Description: In this session, Deana Bell, FSA MAAA provides a comprehensive introduction to the Medicare Risk adjustment Program. Deana is a Principal & Consulting Actuary in the Seattel office at Milliman. She has been working with Medicare Advantage throughout her career as an actuary. Her expertise includes actuarial opinions, pricing, rating, reserving, medical underwriting, benchmarking, and risk adjustment projects. IN this session she sheds light on how Medicare Advantage health plans are compensated by the Centers of Medicare and Medicaid Services (CMS) through risk adjusted revenue. She highlights the significance of risk adjustment in ensuring financial stability for Medicare Advantage plans. Contributors: Deana Bell, FSA MAAA ; David Koenig, FSA, MAAA, John Dawson, FSA, MAAA, Jon Forster, ASA, MAAA

Description: In this video Scott Allen, FSA, MAAA discusses the Medicare Advantage Part C bid template. The template helps Medicare Advantage plans estimate costs and premiums, comparing their bids to CMS benchmarks. It’s a complex process involving worksheets that project costs, calculate revenue requirements, and determine rebates, ultimately influencing the plan’s benefits, premiums, and competitiveness in the market. Contributors: Scott Allen, FSA, MAAA, Eric Milner, ASA, MAAA, Danica Turner, FSA, MAAA, Jon Forster ASA, MAAA

Description: Discuss various analytics and use cases using payer published reimbursement contract data under federal mandate of Transparency in Coverage. These contract rates are publicly available in machine readable format (MRF) starting July 1, 2022, and refreshed monthly. By attending the session, you will have a better understanding of the state-of-art development and analytics using MRF data, including the technologies used to extract and analyze huge MRF files, validation and limitations of published rates, and their use cases.

Description: Explore a brief overview of federal income taxation of health insurers and selected technical tax topics during this panel discussion webcast. You'll dive into the evolution of heath insurers and healthcare-related services and the arising questions regarding their risk-bearing activities, as well as whether or not certain types of healthcare businesses qualify as "insurance companies" for federal income tax purposes. Also, expect to learn about loss reserves for guaranteed renewable contracts and how they can affect insurance company tax status. This webcast will continue to highlight how the IRS challenges loss reserves of health insurers as the panelists review the status of tax cases, IRS guidance and recent IRS activity regarding "margins."

Description: Discuss changes in group life waiver of premium claim recovery and mortality experience since the 2005 table was released, the development of the 2023 table, and the new statutory valuation standard approved by the National Association of Insurance Commissioners (NAIC).

Description: Inflation and the possibility of recession are major factors affecting health care cost increases over the next five years. Insurance and medical organization will continue to evolve but are unlikely to create major shifts in the short run. However, over the long run structural changes in providers and payment mechanisms will determine future trends – raising or lowering the health share of GDP depending upon public choices and private decisions.

Description: Fifty-three percent of Americans responding to a survey conducted by the Society of Actuaries (SOA) Research Institute reported that extreme weather events – including hurricanes, tornadoes, heatwaves, wildfires and flooding – have adversely affected their health.

Description: Kevin Pierce, FSA MAAA divesinto the Inflation Reduction Act’s impact on US drug pricing. He discusses two key provisions: Inflation rebates, where pharmaceutical manufacturers must pay rebates to the government if drug prices rise faster than inflation, and drug price negotiation by Medicare, set to commence in 2026 for selected drugs. Contributors: Kevin Pierce, FSA, MAAA, Deana Bell, FSA, MAAA Mitchell Momanyi, FSA, MAAA, Jon Forster, ASA, MAAA

Description: The impact of COVID-19 on life insurance is a matter of frequent discussion, but the impact on disability insurance has been less understood. This session uses survey data and other information to explore how COVID-19 has affected short-term disability, long-term disability and Social Security Disability Insurance.

Description: Discover results of the ongoing SOA COVID-19 Group Life Mortality Survey. It will also compare Group Life mortality results to U.S. general population excess mortality trends, and explore some of the non-COVID drivers of excess mortality.