Description: Since the Affordable Care Act implemented minimum loss ratio provisions for health plans, several states have passed or at least considered minimum loss ratio regulation for dental plans. While such regulations are intended to improve insurer efficiency and promote value to consumers, they can have unintended negative consequences if the unique characteristics of the dental insurance market are not considered. Learn about this hot topic, including loss ratio basics, recent legislative activity in the dental loss ratio space, how dental differs from medical, and why those differences are critical to account for when trying to regulate loss ratios in that market.

Description: This session will be centered around the roles and responsibilities of a valuation actuary. Learn the best practices of health actuaries, along with technical considerations and professionalism issues surrounding the calculation and reporting of health liabilities and reserves. This session will focus on key actuarial liability and reserve provisions, including Claims Unpaid and Premium Deficiency Reserves. In this session, explore new ideas about calculation methods and the importance of the underlying assumptions. You will also learn best practices and practical applications concerning reserve calculation discuss best practices regarding the preparation of an actuarial memorandum supporting a Health Annual Statement. This will include key considerations from the American Academy of Actuaries' Practice Note about documenting and supporting the actuarial calculations. The discussion will also present views and considerations from both the insurer's and the regulator's perspectives.

Description: This article highlights the provisions under the Health Insurance Portability and Accountability Act of 1996.

Description: The number of uninsured people in the United States has grown to over 40 million. Many possible solutions have been considered at both the federal and state levels to help alleviate the size and growth of the uninsured population. From the Record of the Society of Actuaries, Volume 27, No. 3, Session 73PD of the New Orleans Annual Meeting.

Description: "Advancing health equity is one of the five strategic objectives outlined in the CMS Innovation Center's strategic objectives for the next ten years and is an increasing area of focus across many states. Focus in on recent developments in addressing Medicaid beneficiary needs related to social determinants of health (SDOH), health-related social needs (HRSN), and health disparities and inequities in Medicaid. Several states have introduced non-traditional benefits into their programs in recent years to address these areas, such as various types of housing supports, nutrition-related benefits, and enhanced/advanced case management support. Expect a discussion on the benefits introduced recently in states such as AZ, CA, MA, NC, and OR, including funding considerations around these benefits as well as the 1115 demonstration waiver authorities granted to these states to allow coverage for these non-traditional health care services.

Description: Gene therapy is a quickly evolving field and will continue to grow as a risk concern for many health plans, stop loss insurers and reinsurers. Currently, there are only two approved gene therapies in the U.S., but that number is expected to escalate starting in the fall of 2022. Revisit the experience plans have had with the first two gene therapies, discuss plan design and network considerations in light of gene therapy, and discuss the actual composition of the near-term pipeline along with a range of modeled financial impacts and considerations for payers.

Description: This paper is a discussion on miscellaneous topics such as 1. if the new form annual statement proposed by a subcommittee of the Blanks Committee of the NAIC involves any problems and 2. what factors have prompted life insurance to consider entering the personal accident and the health insurance field. From Transactions of Society of Actuaries 1951, Vol. 3, No. 6.

Description: In this session 2PD of the 2004 Valuation Actuary Symposium panelists share their perspectives on valuation-actuary-related issues, including the hot issues from a regulatory concern.

Description: This panel will discuss various product issues relating to dread disease products: features, cost levels, evolution, the future, the consumer and regulatory environment, and payroll deductions. The panel will describe the current products available in this market, with emphasis on cancer insurance. From the Record of the Society of Actuaries, Vol. 21, No. 4a.

Description: This discussion from 1977 is an interdisciplinary examination into various methods to control costs under Group Medical Expense coverages. Discussion covers the roles of insurers, employers, health care providers, and the government - and the manner in which they interrelate. From Record of Society of Actuaries, Vol. 3, No. 4.