Description: The medical scheme approach adopted by several African countries has failed to meet the needs of those in informal employment and rural communities. This is partly due to affordability amongst these individuals as well as a lack of awareness of how healthcare financing products work. Community based healthcare organisations have achieved greater levels of success in this regard by carefully incorporating the peculiarities of communities in benefit design and involving community members in the management of these healthcare solutions. There are lessons to be garnered from the countries where these have been implemented with some level of success. Even as countries aim towards universal health coverage, observing the unique needs of different communities within a country is essential to ensure resources are utilised efficiently and that healthcare needs are targeted effectively.

Description: This is a discussion of the medical loss ratio, the confusion and debate over the calculation method under the new MLR requirement, and the opportunities it presents to consulting actuaries.

Description: Part II of a two-part series discussing individual market evolution from before the ACA through President Trump's first term.

Description: Discussion of recent developments in the taxation of noncoordinated benefits such as fixed indemnity, hospital indemnity, and specified disease insurance policies. Developments include a recent Chief Counsel Advice Memorandum and proposed triagency rulemaking that would impact non coordinated benefits.

Description: Insurance commissioners and/or deputy commissioners will discuss a variety of current topics including health care reform, risks in the major medical markets, voluntary products and other topics. At the conclusion of the session, attendees will be able to identify issues that are on the mind of the regulatory agencies and the different approaches used across the country.

Description: This paper offers basic, economic and actuarial ideas to improve the balance of cost, access to treatment and quality over time.

Description: This presentation is a Health Section meeting from the 1991 Annual Meeting of the Society of Actuaries, held October 20-23 in Toronto. The session leader, the incoming chair of the section, covers administrative matters, and then the next speaker addresses a newly completed research project, sponsored by the Society and Health Section, on the variation by duration in small group medical insurance claim costs. The speakers then discuss current developments in small group reform, and the various parties involved, including the National Association of Insurance Commissioners [NAIC], and the Health Insurance Association of America [HIAA], and the work that has been done, including modeling to address the impact of a small group reform mechanism. The speakers discuss how the various parties' objectives can differ. Discussion from participants is included. From the Record of Society of Actuaries, Volume 17, No. 4B.

Description: This session discusses what will happen to supplemental coverages under health care reform. Topics include traditional group ancillary benefits, health care reform supplements, and traditional individual/group niche products? From Record of Society of Actuaries Vol. 20, No. 3A.

Description: Republicans have promised to repeal and replace the Affordable Care Act for years. Now that they have power, what will Republican health care reform look like?

Description: A call for essays issued by the SOA Health and Long Term Care Sections on the visions for the future of the U.S. health care system.