Description: Part II of a two-part series discussing individual market evolution from before the ACA through President Trump's first term.

Description: This article analyzed the characteristics of the uninsured. Income had the highest correlation. From: The Actuary, April 2000 – volume 34 - Issue 4.

Description: After the bid process, desk review, rebate reallocation, an “enjoyable” audit, and open enrollment; the Medicare plan year starts. Throughout the year, organizations find it pertinent to get an accurate picture of their Part D liability as reinsurance, LICS (Low Income Cost-Sharing) subsidy, and risk corridors are accrued. Attendees will learn about the basics of Part D accruals, how future accrual amounts are estimated based on patterns in the data, and how bid assumptions versus actual results impact plan sponsor profitability. We will also discuss financial statement treatment of these items. Real-life examples from bids to outcomes will be provided to enhance the discussion. Ultimately, attendees will come away with a deeper understanding how their bid assumptions play out, and how they can use Part D accruals to plan for future bid development.

Description: With the increase of membership in Blue Cross / Blue Shield, this paper presents the practices and experience under the plans using the United Medical Service, Inc as a model. Transactions of SOA Vol. 6, No. 14

Description: This literature guide provides a basic grounding for product development actuaries.

Description: A mathematical framework for benefits and choices must be created, in order to model flexible benefit selection. This paper creates such a framework by defining benefit plans as reimbursement functions. These are then used with a defined choice function to calculate the cost deviation due to selection. From Actuarial Research Clearing House 1992, VOL. 1.

Description: When setting reserves, multiple methods are often used in the creation of the reserve estimate. Judgment is warranted to combine these different estimates into a final recommendation. This paper describes two techniques that can be used to combine these estimates that may result in better accuracy and lower variance.

Description: The always popular Medicaid Hot Topics session is back with discussions from an expert panel on the most riveting Medicaid topics of the year. These could include the following: • Medicaid Fiscal Accountability Proposed Regulations• Tennessee's Block Grant Proposal• ACA court battles: What are the potential impacts on Medicaid? • Pass-through payments are converting to directed payments: What is changing?• And more current topics of interest to Medicaid actuariesMedicaid is dynamic and it is difficult to stay current on all of the changes. This session provides insightful discussion into the major changes that impact actuaries and their companies or state clients.

Description: This paper discusses the purpose and nature of the benefit ratio [otherwise known as active life] reserve in relation to the class of health insurance contracts to which it is intended to apply. From Transactions of Society of Actuaries 1988, Vol. 40, Pt. 1.

Description: This session discussion is about surplus requirements, unique health insurance surplus needs, and the impact of A.M. Best and other rating agencies. From Record of the Society of Actuaries Vol. 15, No. 1