Description: In the time since the original proposal to move healthwriting companies from the blue blank to the orange blank, there have been several incremental updates to the blue blank by the NAIC Blanks Working Group to integrate portions of the orange blank into the blue blank. Meanwhile, the NAIC RBC Working Group has issued their proposal to change the health test for comment and appear to be moving forward with the proposal to revise the health test. This would obligate companies that write predominantly health business onto the orange blank rather than the blue blank, which they have historically used for reporting. Discover background of the revised health test, the incremental updates to the blue blank that have been implemented recently, additional incremental updates proposed for upcoming blue blanks, and the current status of the Health RBC Working Group proposal to revise the health test. Hear observations about companies that have opted to 'take the plunge' and move to the orange blank ahead of the revised health test as well as companies that have opted to remain on the blue blank and incrementally update as new requirements are integrated into the Blue blank. By attending the session, you will be able to: • Understand the context of the initiative to revise the NAIC health test. • Summarize the recent changes to the blue blank implemented by the Blanks Working Group that integrate portions of the orange blank into the blue blank. • Summarize the upcoming proposed changes to the blue blank by the Blanks Working Group that integrate additional portions of the orange blank into the blue blank. • Summarize the current status of the Health RBC Working Group proposal to revise the health test. • Provide industry perspective on companies that have opted to move to the orange blank ahead of the revised health test and companies that have opted to remain on the blue blank until the NAIC requires it.

Description: Fully remote and hybrid environments are here to stay and actuarial leaders are continuing to evolve their styles and strategies to accommodate shifting needs. In order to build engaged and future-focused teams, leaders must refine their management approach and be intentional about helping employees build relationships, connect to culture, and lean into their futures with the organization. Listen as the panel shares their insights and experiences on how they have built loyalty and increased productivity among staff to meet business goals and move forward in the new working environment. By attending this session, you will be able to: • Understand the state of the actuarial talent market and changing employee expectations, and what it may mean for your department. • Identify how to best support and engage your employees in a remote and/or hybrid work model. • Apply strategies to enhance communication, lead with empathy and build trust among your team. • Empower and energize your team to increase retention and overall productivity.

Description: Currently there are ten states in the U.S. —Rhode Island, California, New Jersey, New York, Washington, DC; Washington, Massachusetts, Connecticut, Oregon and Colorado —that have enacted Paid Family Leave. Paid Family leave is an employee funded state insurance program that provides wage replacement to eligible workers when they take time off of work to care for a seriously ill family member or to bond with a new child. Who pays the taxes? The employer or the employee? How will this effect short term disability benefit offerings in the work place? How does a Paid Family Leave plan get implemented? Is it up to the employee to file for the benefit through the unemployment office or does the employer file? At the state level, how is paid family leave reserved for? How is it administered? What job protections are there? How does this work with the Family Medical Leave Act? Get these and more questions answered. By attending this session, you should have an understanding of the state Paid Family Leave programs, what it means to future short term disability plans, and how the state accounts for this program.

Description: The rules governing the framework of Affordable Care Act (ACA) marketplaces continue to be refined at the state and federal level. The catalyst for such changes has been a desire to improve markets, which has been primarily informed by data and experience in the ACA's first decade. This session will feature a panel of consulting actuaries, a state policy advisor who has influenced ACA legislation, and an attorney deeply involved in ACA risk adjustment litigation. Discussion will include new federal proposals, efforts to strengthen enforcement of rating compliance, new actuarial insights from public data, and the anticipated future implications for ACA markets. By attending this session, you will be able to: • Understand what precipitated risk adjustment lawsuits and how proposed federal rules address these concerns. • Identify how state regulators are addressing premium misalignment between metal levels and shaping local policies. • Develop new insights on publicly available data. • Understand the implications these policy changes will have on the future of pricing health insurance benefits, consumer value and enrollment distributions in ACA marketplaces. • Understand the primary factors leading to ACA market success.

Description: The presenters in this session will highlight the SOA’s work on an updated Medicaid underwriting margin model. This research project includes the model along with a set of instructions and a paper describing the key components of underwriting margin, including cost of capital and risk margin. The model was created as a tool for Medicaid actuaries representing both MCO and State principals to determine appropriate underwriting margins components within Medicaid managed care rates. Understand a brief description of the motivation for and underlying theory behind the model. Walk through different model inputs and run through some realistic scenarios that Medicaid actuaries may encounter in where they operate. By attending this session you will be able to: • Understand the role that Medicaid underwriting margin plays in Medicaid rate setting. • Understand the key components of Medicaid underwriting margin. • Understand the factors that necessitate underwriting margins. • Understand how to incorporate appropriate Medicaid underwriting margin levels in Medicaid rate setting.

Description: Many drugs, like the immunologic drugs used to treat inflammatory and oncologic conditions, are FDA-authorized to treat more than one condition. Given different conditions have varying clinical outcomes and costs, it is likely the same drug provides a range of value across multiple conditions. However, such drugs have traditionally had a single list price and corresponding payer net cost. Indication-based pricing and benefit design (IBPBD) is intended to address the variable clinical and economic value for the same drug across multiple treatment indications. As this trend continues to evolve, the determination of drug value by treatment indication will create risks and/or opportunities in pharmacy benefit design, ultimately impacting pharmacy PMPM forecasting and incurred costs. Learn from faculty as they: Provide the business context for IBPBD. Describe varying structural approaches. Discuss the market conditions that can motivate or demotivate payers. Explore operational barriers. Recommend a role for actuaries. To bring the discussion to life, a case study will be reviewed. By attending the session, you will be able to: • Describe the meaning of Indication-Based Drug Pricing and Benefit Design (IDPBD). • Understand the risks and opportunities with IBPBD. • Articulate the advantages and disadvantages of distinguishing the value of a drug by treatment indications.

Description: "Direct medical costs for cancer care topped $209 billion nationally in 2020, accounting for a significant proportion of all health care expenditures in the U.S. Indirect costs are also significant, encompassing loss of productivity, wages, leisure time and decreased quality of life. The way cancer programs deliver and are reimbursed for care is rapidly changing. As the cost of cancer care continues to rise, several new value-based care programs - both public and private - have attempted to curb these rising costs. Learn about the current landscape of VBC oncology programs, several key challenges and opportunities with oncology analytics, as well as anticipated evolution of cancer care in the near future. Topics include: Current VBC oncology landscape, including a more detailed discussion on CMS' latest oncology program, Enhancing Oncology Model (EOM) Discussion on current challenges and opportunities with oncology analytics, including some advanced methodologies that have been developed based on documented clinical pathways to better understand cost drivers Future state of oncology care including emerging pharmaceuticals and novel therapies, personalized care regimens, and other clinical innovations"

Description: Level funded products often target the small group market (2-50) and can result in many manual and tedious processes for underwriting to perform risk assessment. Learn how a carrier used technology to help automate risk assessment without the need for paper medical questionnaires, and exposed a risk engine for broker quoting to enable near real-time of pricing for risk-based products. The approach reduced labor and allowed underwriting to focus solely on fallout cases while also improving pricing consistency. Discuss broader trends in the health market for risk assessment, including new machine learning cost predictions that can be used for automation and better predictions of future costs. Discussion topics will include underwriting guidelines, business rules, risk scores, and machine learning. By attending this session, you will have a better idea of new trends in risk assessment for small groups where no claims experience is available. And, better understand business rules that are common in underwriting for flags for review as well as how risk scores and machine learning can be used during the underwriting process.

Description: Discover a comparison of U.S. and international mandated leave programs which mandate employers to provide a minimum level of benefits to employees for qualifying leaves of absence, such as parental leave or medical leave.

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).