a ruling! A regulatory concern, we will help guide the way!! No question is off limits! There are no stupid questions!

Description: India is in the process of updating to a more risk-based capital framework. The article provides a high level introduction of the development and discusses some of the key design and implementation considerations.

Description: Recognizing the benefit for actuarial discussions about how COVID-19 will affect our work, the Smaller Insurance Company Section of the Society of Actuaries hosted “COVID-19: What a Smaller Insurance Company Actuary Needs to Know Virtual Town Hall” on April 17, 2020. The following delves into these presentations and discussions.

Description: Article on the history of the Long Term Care Discussion Group, a Washington DC-based venue for discussing long-term care and related issues for over 20 years.

Description: Misalignment in value-based care approaches between payers and market segments (Medicare, Medicaid, self-funded employer groups, and commercial insurance) creates significant headwinds and friction for health care providers seeking to succeed in an environment that is moving toward more value-based care models and payment approaches. However, while multi-payer approaches in value-based care are critical to eliminating these misalignments, uptake in such programs has been lagging for a variety of reasons. Hear about lessons learned from a selection of specific multi-payer initiatives to understand what went well and what challenges were encountered in expanding these initiatives more broadly. You should be able to walk away from this session with an appreciation of the potential for multi-payer approaches and the challenges faced in gaining traction with them.

Description: Company Considerations and Regulatory Perspective for Offering Reduced Benefit Options

Description: Investigate the importance of collaboration with accounting, underwriting, sales, marketing and other professions as an actuary when you attend this webcast. Cross-functional positions can cause unique challenges to arise, like various experts attempting to balance growth and profitability. Discover an opportunity to learn about relevant ASOPs and dive deeper into contemporary examples that highlight specific professionalism issues that can develop.

Description: This session will include examples of healthcare claims and market data to be used for educational purposes to highlight trends in the insurance industry. It will also highlight opportunities to enforce existing laws around fraud and abuse, and areas for regulators and legislators to focus to address this growing problem. Finally, it will discuss recent law changes and highlight areas requiring additional regulatory intervention. Expect discussions of recent claim issues and laws in the healthcare market as well as emerging issues in healthcare. The presentation will be beneficial to healthcare professionals working for health insurers, healthcare providers, auditors, regulators and healthcare providers and will also cover professionalism related topics for actuaries.

Description: This presentation shares experience and ideas of both AIA Group and AIA China during implementation of the IFRS17 project and will discuss potential impact and outlooks in the domestic market from IFRS 17. This presentation includes a general overview of an IFRS17 implementation project, focusing on changes and requirements, as well as the resources cost of the main challenges and relative resources.