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 health risk adjustments. Health care reform issues and Society of Actuaries research activities will also be discussed. From Record of Society of Actuaries Vol. 20, No. 3A.

Description: Research report sponsored by SOA to model and compare projected costs of different proposals for a Medicare prescription drug coverage plan. 3 types of costs are studied: net benefit cost estimates per member per month, continuance table data, and projected annual costs to the government over 10 years for two selected plan designs.

Description: Provides a summary of recent proposed regulations for the health insurer fee, section 9010 of the Affordable Care Act (ACA).

Description: A review of the academic article "Health Insurance for ‘Humans’: Information Frictions, Plan Choice, and Consumer Welfare."

Description: Using Healthcare Claims Data to Create Actuarial Models.

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: Panelists with close ties to prescription drug programs provide information such as factors driving pharmacy cost increases, combating rising utilization, and the value of mail-order drug programs. From the Record of the Society of Actuaries, Volume 29, No. 2, Session 53

Description: An analysis of prescription drug use in the Kansas individual market

Description: Rising drug—and, to a lesser extent, health care—costs in Canada are creating long-term challenges for not only governments and employers across Canada but for individuals as well, with no easy answers.