Description: Recap of content contained in the May 2013 issue of the Health Watch newsletter.

Description: Essay offers a vision of health care where everyone is covered, everyone is eligible, receives fair pricing, receives vital information and is taxed the same.

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: A discussion of the impact of the June, 2012 U.S. Supreme Court decision on Medicaid expansion and the financial impications for states.

Description: Recent health care reform activity has highlighted the importance of Clinical Integration in improving the quality, safety, efficiency and reimbursement infrastructure of the health care system. This article discusses relevance and implication of regulatory measures, implementation and data issues, and provides an end-to-end example.

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: 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: 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: 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: This article explores the changing risk profile between the transitional Affordable Care Act (ACA) period (2014-2016) and under the final ACA period (beyond 2017) for the individual market. Actuaries are in a unique position to help facilitate the change from the current ACA period to the final period when health plans will have to take on substantially more risk.