Description: ACA risk adjustment is intended to "bridge the gap" between allowed rates and actuarial rates. If risk adjustment methodology is not bridging that gap & becomes an additional input to pricing formulae, it is not serving its intended purpose.

Description: Actuaries have the business acumen, problem-solving capabilities, and technical skills to develop innovative and data-driven solutions in the social insurance space. It is time we expand our scope and embrace an increased role in making a positive impact within the health care ecosystem. The primary focus of this paper is on social insurance programs dedicated to the most vulnerable population: low-income families accessing care through Medicaid. While there are numerous challenges that require other subject matter experts to take the lead, this article highlights topics where actuaries can be key players in developing and implementing tangible solutions to improve the care for the most vulnerable. Issues and solutions in this paper focus on the following three areas: 1. Access to appropriate care, 2. continuity of care, and 3. social determinants of health.

Description: Overview of call center and digital sales platforms for the development of distribution strategy in the individual insurance market.

Description: This article highlights the fact that new requirements for disclosure of average liability duration and interest rates could lead to diversity in practice. It also recognizes that elements of the new disclosure requirements will enable financial statement users to perform their own crude estimates of these averages in ways that could help them to better understand the liabilities and to compare companies using consistent methods. Finally, the article describes how companies might also find value in such crude estimates.

Description: This article provides an overview of activities that should be considered by an actuary when validating a predictive model. It describes several components to consider when validating a predictive model and provides an examination of various methodologies that can be implemented in the validation process.

Description: Best practices for a successful model conversion or transformation. It details the key stakeholders involved and the processes and tasks across various stages of the model conversion.