Description: The American Academy of Actuaries is engaged in several projects that proactively examine the future status of the Medicare Program. This session presents the findings that have resulted from these efforts. From the Record of the Society of Actuaries, Vol. 24, No. 2.

Description: This is a discussion of the medical loss ratio, the confusion and debate over the calculation method under the new MLR requirement, and the opportunities it presents to consulting actuaries.

Description: This session from the 1994 Valuation Actuary Symposium covers long term care and health related issues for valuation, an update from the Risk-Based Capital Task Force of the Academy on developing a risk-based capital formula for health coverages, an overview of the health practice notes.

Description: Recap of Q&A sessions held to discuss the findings and methodology of a SOA study on the cost of the newly insured under the ACA.

Description: In practice, the actuary may be required to forgo independent mathematical judgment in order to follow regulations which prescribe specific exposure or enforce counts for full and partial credibility. In this paper the authors give specific examples of such regulation from various states, and discuss the positive and negative features of the regulatory approaches. From Actuarial Research Clearing House, 2003 Vol. 3.

Description: The SOA’s research objective is to provide guidance to state exchange officials and administrators, federal officials and administrators, and actuaries assisting states and health plans. The goal of the project is to estimate the morbidity and/or cost for newly insured individuals in the individual market (and to some degree, the small group exchange) relative to the morbidity and/or cost for the current commercially insured population. This analysis will primarily focus on the individual, non-group market. In order to plan for the impact that these currently uninsured individuals will have on the health insurance markets, it will be important to understand their costs relative to the costs for people already enrolled, for whom many health insurers have experience and data.

Description: A call for essays issued by the SOA Health and Long Term Care Sections on the visions for the future of the U.S. health care system.

Description: The PPACA imposed a market share-based health insurance provider fee, known as the "Section 9010 Fee", "Health Insurer Fee", or simply the "HIF", on each “covered entity” with net premiums written in excess of $25 million that is engaged in the business of providing health insurance coverage for U.S. health risks. This article provides background information to help unpack the language behind the Section 9010 Fee and highlights a few areas of special interest including merger and acquisition-related issues, application of the Section 9010 fee to expatriate plans, and considerations regarding fee administration.

Description: Discussion of the following topics pertaining to disability income and other health insurance: 1. What portions of the loss of income and of the expenses incurred are properly insurable? 2. What special problems are encountered in providing suitable coverage for the following: a Employees and dependents eligible under Group plans b Individuals employed or not employed and their dependents ineligible under Group plans c Aged persons. 3. Methods for companies to meet the problems of overinsurance arising from duplication of coverage or from other causes?

Description: A discussion of the future of the Brazilian Health Market with a focus on the legislation which passed in June 1998 to regulate the private health insurance industry