Description: Panelists discuss the following managed care topics: · Design issues/pros and cons e.g., self-directed health-care model · Provider reimbursement methodologies · Consumer and regulatory issues · Insurance and reinsurance pricing and underwriting issues · Catastrophic claims · Risk-based capital repercussions · Defined contribution health plans From the Record of the Society of Actuaries, Volume 27, No. 1, Session 61

Description: The arrival of ASU 2018-12 (a.k.a Targeted Improvements to the Accounting for Long-Duration Contracts or GAAP Targeted Improvements) presents insurers with augmented financial reporting risk across all areas of the valuation process. Naturally, the internal control frameworks that serve to mitigate these risks must evolve and expand. Valuation actuaries should view this transformative event as an opportunity to take an active role in developing new and improved controls that are both effective and sustainable.

Description: This session will explore the national landscape of state Medicaid risk adjustment program design & application and the key differences that drive effective managed care organization program management. Risk adjustment is a mechanism to adjust capitation rates between Managed Care Organizations to account for population morbidity differences. Although many states utilize this mechanism, the application of risk adjustment can vary significantly across states. The primary differences include populations, risk score models and data collection. These state application nuances affect the strategies and tactics utilized by MCOs for effective risk adjustment program management including provider financial alignment, encounter data submission and the capture of accurate diagnosis codes. The session is intended for Medicaid Managed Care Actuaries working to develop or support comprehensive risk adjustment program management functions.

Description: CMS provides a significant and growing amount of information that can be leveraged by actuaries. Between the public use and research files CMS makes publicly available, large amounts of information that can be assimilated to help understand the who, what, when, where and how of Medicare. With the CMS allowance of supplemental benefits to address SDOH, adding SDOH data into your data landscape is critical to better understand your members' cost drivers. The presenters will focus on the depth and breadth of data available, summarize any restrictions on the use of the data, and identify areas where access to the new data can provide more meaningful insights.

Description: There will be no easy resolution to the current trade friction between the U.S. and China. If anything, the motivations for increasing protectionism are set to intensify. What are these motivations? Where is this trade war headed? And what impact could this have on economies and financial markets?

Description: Insurance is a technically demanding, risk-based, capital intensive business. It is therefore not surprising that the industry is fertile ground for the development of technical models used to measure and price risk and manage capital. This session presents the forces which have significantly influenced the evolution of risk and capital management techniques and organization in the insurance industry, including regulatory changes, financial market instability, enlightened self-interest and ultimately a focus on shareholder value creation. Combining over 20 years in the industry in risk and finance roles with a rigorous academic approach, the presenter will provide insights into the most important business questions which insurers face today and the technical tools and frameworks used to answer them.

Description: 1999 SOA Regional Meeting, Atlanta. In this presentation on translating bond default experience studies into a pricing deduction, the panelists focus on: 1. An approach to anticipating defaults of publicly rated companies. 2. Use of bond default experience studies in a specific company environment. 3. A Wall street approach.

Description: 1993 SOA Meeting, Quebec. This session is about implementing new technology, choosing between competing technology, problems to watch out for, unexpected benefits, migrating from mainframe to client/server, automating the field force and large-scale networks.

Description: 1998 SOA Spring Meeting, Maui. Panel discusses the some of the newer outlets that portfolio managers have been using for their investable cash. Topics discussed: 1. New risk classes. 2. Update on insurance and catastrophe risk bonds. 3. Capital-efficient structured notes. 4. Leveraged debt and equity plays. 5. Other risk/reward enhancement techniques.

Description: 1993 SOA Meeting, Quebec. This session discussion is about the dilemma for mutual companies including the search for capital, M&A considerations, and the demutualization alternative. Topics included: 1 Large mutual companies and their issues. 2. Small mutual companies and their issues. 3. The regulatory, legal, and tax aspects.