Description: 2021 ImpACT Conference - Session 7E: Impact of COVID-19 on LTC 10.27.21 Recording

Description: This session will include examples of healthcare claims and market data to be used for educational purposes to highlight trends in the insurance industry. It will also highlight opportunities to enforce existing laws around fraud and abuse, and areas for regulators and legislators to focus to address this growing problem. Finally, it will discuss recent law changes and highlight areas requiring additional regulatory intervention. Expect discussions of recent claim issues and laws in the healthcare market as well as emerging issues in healthcare. The presentation will be beneficial to healthcare professionals working for health insurers, healthcare providers, auditors, regulators and healthcare providers and will also cover professionalism related topics for actuaries.

Description: The Child Tax Credit and Social Security have demonstrated how simple rules based cash transfer programs can significantly lower poverty. Discover information from a paper that describes how the expansion of Social Security can more effectively and efficiently reduce poverty than the current alphabet of anti-poverty programs.

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: Climate change will lead to an increase in the frequency and severity of many weather-related hazards. In turn, these hazards will impact health outcomes for individuals. Explore examples of this connection with a climate scientist, including how the increase in wildfire severity in the western U.S. is expected to drive a 40% increase in organic carbon aerosols by 2050 and howheat stress will impact vulnerable populations and workers in non-air-conditioned environments. Investigating these relationships will increase literacy on disproportionate impacts of climate change-related health outcomes. Presenters will illustrate the disproportionate impacts by geographically analyzing climate change signals and comparing them with socioeconomic data. Last but not least, you will learn about the evolution in both voluntary and required disclosures for payors and the landscape of why understanding climate risk is relevant for many payors.

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: "Spread pricing is a pricing methodology where pharmacy benefit managers (PBMs) bill a payer one price but reimburses the dispensing pharmacy a lower price for the same prescription drug. PBMs have historically relied on spread pricing as a revenue source. However, a growing number of states are introducing and passing legislation prohibiting spread pricing for Medicaid and commercial clients. In addition, new entrants to the PBM and mail-order pharmacy space are disrupting the market by offering services that promote increased transparency and member satisfaction. Expect updates on recent legislative trends and market disruptions targeted towards increasing PBM drug pricing transparency. By attending this session, you will have a better understanding of how changing legislation and market disruptions may impact current pricing methodologies."

Description: Following her first 100 days as the CMS Administrator, Chiquita Brooks-LaSure released her six strategic pillars for the agency. The Center for Medicaid and CHIP Services (CMCS) followed these pillars and laid out their priorities for states under the Biden-Harris administration. With these priorities established, recent 1115 submissions from several large states, including California, Massachusetts and New Jersey, may give insight to how CMS will operationalize their vision under this program authority. This session will include presentation from state policy staff who have led recent 1115 waiver proposals. By attending the session, you will be able to: • Demonstrate understanding of the current administration’s strategic priorities for State Medicaid & CHIP programs. • Identify trends in recent 1115 waiver submissions.

Description: The Special Financial Assistance (SFA) program included in the American Rescue Plan Act (ARPA) will provide grants to some of the more troubled multiemployer plans. While this is a welcomed relief for many multiemployer plans facing insolvency, plenty of challenges remain in the implementation of the funds and ability to maintain solvency after the SFA funds are fully utilized. Explore the challenges and opportunities from the pension relief provisions.

Description: 2021 ImpACT Conference - Session 1D: Reserved Roles for Actuaries in Defined Contribution Plans 10.25.21 Recording