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: Discussion of anticipated marketing and pricing considerations of Group Insurance in the 1980's including: a. Regulatory environment including National Health Insurance b. Economic and growth potential c. Competition including Health Maintenance Organizations d. Technology e. Evolving role of employee benefits f. Products g. Pricing considerations h. Marketing approaches Also, discussion of the 1960's and the 1970's a. Major influences b. Benefit changes c. Alternate funding approaches 2. The 1980's environment a.

Description: The Brazilian private health care market ended 2010 with US $48 billion worth of premium. This already makes it Latin America’s largest health care market and sixth in the world ranking. This article provides information on the market and opportunity for growth.

Description: A discussion of funding arrangements that can reduce the costs of providing medical coverage through lower reserves or state tax savings, instead of through cutting benefits.

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: The winner's curse, applied to Affordable Care Act plan pricing.

Description: The Affordable Act's risk corridor program is a temporary feature that applies to individual and small group QHPs from 2014 through 2016. Designed to protect insurers against pricing uncertainty, the program appears straightforward but has many subtle consequences. In this article, we review the need for risk corridors, the calculation itself, and the implications that result.

Description: Presented at April 1986 Spring Meeting. Addresses costs, cost measurement and control, how target cost levels are established, and the cost/benefit perceptions of employers.