Description: Discover a comparison of U.S. and international mandated leave programs which mandate employers to provide a minimum level of benefits to employees for qualifying leaves of absence, such as parental leave or medical leave.

Description: While states face a wide variety of circumstances and have implemented diverse approaches to the MOE phase-out, we revisit the conversation to discuss emerging experience across stakeholders as we examine the operationalization of the PHE unwinding as it relates to this major disruptor in the distribution of the healthcare enrollment.

Description: "Through both informed policy debate and opinionated social media, there are many current event health topics actively discussed and debated. The question remains... how does one separate out subjective information, seek objective analysis, and at the same time consider where there might be more research needed to come to conclusions? This session will use several current event topicsas examples and discover insights as to where research has been performed, what it may or may not cover, and also note where lines are still blurred and may need further details to be studied. Topics that may be discussed include: How valuable and exact is the use of risk-adjustment for Medicare Advantage What is the health and mortality impact of receiving COVID-19 vaccinations"

Description: Risk adjustment (RA) is a key component for CMS Medicare Advantage program and California Medicaid Managed Care program. While both RA programs follow generally accepted basic principles at a high level, their underlying methodologies and assumptions are also quite different. Due to recent events such as COVID-19 Public Health Emergency and Medicaid redetermination delay and restart, it adds complexity to Risk Adjustment. This is a hot topic in the industry and has significant impact to health plans. Keeping current with risk adjustment program changes and understanding the commonalities and differences of these two government risk adjustment programs is important to our health actuaries. Compare these two risk adjustment programs so you can learn key elements of a risk adjustment program, similarities and differences in methodology and assumptions , as well as special considerations due to serving different populations.

Description: Paid Family and Medical Leave (PFML) benefits have expanded rapidly in recent years as an increasing number of states have required employers to provide these benefits to their employees. Examine recent developments in PFML benefits, for example, the presenters will provide information on which states are introducing or considering PFML programs, what types of benefits are provided, what types of data is available to monitor experience, and what challenges programs have encountered.

Description: As we entered 2014, actuaries became familiar with three risk stabilizing mechanisms in the early years of the ACA marketplaces, colloquially known as 'the 3Rs'. As we enter 2024, there is renewed focus on rating compliance and risk adjustment. Speakers will highlight pricing considerations when determining cost-sharing reduction premium loads as well as related issues pertaining to risk adjustment and metal tier pricing.

Description: Join this presentation covering the key provisions of the IRA which govern the selection of drugs for negotiation. We will also discuss what these changes mean for all Medicare Part D stakeholders, including: Government Beneficiary Part D Plans Drug Manufacturers Original Content:

Description: "Informal caregiving is far more costly than many people realize. And not just in the immediate future. Current demographic trends suggest that caregiving will become even more necessary and costly as the Baby Boomers continue to age and require more support and services. In 2022, the SOA engaged Milliman, Inc. to conduct an analysis of the need for informal caregiving and its impacts on employees, employers, and other stakeholders. The purpose of this research was to educate stakeholders, policymakers, and other interested parties on the realm of informal caregiving, as well as how the challenges associated with providing informal care of all kinds might be addressed. Discover key findings and themes from the research project, as well as stories highlighting the various forms this role can take, and solutions currently being developed around the country. An open discussion on ways our profession can impact this growing need with the work we do every day in our respective roles will also be included."

Description: "Advancing health equity is one of the five strategic objectives outlined in the CMS Innovation Center's strategic objectives for the next ten years and is an increasing area of focus across many states. Focus in on recent developments in addressing Medicaid beneficiary needs related to social determinants of health (SDOH), health-related social needs (HRSN), and health disparities and inequities in Medicaid. Several states have introduced non-traditional benefits into their programs in recent years to address these areas, such as various types of housing supports, nutrition-related benefits, and enhanced/advanced case management support. Expect a discussion on the benefits introduced recently in states such as AZ, CA, MA, NC, and OR, including funding considerations around these benefits as well as the 1115 demonstration waiver authorities granted to these states to allow coverage for these non-traditional health care services.

Description: "During the pandemic there has been provider burn out, early retirement, hospital consolidation, and lack of staff in step down facilities. It is taking longer to get appointments. Take a look at the impacts of this andat how this can affect quality ratings in Medicare. You can also explore meeting quality incentives in Medicaid and how the current requirements for these plan to say they have adequate networks. Will the provider shortage have an effect upon actuarial rate certifications? If so, how? Are there any forecasts for how long this shortage will last? What are the impacts to care giving to the Seniors and Medicaid beneficiaries as well as plan design changes? Those who are intermediate level Medicaid and Medicare actuaries are encouraged to attend. By attending this session, you will be able to: Have a good understanding of the current Medicare and Medicaid situation and its impacts Understand strategic ideas of how to keep quality of care and access to care available"