Description: This article provides a detailed description of the unbalanced subsidy provisions in the Affordable Care Act with easy to follow numerical illustrations. An understanding of the illustrative calculations is necessary to understand the subsidy implications. The article highlights some surprising and likely unintended results that will be interest to issuers, employers, consumers, regulators and policymakers. Actuaries can add expertise to their clients and to the public discussion with a proper understanding of the subsidy calculations and the resulting implications.

Description: Discussion of the impact of the ACA on RBS and required surplus for a health plan

Description: Health Watch, Issue 79, December 2015, Health Watch

Description: Under the Affordable Care Act (ACA), groups with 50 or less full time employee equivalents will eventually be subject to the ACA’s modified community rating rules. While some groups will see lower premiums than they would have without the ACA, others will see significant premium increases. Many of the latter type opted for transitional relief beginning in 2014 to avoid the ACA as long as possible. With the end of transitional relief approaching in 2018, what will these groups do? One option will be to self-insure using a product generically termed Level Funding.

Description: Results of an SOA survey regarding the expectation for 2015 accruals for 3Rs and cost sharing reduction payments

Description: This article discusses the challenges and unknowns relating to the regulatory inclusion of pediatric dental benefits within the essential benefits list of the Affordable Care Act (ACA).

Description: October 2012 issue of Health Watch newsletter

Description: This paper discusses the need for actuarial judgment to be used in conjunction with statistical analysis in the calculation of incurred but not reported IBNR claim reserves.

Description: This paper derives exact expressions for the ultimate ruin probability and establishes the effect of correlation on ruin probability using the Wiener-Hopf factorization.

Description: Discussion of how to mature value-based contracts between health insurers and provider organizations to improve population health and financial sustainability. Centers around contract parameter consistency, revenue predictability and risk assessment. Intended audience are health plan and ACO actuaries and leaders. Authors are writing from the provider perspective in value-based contracts.