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  • Chairperson's Corner
    Chairperson's Corner Hear from the chairperson on themes in the March 2017 issue of Health ... Chairperson's Corner Hear from the chairperson on themes in the March 2017 issue of Health Watch ...

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    • Authors: Brian Pauley
    • Date: Mar 2017
    • Competency: External Forces & Industry Knowledge>Actuarial theory in business context; Technical Skills & Analytical Problem Solving>Problem analysis and definition
    • Publication Name: Health Watch
    • Topics: Health & Disability>Health care; Health & Disability>Health insurance; Health & Disability>Public financing - Health & Disability
  • The ACA’s Medical Loss Ratio Provisions: Looking Back
    The ACA’s Medical Loss Ratio Provisions: Looking Back The ACA’s Medical Loss Ratio Provisions Patient ...

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    • Authors: Rowen Bell
    • Date: Aug 2015
    • Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>Actuarial theory in business context; External Forces & Industry Knowledge>External forces and business performance
    • Topics: Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health information technology; Health & Disability>Health insurance; Health & Disability>Health risks; Health & Disability>Payment models; Health & Disability>Public financing - Health & Disability
  • Prologue
    it results in higher rates of mor- bidity and mortality for the uninsured and in some cases those around ... that in 2009— the year before the ACA was passed—U.S. health care spend- ing topped 16 percent of gross ...

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    • Authors: Jim Toole
    • Date: Aug 2015
    • Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>Actuarial theory in business context; External Forces & Industry Knowledge>External forces and business performance
    • Topics: Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health information technology; Health & Disability>Health insurance; Health & Disability>Health risks; Health & Disability>Payment models; Health & Disability>Public financing - Health & Disability
  • The CLASS Act and its Aftermath
    guid- ance. Nevertheless, the Secre- tary of the U.S. Department of Health and Human Services had sufficient ... future workers. Currently, there are 217 million U.S. adults age 25 and over.9 In order to appreciate ...

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    • Authors: Robert Yee
    • Date: Aug 2015
    • Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>Actuarial theory in business context; External Forces & Industry Knowledge>External forces and business performance
    • Topics: Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health information technology; Health & Disability>Health insurance; Health & Disability>Health risks; Health & Disability>Payment models; Health & Disability>Public financing - Health & Disability
  • Health Care Reform: Essential Health Benefits and Actuarial Value
    pre- ACA policies to do so.) In addition, the U.S. Depart- ment of Health and Human Services (HHS) ... required to cover the greater of one drug per U.S. Pharmaceutical (USP) category or class or the same ...

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    • Authors: Catherine Knuth
    • Date: Aug 2015
    • Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>Actuarial theory in business context; External Forces & Industry Knowledge>External forces and business performance
    • Topics: Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health information technology; Health & Disability>Health insurance; Health & Disability>Health risks; Health & Disability>Payment models; Health & Disability>Public financing - Health & Disability
  • ACA Impact on Employers - The road ahead and the road behind
    size employers constitute 2 per- cent each of all U.S. employers and are subject to phased-in employer ... the United States. Per the report2 issued by the U.S. Census Bureau, over 169 million buy employment-based ...

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    • Authors: Sujaritha Tansen, Brian Stentz
    • Date: Aug 2015
    • Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>Actuarial theory in business context; External Forces & Industry Knowledge>External forces and business performance
    • Topics: Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health information technology; Health & Disability>Health insurance; Health & Disability>Health risks; Health & Disability>Payment models; Health & Disability>Public financing - Health & Disability
  • Surplus and the ACA
    construct intended to be an early warn- ing system for U.S. insurance regulators and provide capital adequacy ... Considerations for a Managed Care Orga- nization”, © 2000 Milliman and Robertson, Inc. • NAIC RBC article:  ...

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    • Authors: Daniel Pribe
    • Date: Aug 2015
    • Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>Actuarial theory in business context; External Forces & Industry Knowledge>External forces and business performance
    • Topics: Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health information technology; Health & Disability>Health insurance; Health & Disability>Health risks; Health & Disability>Payment models; Health & Disability>Public financing - Health & Disability
  • Taxes and Fees Introduced by the ACA
    classes of insur- ers. As shown in the illustrative table in Figure 1, the amount by which the insurer would ... cases. The industry made an effort to lobby the U.S. De- partment of Health and Hu- man Services (HHS) ...

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    • Authors: Michael Gaal
    • Date: Aug 2015
    • Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>Actuarial theory in business context; External Forces & Industry Knowledge>External forces and business performance
    • Topics: Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health information technology; Health & Disability>Health insurance; Health & Disability>Health risks; Health & Disability>Payment models; Health & Disability>Public financing - Health & Disability
  • Medicaid and the ACA
    Medicaid and the ACA Medicaid and the ACA Patient Protection and Affordable Care Act= PPACA=Affordable ... to interface between the On June 28, 2012, the U.S. Supreme Court issued a deci- sion that while the ...

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    • Authors: Rebecca Owen
    • Date: Aug 2015
    • Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>Actuarial theory in business context; External Forces & Industry Knowledge>External forces and business performance
    • Topics: Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health information technology; Health & Disability>Health insurance; Health & Disability>Health risks; Health & Disability>Payment models; Health & Disability>Public financing - Health & Disability
  • A Regulatory Perspective on Rate Review Before and After the Affordable Care Act
    released separate guid- ance indicating that the U.S. Department of Health and Hu- man Services (HHS) ... eration of Independent Business v. Sebelius, the U.S. Supreme Court upheld two of the main provisions ...

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    • Authors: Annette James
    • Date: Aug 2015
    • Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>Actuarial theory in business context; External Forces & Industry Knowledge>External forces and business performance
    • Topics: Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health information technology; Health & Disability>Health insurance; Health & Disability>Health risks; Health & Disability>Payment models; Health & Disability>Public financing - Health & Disability