Description: 2021 ImpACT Conference - Session 7B: Premium Alignment in ACA Markets: New Trends in State Guidance 10.27.21 Recording

Description: The June 2021 Supreme Court ruling in California vs. Texas has significant ramifications on Affordable Care Act markets. This session will provide the actuarial community an overview of the ruling, the likely impact on health insurance markets, and potential legislation to address the ruling details.

Description: 2021 ImpACT Conference - Session 1B: Mental Health Care in a Virtual World 10.25.21 Recording

Description: Actuaries have the business acumen, problem-solving capabilities, and technical skills to develop innovative and data-driven solutions in the social insurance space. It is time we expand our scope and embrace an increased role in making a positive impact within the health care ecosystem. The primary focus of this paper is on social insurance programs dedicated to the most vulnerable population: low-income families accessing care through Medicaid. While there are numerous challenges that require other subject matter experts to take the lead, this article highlights topics where actuaries can be key players in developing and implementing tangible solutions to improve the care for the most vulnerable. Issues and solutions in this paper focus on the following three areas: 1. Access to appropriate care, 2. continuity of care, and 3. social determinants of health.

Description: The Health Insurance Portability and Accountability Act affects all exchanges of health information. It has a major impact on health-care management and the distribution of health information used in underwriting and claim management practices for all medical and non-medical lines. Also discussed are changes to Medicare, Children's Health Insurance Program, CHIP, and a proposed prescription drug plan under Medicare. From the Record of the Society of Actuaries, Volume 27, No. 1, Session 24PD of the Dallas Spring Meeting.

Description: This is a Request for Proposals (RFP) issued by the SOA Research Institute (SOARI) seeking research studies related to anxiety, depression, and their impact on mortality in the United States.

Description: As we entered 2014, actuaries became familiar with three risk stabilizing mechanisms in the early years of the ACA marketplaces, colloquially known as 'the 3Rs'. As we enter 2024, there is renewed focus on rating compliance and risk adjustment. Speakers will highlight pricing considerations when determining cost-sharing reduction premium loads as well as related issues pertaining to risk adjustment and metal tier pricing.

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: State Medicaid agencies have been implementing value-based payment (VBP) models for the last decade and are increasingly exploring advanced population-based payment (PBP) models that increase flexibility, predictability, and accountability for participating provider organizations. PBP models show promise in advancing Medicaid priorities, but are still in the early stages of development, and model design and implementation challenges remain. This article from the Center for Health Care Strategies explores the fundamentals of VBP and how PBP - a particular type of payment model - can help Medicaid agencies achieve goals related to care transformation and quality improvement, revenue stability, and controlling cost of care.

Description: This is an introduction to the SOA call for essays around risk strategies pertaining to the diverse risks found in retirement. We are pleased that these essays can be included in this issue of Pension Section News, along with a short interview with each author.