Description: The introduction of new gene and cell treatments is not without scrutiny. Although these treatments are often curative, they come with a significant price tag. Health plan actuaries find themselves wondering if the intended outcome supports the cost and whether the potential medical cost savings will offset the high drug cost. The Institute for Clinical and Economic Review (ICER) reviews results from clinical trials to produce a report evaluating the cost-effectiveness of new therapies. Depending on the results, the ICER report can be used by pharmaceutical companies to justify the high cost or by the health plan to do the opposite. Go beyond the ICER report and discuss an alternative method for valuing new drugs using nonmedical revenue streams, such as disability and nutrition benefits, and return-on-investment modeling. By attending this session, you will have a better understanding of the nonmedical revenue streams, such as disability and nutrition assistance benefits, that may offset the cost of a drug and how those revenue streams can be incorporated into return-on-investment modeling.

Description: Data is at the core of the actuaries' role within companies, but how can actuaries translate data insights into informed and actionable decision making? The key is communicating data insights into a language that transcends analysis and enables real-time decisions that can provide an advantage to your management team. Learn an approach to choosing a tool or medium for your data insights, questions to ask yourself to better understand the communication necessary, and perspectives on how actuaries can take a larger role in actionable decisions within the industry. Understand availability, quality, and practical application of data sources health actuaries can access easily, how that data looks, approaches to transforming data into decisions, how it enriches administrative and claims data, and applications to pricing and reserving. Finally, discuss implications of ASOP 23, ASOP 41, and ASOP 56 as it relates to this topic. By attending this session, you will be able to: - Create an action plan on how to transform data into messaging for your leaders. - Use real experiences to formulate a strategy to expand the actuaries' role in informing decisions within the industry, including examples, to illustrate how data can benefit financials of health coverages. - Understand the application of ASOP 23 (Data), ASOP 41 (Communication), and ASOP 56 (Modeling) as it relates to turning data into decisions. - Be knowledgeable about new sources of morbidity for medical care and LTC and how to acquire and apply this information in actuarial models.

Description: "As digitization and automation rapidly progress in today’s life and health industry, issues with misrepresentation during the insurance application process are also becoming a growing concern for insurers around the globe. A recent survey finds that misrepresentation in application forms costs the average insurance customer an estimated 5% to 10% in higher premiums. In order to reduce this risk, insurers must find and correct areas of misrepresentation, consult post-issue sampling, review the automated underwriting processes, and monitor the quality of financial advisory firms. Learn how predictive disclosure modeling detects and reduces misrepresentation by harnessing readily available underwriting data to analyze issues, helping insurers understand various drivers for disclosure rates and areas of misrepresentation.Advantages of this modeling to various stakeholders in the life insurance journey include improved risk selection, claims experience, and reinsurance terms for insurers. For customers, it leads to increased certainty of coverage, payout of the claim, and ultimately lower premiums on average. By the end of the session, attendees will understand: The disclosure modeling process at a high level The technical details of a standard approach to disclosure modeling: data cleaning, standardization, visualization, and predictive modeling Success stories about how predictive disclosure modeling has impacted insurers"

Description: Charles Cadman and his team may be new to Kaggle’s data science challenges, but that didn’t stop them from achieving a top-ten finish.

Description: This interactive session provides an introduction to behavioral economics, including groups identifying areas where behavioral economics could be applied in actuarial practice. Experience a practical application workshop using behavioral economics for direct sale products. Break out into small groups and develop an outline of a BE based sales program for a product of your choosing to be sold over the internet. Gain feedback and take part in a discussion. By attending the session, you will: - Understand the basic concepts of behavioral economics. - Have some ideas of how it can be applied to actuarial practice. - Learn how to design a product using BE and how to design an experiment to test the effectiveness of an application of BE.

Description: The National Association of Insurance Commissioners (NAIC) is in the middle of a project to change the real-world economic scenario generator (RW ESG) prescribed for principle-based reserve and capital calculations. Explore a brief summary of the NAIC's RW ESG project and gain a general overview of RW ESGs. Learn how RW ESGs impact principle-based reserve and capital levels, their potential impact on life insurance companies and consider differences between the currently prescribed RW ESG and the proposed RW ESG.

Description: Electronic Health Records are here to stay. Take a deep dive into the world of electronic health records and how the industry is poised to utilize this new form of digital medical data to transform the way policies are underwritten and ultimately, transforming the client experience. Listen to industry experts speak about what they are doing to use this data most effectively and how this ultimately develops into ground-breaking solutions for the industry.

Description: Open source programming languages have become a common part of the actuarial toolkit over the years. Using tools like R and Python, highly technical actuaries can automate onerous processes, easily work with massive amounts of data, create models and generate reports. Although these tools excel at turbo-charging analysts, it can be difficult for benefits to inure to the rest of the organization given the learning curve (“Can’t you just put this in Excel?”), control risks (“So your entire process could break overnight if some random person in Nebraska changes something?”), and internal IT environments. Listen in on a panel discussion where presenters share their personal stories of working with open source in a production setting. Hear about real world business problems, how open source tools were used, what risks were present, how they were overcome and the final business result.

Description: Following her first 100 days as the CMS Administrator, Chiquita Brooks-LaSure released her six strategic pillars for the agency. The Center for Medicaid and CHIP Services (CMCS) followed these pillars and laid out their priorities for states under the Biden-Harris administration. With these priorities established, recent 1115 submissions from several large states, including California, Massachusetts and New Jersey, may give insight to how CMS will operationalize their vision under this program authority. This session will include presentation from state policy staff who have led recent 1115 waiver proposals.

Description: Much of the work performed by disability insurance actuaries depends on the availability of accurate and detailed data, which is not always as simple as it sounds. Explore a variety of data challenges faced by disability actuaries, along with potential solutions. Potential topics include finding relevant data, the impact of poor data on valuation work, the impact of new privacy rules, and the potential bias in the data used to develop predictive models.