Description: 1. Overview of challenges with Managed Medicaid (MLTSS/Dual Medicaid) 2. Mechanisms to identify the business problem. 3. Predictive Model approach a. Understand / Define the business problem b. Determine the appropriate solution c. Model build (data manipulations/transformations) d. Model scoring & monitoring results 4. Case Study - Disenrollment predictive model a. Describe the problem b. Recommended model to solve the problem c. Results d. Monitor results e. Fine-tune / calibrate model

Description: CMS provides a significant, and growing amount of information that can be leveraged by actuaries. Between the public use and research files CMS makes publicly available large amounts of information that can be assimilated to begin to understand the who, what, when, where, and how of Medicare. This session will focus on the depth and breadth of data available, summarize any restrictions on the use of the data, and identify areas where access to the new data can provide more meaningful insights than CMS's historical data sets.

Description: The proposed session will introduce Outcome Based Risk Sharing Arrangements (“OBRSA”) between health insurance payers (“payers”, including insurance companies, health plans, sponsored employers, and government programs) and pharmaceutical manufacturers (“pharma”), and it’s intended to meet the needs of actuaries who focus on pharmacy benefits and risk sharing arrangements. The covered content will include (1) the background of OBRSAs, definitions, stakeholders, and OBRSA’s role in shifting the system from volume-based toward value-based; (2) conflicting perspectives about OBRSAs between payers and pharma (cultural and methodological); (3) identification of incentive gaps between payers and pharma, and incentive alignment between them; (4) barriers to implement OBRSAs; (5) limitations and considerations of OBRSA implementation; and (5) hypothetic OBRSA examples.

Description: Predictive Analytics and Epigenetics are two of the most impactful driving forces for the future of healthcare, precision medicine, and insurance. Learn why this is true, how if will change the way our industry operates, and how you can stay viable and contribute to the betterment of humanity while also protecting the actuarial profession from obsolescence. Learn how personalized medicine keying off genetic testing is saving life insurers big dollars. The only limit seems to be testing access for their insureds.

Description: Certain valuation assumptions are difficult to set with a high degree of accuracy, whether because the underlying experience is in different economic or interest rate environments, in addition to other reasons. Examples include assumptions for long-term care insurance, annuity options, lapsation and premium persistency on ULSG. This session will share how the actuary can use predictive analytics to augment the assumption-setting process. Some of the benefits to the actuary (along with the company and the regulator) include more accurate assumptions with lower margins for adverse deviations. Of possible interest as well is that applications go beyond valuation and include acquisitions, reinsurance and pricing.

Description: This seminar is designed to give life and annuity practitioners an in-depth view of the important topics and fundamentals of reinsurance, from the perspective of a U.S. life insurance company. Reinsurance industry experts will present on the various types of reinsurance, contract issues, financial implications and other considerations. Attendees will leave this seminar with a stronger understanding of life and annuity reinsurance, and current topics. Keep in mind this seminar is designed for participants with a moderate level of experience. Educational Objectives • Provide attendees with a stronger understanding of life and annuity reinsurance, and current topics • Give attendees an in-depth view of important topics and fundamentals of reinsurance

Description: The baby boom generation continues to represent a tremendous opportunity for the financial services industry. Much of the industry attention is paid towards customers whose needs include wealth management, retirement, or wealth transfer/estate planning.However, there is a significant portion of that demographic that will require a solution that helps them with their final expenses (e.g. burial, credit card debt, medical bills, etc.). Currently, there is a good-sized market to service customers in this demographic representing $1.3 billion in new business premium in 2017 (according to LIMRA/LOMA). Steady growth is expected in this industry as there is a growing number of individuals who have not traditionally owned life insurance or can no longer afford premiums on existing products they may own. There are many different distribution strategies employed to reach customers in this market and each of them will be discussed during the session. Topics such as pre-need and guaranteed acceptance products will be included in this session. Underwriting approaches vary by carrier, as well, and this session will cover the pros and cons of each approach from both a new business point of view and the post-sale/rescission point of view.

Description: Offering supplemental benefits likes accident, hospital indemnity and critical illness to traditional worksite employees has become routine, but how do you handle gig workers? Traditionally these workers would be considered uninsurable, but can you afford to ignore them? The panel will discuss the unique factors of the gig economies and key thoughts for providing insurance in this space.

Description: As baby boomers continue aging into Medicare, prescription drug plans (PDPs) will continue to be an option to meet prescription drug needs. Several new PDPs introduced in 2019 address these needs, and we will share our experiences with implementing, pricing and operationalizing a new PDP, including how this product integrates across the enterprise. While we will discuss topics specific to launching a PDP, several of the concepts can be generalized to starting other insurance product lines within an organization.

Description: Accelerated underwriting is changing the world of consumer engagement. The newness and overhaul of these programs creates challenges for development, coordination and management. This seminar will take attendees through how the market is developing, the major pricing, underwriting, and marketing considerations, and what regulators are considering with regard to these programs. At the conclusion of this seminar, attendees will: • Discuss trends in accelerated underwriting • Understand the issues that arise when developing an accelerated underwriting program • Understand best practices in developing an accelerated underwriting program • Explain the impact of accelerated underwriting on underwriting, pricing, marketing and compliance