Description: This article compares the Prescription Drug Plan (PDP) market to the commercial individual market exchanges included in the Affordable Care Act. PDP carrier actions to date could help predict certain aspects of the exchange market.

Description: Provides background about Prescription Drug Plans, PDPs, and the standard benefit package offered under Medicare Part D. It also provides a basic overview of the bid-development process for a PDP and summarizes some general strategies and observations used in developing the 2006 bids that will likely be used for 2007.

Description: In session 26PD of the 2004 Valuation Actuary Symposium, discussed is how the new Medicare prescription drug legislation creates a number of issues for employers and managed-care plans. Employers must determine the impact of the legislation on their retiree prescription drug costs, evaluate options for plan design and make decisions about how to reflect the effect of the legislation in their FAS 106 valuations. Managed-care plans need to review the effect of the legislation on plan design, statutory filings and financial reporting for their Medicare products.

Description: This session is about compliance with NAIC requirements and Medicare-Select products. From Record of Society of Actuaries Vol. 19, No. 1B.

Description: Panelists explore issues facing carriers of Medicare Supplement products, including high trend, fixed designs, limited underwriting ability, legislation, National Association of Insurance Commissioners [NAIC] pursuits, and the American Academy of Actuaries [AAA] task force. From the Record of the Society of Actuaries, Volume 27, No. 1, Session 66

Description: Two Medicare risk funding provisions that were radically changed by the BBA of 1997 funding variations by geographic area and risk adjustment. Issue No. 36

Description: A proposal to reform current health care market, from a 'preferred payer' system, in which Medicare and Medicaid pay less than the true cost while others must then pay more, to a 'value for money' system. This would be achieved by requiring providers to bill all patients the same rate for the same services, with a standard bundling format to make all providers' rate differences transparent. Differences between billed charges and what Medicare pays would be made up by the Medicare patient, rather than subsidized by those outside of Medicare.

Description: Risk adjusters were first used for the Y2K reimbursements to Medicare+Choice laws. How did plans fare? What was the financial impact to the Medicare program? What changes are expected for the future? From Record of Society of Actuaries, Volume 26, No. 1. From Record of Society of Actuaries, Volume 26, No. 1: Las Vegas Spring Meeting, May 22-24, 2000, Session 125PD.

Description: This article takes a closer look at Medicare Part D Coverage and the types of payment demonstration payment of the federal reinsurance amountFlexible Capitation, Fixed Capitation, MA Rebate. Issue No 60

Description: Article from The Actuary September 1992 – Volume 26, No. 7 is about Social Security's projected costs exceeding income