Description: View the report on Modeling the Impact of the Great Unwinding on State Medicaid Programs

Description: Learn more about the influence of excessive heat and human health, as it pertains to drug concerns, in this essay by Rebecca Owen.

Description: The coming wave of biosimilars could have a major impact on prescription drug spend in coming years. The big event of Humira biosimilar launches in 2023 will be significant in determining that ultimate impact. Payers are making coverage decisions. The more biosimilars are utilized, the greater the potential savings. How will biosimilar adoption be maximized?

Description: Paid Family and Medical Leave (PFML) benefits have expanded rapidly in recent years as an increasing number of states have required employers to provide these benefits to their employees. Examine recent developments in PFML benefits, for example, the presenters will provide information on which states are introducing or considering PFML programs, what types of benefits are provided, what types of data is available to monitor experience, and what challenges programs have encountered.

Description: Since the Affordable Care Act implemented minimum loss ratio provisions for health plans, several states have passed or at least considered minimum loss ratio regulation for dental plans. While such regulations are intended to improve insurer efficiency and promote value to consumers, they can have unintended negative consequences if the unique characteristics of the dental insurance market are not considered. Learn about this hot topic, including loss ratio basics, recent legislative activity in the dental loss ratio space, how dental differs from medical, and why those differences are critical to account for when trying to regulate loss ratios in that market.

Description: Read this report, which is part of the series "Understanding and Managing Post-Retirement Risks", to learn more about the perspective of the individual with respects to long-term care, caregiving, and housing issues.

Description: Actuaries historically modeled new launches in pharmaceuticals by anticipating the expected change to the market basket. This became more complicated with the recent launches of gene and cell therapies as they address rare diseases. Rare conditions have low total member volume to study and some do not currently have a diagnosis code to identify them within claims data. Addressing this modeling challenge has been growing more important in the recent years with the number of therapies launching. What has the health care industry, and more specifically health care, done to enhance modeling and how should this be altered for the future? Additionally, historic modeling has sometimes incorporated a level of direct medical treatment cost offsets where studies have shown lower treatment costs are achievable. Can gene and cell financial modeling include cost offsets as well? And if so, what are suggested precautions or limitations to this effort?

Description: This article provides an update, as of October 2023, on Financial Reporting Section research projects in process and those recently completed.

Description: Generative artificial intelligence (AI) tools like ChatGPT will redefine the nature of work across industries in coming years, What does this mean for the actuarial profession? Delivering generative AI tools to actuaries capable of leveraging them effectively will dramatically modernize how actuaries work and contribute to organizational growth. In this educational session, explore how generative AI can accelerate actuarial model development. Gain an introduction to generative AI and its implications for actuarial modeling. Learn how it specifically helps actuaries improve accuracy, reduce errors and save time in model development. Then explore use cases, including how generative AI can improve data cleaning, model building, as well as simulate scenarios and test model robustness. Close with a discussion on how to integrate generative AI into actuarial modeling workflows effectively, including common challenges actuaries may face during implementation and tips to overcome them. You will come away with a deeper understanding of how generative AI can accelerate actuarial model development.

Description: Adjusting GAAP reinsurance reserves to account for reinsurance protection against the events that trigger direct reserve constraints (such as NPR capping or LFPB flooring) can be a challenge any time. Ceding a block of business that is already in force increases the challenge—especially if one of those constraints was already present at inception of the reinsurance. This article builds on previous work (published in the July 2022 and June 2023 issues) to show how to measure initial reinsurance reserves in a way that complies with AICPA guidance and prepares for effective measurement of subsequent changes in the effects of the constraints.