Description: In order to encourage health insurance issuers to offer health insurance coverage on the Exchange and on the individual and small group markets, while ameliorating the potential impact on any particular health insurance issuer of providing coverage without pricing for pre-existing conditions or the gender of the insured, the Affordable Care Act includes three risk-sharing programs: the Transitional Reinsurance program, the Risk Corridor program and the Risk Adjustment program (collectively referred to as the “3Rs”). The financial and tax reporting of each health insurance issuer is affected by the implementation of these risk-sharing programs because each health insurance issuer is required to pay for the programs’ costs, and some issuers are or will be eligible for benefits under them.

Description: The article discusses the sustainability of the ACA individual market from a public entitlement standpoint. A key point of measuring sustainability is the reliance on market forces rather than federal budget constraints. The article explains why an actuarial viewpoint of sustainability is necessary to a greater extent than other public assistance and social insurance programs. The article challenges actuaries to be a bold, objective voice in a space that is full of opinionated but often uninformed viewpoints.

Description: An actuarial model that provides financial incentives to providers to offer patients an approach that can reverse chronic disease and reduce health care costs

Description: Mental health spending has reached $147 billion in the United States with demand only increasing greatly impacting society as nearly 1 in 5 experience these issues. There are even more indirect costs associated with mental health causing a national crisis surpassing 1 percent of the GDP. These costs coupled with the severe lack of licensed clinicians calls for an innovative solution. Through years of development and completion of a randomized controlled trial, Prevail has built and validated a low-cost, scalable solution. Prevail's clinically proven digital mental health treatment provides increased access to care while reducing overall health costs. Private and public payors should being reimbursing this model and offering it to their members.

Description: Provides an overview of a Columbia University graduate course in actuarial science called a Global Perspective of the Health Insurance Market. It includes an overview of this unique course and a summary of course content and completed research in the course. The course covers all financial aspects of US and international health insurance.

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

Description: Discussion of direct primary care and how it helps with several challenges in health care today. DPC improves care coordination, improves outcomes, improves doctor and patient satisfaction, and reduces spending. DPC successes promote the view that primary care should not be covered by insurance; rather, it should be paid for directly.

Description: A call for papers on health insurance topics to enhance the program for a 1979 special topic meeting of the Society of Actuaries.

Description: A follow-up to the 2012 article “A Global Perspective of the Health Insurance Market” about teaching a course at the Columbia University Masters in Actuarial Science program. The course provided an overview of the health care insurance industry.

Description: Discussion of the impact of the ACA on RBS and required surplus for a health plan