Description: The PPACA imposed a market share-based health insurance provider fee, known as the "Section 9010 Fee", "Health Insurer Fee", or simply the "HIF", on each “covered entity” with net premiums written in excess of $25 million that is engaged in the business of providing health insurance coverage for U.S. health risks. This article provides background information to help unpack the language behind the Section 9010 Fee and highlights a few areas of special interest including merger and acquisition-related issues, application of the Section 9010 fee to expatriate plans, and considerations regarding fee administration.

Description: This article contains excerpts from the first three articles that were released through the strategic initiative - Commercial Health Care: What’s Next?

Description: Evaluation of Taiwan's National Health insurance program and a discussion of a managed competition model to reform it.

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: A proposal to address provider payment issues by gradually moving to accountable care organizations. Capitations would be risk-adjusted, non-capitated costs would be covered by hospitalization fund and stoploss, incentives for quality & effective preventive care would be tied to the amount remaining in the fund, and government involvement would be through incentives rather than mandate.

Description: Summary of results of a 2010 Health Section survey of actuaries and Medicare population, on ways to bend the cost trend curve downward. Issues included transparency, quality measures, fraud and abuse, provider payment, malpractice, medical errors, consumer education, and the pros and cons of employer-sponsored coverage.

Description: Shannon Brownlee shares her perspectives on the current health care crisis, including: inconsistent treatment patterns across providers and geographic regions, providers lacking evidence-based guidelines, the need for better independent clinical research to establish those guidelines, and the limits to consumerism's potential to fix the crisis.

Description: Panelists discuss key aspects of recent and pending laws and the cost and design implications on group health plans. From the Record of the Society of Actuaries, Vol. 24, No. 2.

Description: This session discussion is about two proposals for health-care reform will be presented, one from the Blue Cross/Blue Shield Association and one from the Council for Affordable Health Care. These dramatically different proposals will be compared and open for critique. From Record of Society of Actuaries Vol. 18, No. 4A.

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