Description: CPT, NCCI, ICD, CCI, DRG, APC, PTP – understanding healthcare claims involve a dizzying array of code sets and payment methodologies, and yet the claim form is the intersection of health plan affordability, provider payment, and data analysis. This webcast will cover: • The code sets used in medical coding • Types of correct coding policies implemented by CMS and commercial payers • Payment integrity strategies to drive health plan affordability • Data analytics approaches leveraging medical coding knowledge

Description: The COVID-19 pandemic has had an impact on all aspects of daily life and its impact extends to how disability incidence may play out in the future. Product profitability will be shaped by how morbidity patterns, interest rate levels and other key drivers will play out into the future. In this session, our panel will discuss COVID’s impact on IDI morbidity experience as observed over the past 18 months, offer comparisons and insights in light of other insurance lines of business, and share emerging information on the on-going effects of Long COVID. Highlights will also include how regional differences and implications for insurers as the industry moves further into the COVID vaccine era.

Description: This article provides an overview of critical illness insurance: history, product description, and the three primary ways to offer critical illness coverage in the United States. This article also contains an illustration of an issue age premium rate calculation, as well as product features and rating applications specific to the various types of critical illness coverage.

Description: Discuss changes in group life waiver of premium claim recovery and mortality experience since the 2005 table was released, the development of the 2023 table, and the new statutory valuation standard approved by the National Association of Insurance Commissioners (NAIC).

Description: The Individual Disability Experience Committee (IDEC) of the SOA has gathered industry data covering 2006-2015. This sessions will highlights their findings on the recent industry experience compared to the 2013 Individual Disability Income Valuation Table (2013 IDIVT), including the impact of the recession on incidence and terminations. The audience will gain an understanding of how the recent industry experience compares to the most recent valuation table. The session will cover claim incidence and claim termination Actual to Expected (A/E) using 2013 IDIVT as the expected basis. The adequacy of the modifiers will also be also be discussed.

Description: The Individual Disability Experience Committee (IDEC) of the SOA has gathered industry data covering 2006-2015. The presenters will highlight findings on the recent industry experience compared to the 2013 Individual Disability Income Valuation Table (2013 IDIVT), including the impact of the recession on incidence and terminations. They will cover claim incidence and claim termination Actual to Expected (A/E) using 2013 IDIVT as the expected basis. The adequacy of the modifiers will also be discussed.

Description: With the mandated health plan transparency files, health plans and providers are now able to substantially enhance their provider contracting efforts. Although the files are large and cumbersome they are market disruptors and provide new insights for provider contracting efforts. Explore a demonstration on the type of information now available and how it can be used to enhance this from both a health plan and health care provider perspective.

Description: CMS has required hospitals to publish their chargemaster rates, cash discounts and negotiated rates as of January 1, 2021. Our panel is comprised of a data strategist, an executive from a large hospital system and an actuary.

Description: This webcast will walk through several statistical methods for imputing race and ethnicity from U.S. datasets, highlighting their strengths and weaknesses, talking about how to use them and evaluating their accuracy, and telling you where you can get code packages as well as a free dataset to try the methods out.