Description: A Regulatory Perspective on Rate Review Before and After the Affordable Care Act

Description: Essential Health Benefits and Actuarial Value

Description: Medicare Advantage and ACA

Description: This paper describes in detail each of five options available to small Texas employers wanting to purchase insurance for their employees. It then describes the advantages and disadvantages to the various players: carriers, employers, employees, and agents. It points out that each player will act in its own interest.

Description: The article explores how deeply the Affordable Care Act reduced the Medicare Advantage benchmark payment rates and quantifies how much of that reduction Medicare Advantage Organizations earned back through quality bonuses.

Description: The editorial shares observations and lessons learned from the process of implementing the Affordable Care Act.

Description: ReMark's Global Consumer Study delivers 10 key insights to empower customers. Insurers can design products that meet customers' needs and enhance client experiences and add significant value to their business. At the same time with new products being launched seemingly continuously, it is important to take a step back and assess risk throughout the product management cycle.

Description: Learn more about interpretable machine learning techniques for health insurance fraud detection.

Description: This presentation is a Health Section meeting from the 1991 Annual Meeting of the Society of Actuaries, held October 20-23 in Toronto. The session leader, the incoming chair of the section, covers administrative matters, and then the next speaker addresses a newly completed research project, sponsored by the Society and Health Section, on the variation by duration in small group medical insurance claim costs. The speakers then discuss current developments in small group reform, and the various parties involved, including the National Association of Insurance Commissioners [NAIC], and the Health Insurance Association of America [HIAA], and the work that has been done, including modeling to address the impact of a small group reform mechanism. The speakers discuss how the various parties' objectives can differ. Discussion from participants is included. From the Record of Society of Actuaries, Volume 17, No. 4B.

Description: The focus of this article is to provide background to actuaries on the updates in the employer stop loss medical insurance market including underwriting and pricing trends.