Description: This article will consider several issues arising from ACO budgeting and pricing of stoploss coverage, including: 1) attribution of members; 2) claim carve outs; 3) ambiguous stoploss terms; 4) providers gaming the system and 5) credibility of data.

Description: This session is about regulatory constraints and the role the NAIC is playing to help facilitate 24-hour programs, plan design issues, the use of managed care, coverage as part of a workers' compensation plan versus coverage of health care outside of the workers' compensation system. From Record of Society of Actuaries Vol. 18, No. 4A.

Description: This session is about rationing health care. From Record of Society of Actuaries Vol. 18, No. 4A.

Description: This article is a review of the book “Public Employee Pension Funds,” by Robert Tilove, published in 1976 by Columbia University Press. The book concentrates on the major public policy issues affecting plans of state and local governments. A more detailed review of this book will be published in the “Transactions.”

Description: Article Speed Limits - Save Lives by Seltzer in The Actuary, April 1979, Volume 13, Number 4

Description: Changes in CMS requirements for 2011 Medicare Part D plans aimed at reducing confusion surrounding the PDP selection process by making plan differences more visible to seniors. Carriers have responded by making the most significant changes in plan offerings since the program's inception, which is expected to result in membership shifts.

Description: This article is a detailed review and discussion of “The Report on Actuarial Principles and Practical Problems with Regard to Non-forfeiture Requirements, Society of Actuaries, January, 1976.” The author of the article notes that It is an important report which should be read by all members of the Society irrespective of their professional affiliations, and in its present form the report is primarily an exposure draft and the Committee will therefore, welcome comments as to its content and recommendations prior to the discussion of the report scheduled for the Houston and Chicago SOA meetings.

Description: Diverse Risks 2016 Call for Essays

Description: Summary of House of Representatives Tri-Committee Bill – H.R. 3200.

Description: Summary of testimony by an AAA Board member before a congressional subcommittee, as an expert on risk assessment and adjustment, especially in relation to Medicare risk contracting and HMO payments. She recommended: mitigating the geographical region values, credibility weights for payments to health plans, carving out high cost claim segments, reengineering the ACR methodology, shifting AAPCC methodology from fee-for-service toward competitive bidding, and further projects to improve risk methods.