Description: The Affordable Care Act (ACA) changed the health insurance value proposition for lower-income Americans. Consequently, the uninsured rate has dropped dramatically since the implementation of ACA marketplaces and the expansion of state Medicaid programs to a broader eligibility group. It is not difficult to connect the change in financial dynamics to the increase in health insurance coverage. At the same time, many Americans remain uninsured due to non-financial barriers. Identifying solutions to further reduce the uninsured rate is more difficult than intuitively 'spending more federal money'.

Description: Since the Affordable Care Act implemented minimum loss ratio provisions for health plans, several states have passed or at least considered minimum loss ratio regulation for dental plans. While such regulations are intended to improve insurer efficiency and promote value to consumers, they can have unintended negative consequences if the unique characteristics of the dental insurance market are not considered. Learn about this hot topic, including loss ratio basics, recent legislative activity in the dental loss ratio space, how dental differs from medical, and why those differences are critical to account for when trying to regulate loss ratios in that market.

Description: "Direct medical costs for cancer care topped $209 billion nationally in 2020, accounting for a significant proportion of all health care expenditures in the U.S. Indirect costs are also significant, encompassing loss of productivity, wages, leisure time and decreased quality of life. The way cancer programs deliver and are reimbursed for care is rapidly changing. As the cost of cancer care continues to rise, several new value-based care programs - both public and private - have attempted to curb these rising costs. Learn about the current landscape of VBC oncology programs, several key challenges and opportunities with oncology analytics, as well as anticipated evolution of cancer care in the near future. Topics include: Current VBC oncology landscape, including a more detailed discussion on CMS' latest oncology program, Enhancing Oncology Model (EOM) Discussion on current challenges and opportunities with oncology analytics, including some advanced methodologies that have been developed based on documented clinical pathways to better understand cost drivers Future state of oncology care including emerging pharmaceuticals and novel therapies, personalized care regimens, and other clinical innovations"

Description: The Part D program is funded through a variety of government subsidies and manufacturer discounts. The federal reinsurance, initially designed as protection from catastrophic spending, became a primary source of subsidies for the program. When the Inflation Reduction Act (IRA) is fully implemented in 2025, the funding of Part D will realign to its original intent.

Description: "Are you a health actuary affected by recent developments in business practices and accounting standards that have created situations in which you may be involved in estimating balances under accounting rules that differ from those typically used by insurers? In this session you will learn about situations where non-insurance accounting regimes may intersect actuarial practice, with an intended focus on two particular topics. One topic is general accepted accounting principles (GAAP) for insurance brokers under ASC 606 (Revenue Recognition) for commissions on Medicare Advantage and Medicare Supplement contracts, where the broker may get to recognize the expected value of all future commissions on a contract as revenue when the contract is placed. The other topic is GAAP under ASC 460 (Guarantees) in situations where a non-provider entity is bearing risk related to health care services, which can occur under the CMS Direct Contracting/ACO REACH model or under private sector care coordination contracts."

Description: Broaden your understanding of how long-term care (LTC) is provided and brainstorm with other actuaries on ways to help society fund future LTC solutions. How we fund and provide LTC for our loved ones has changed over time and will evolve still by the time we retire. In this session we will explore the variety of ways that we fund LTC services: out of pocket and with informal care, Medicaid, lifeplan communities (Continuing Care Retirement Communities and and the Continuing Care at Home model), private LTC insurance and more. You will leave the session appreciating that providing long-term care is a key feature of our aging society and understand the variety of ways that we fund LTC today and may in the future.

Description: Leveraging advanced technologies like Generative AI is essential for insurers looking to compete and drive business growth. In this high-level webcast, we discuss the transformative potential of Generative AI in actuarial work and how it empowers actuaries to become more efficient and effective.

Description: Actuaries historically modeled new launches in pharmaceuticals by anticipating the expected change to the market basket. This became more complicated with the recent launches of gene and cell therapies as they address rare diseases. Rare conditions have low total member volume to study and some do not currently have a diagnosis code to identify them within claims data. Addressing this modeling challenge has been growing more important in the recent years with the number of therapies launching. What has the health care industry, and more specifically health care, done to enhance modeling and how should this be altered for the future? Additionally, historic modeling has sometimes incorporated a level of direct medical treatment cost offsets where studies have shown lower treatment costs are achievable. Can gene and cell financial modeling include cost offsets as well? And if so, what are suggested precautions or limitations to this effort?

Description: At the end of December 2020, Congress enacted the Consolidated Appropriates Act, 2021, which included revisions to Section 7702. Effective for policies issued after December 31, 2020, the fixed 4% and 6% minimum annual effective rates under these tests were changed to refer to a market-based rate called the “insurance interest rate”. For contracts issued in 2021, the insurance rate was set to 2% - defined as the lower of the Section 7702 applicable federal interest rate based on the 60-month period ending December 2019 (2%) and the Section 7702 valuation interest rate in effect for 2020 (3.5%). This reduction in the rates used for compliance testing required significant product, operational, and technology changes for companies to reach product compliance. After 2021, the insurance interest rate is redetermined annually with a minimum change floor.

Description: The Society of Actuaries Retirement Section Research Committee has sponsored a retirement project on the impact of megatrends and paradigm shifts on retirement plan design and funding. Various aspects were examined in the context of the future of retirement plans, including: Sociocultural Economic Technological Health and Long-term Care Environmental Presenters will address how the future is changing and challenge accepted thinking about retirement issues, as well as highlight new areas for consideration. At the end, you will have a better understanding of megatrends and how actuaries and others may address the changes in retirement plans.