Description: This session discusses affordable health care including cost drivers, trends, the uninsured, federal funding and state initiatives. From the Record of the Society of Actuaries, Volume 29, No. 2, Session 109

Description: Beginning with the 2019 Benefit Year, CMS (the Centers for Medicare and Medicaid Services) has provided guidance that allows Medicare Advantage Plan Sponsors much greater flexibility in tailoring benefits to promote clinical, care management, and financial goals. The guidance allows for a broader menu of supplemental benefits and also enables plans to target benefit enhancements to beneficiaries afflicted with specific disease states. This session explores the ramifications of the policy changes on Plan Sponsors and beneficiaries, and discusses the different ways that Plan Sponsors are taking advantage of the additional flexibility.

Description: This session will discuss the role of actuaries under national health insurance, role of the Canadian health actuaries under that national program and how actuaries can shape the health-care environment in the U.S.. From Record of Society of Actuaries Vol. 18, No. 4B.

Description: MHPAEA prohibits health plans from imposing financial requirements or treatment limitations on behavioral health benefits that are more restrictive than those applied to medical and surgical benefits. MHPAEA's regulations define treatment limitations to include nonquantitative treatment limitations (NQTLs), which are benefit design features that are not numerical, but otherwise limit the scope or duration of benefits.

Description: HIV is still a big public health concern, but there are therapies available to prevent infection before and immediately after exposure. As legislatures and the USPSTF considers adding these therapies to the list of preventive care covered without cost share, actuaries will need to estimate the impact on their care cost. The presenters will share an actuarial tool kit to estimate the impact of covering PrEP and PEP for different populations. Examples are provided and discussion is welcome.

Description: This presentation is an open forum from the 1991 Meeting of the Society of Actuaries, held June 3-5 in Colorado Springs. The panelists debate on who should pay for medical care for the uninsured, and how it should be financed. The debaters represent advocates of private, voluntary, and cooperative private state solutions and state or government intervention to finance health care for the uninsured. Discussion from participants is included. From the Record of Society of Actuaries, Volume 17, No. 3B.

Description: This session discussed about expected trends in medical care costs, changes in Medicare reimbursement practices and their short- and long-term effects, the emerging responsibility for providing long-term care, rise of managed health care, new and old participants, selection issues, multiple options, and small group market.

Description: This session from the 1995 SOA Vancouver Meeting discusses and debates the merits and implications of community rating and guaranteed issue state requirements. State examples are discussed. From the Record of the Society of Actuaries, Vol. 21, No. 3a.

Description: Presented at October 2000 Annual Meeting. Discusses prescription cost trends, factors behind the trends, and cost management strategies for both the commercial and Medicare markets.

Description: In this discussion, experts in specific areas reported on recent and current happenings in their field. These include HMOs and manged care, Congressional legislation initiatives, disability insurance and mergers and acquisitions within the health providers/insurers. From Record of Society of Actuaries, Vol. 22, No. 2.