Description: The SOA’s research objective is to provide guidance to state exchange officials and administrators, federal officials and administrators, and actuaries assisting states and health plans. The goal of the project is to estimate the morbidity and/or cost for newly insured individuals in the individual market (and to some degree, the small group exchange) relative to the morbidity and/or cost for the current commercially insured population. This analysis will primarily focus on the individual, non-group market. In order to plan for the impact that these currently uninsured individuals will have on the health insurance markets, it will be important to understand their costs relative to the costs for people already enrolled, for whom many health insurers have experience and data.

Description: This session discusses the impact of rising costs and increased litigation on managed care. From the Record of the Society of Actuaries, Volume 27, No. 1, Session 133

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: 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: Panelists at this session of the SOA 1989 Chicago Spring Meeting discuss Health Maintenance Organizaions [HMOs] including their hisotry, the marketplace, physician structures and relationships with HMOs, cost control issues and the future of HMOs.

Description: A glossary of terms.

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.

Description: This session discussion is about a review of experience under PPOs, measuring the success of PPOs, PPOs affect on employer health care expenditures, employee utilization of PPOs, the future of PPOs. From Record of the Society of Actuaries Vol. 11, No. 4A.

Description: On Dec. 29, 1973 President Nixon signed into law the Health Maintenance Organization Act of 1973, which authorizes $375 million to be used by the DHEW to stimulate the establishment and development of HMO's over the next five years. This article describes the status of the regulations and the development of additional HMO's.