Description: Why and how to set up an advance directive, in case a health event renders you unable to make your own medical to decisions.

Description: This article provides a detailed description of the unbalanced subsidy provisions in the Affordable Care Act with easy to follow numerical illustrations. An understanding of the illustrative calculations is necessary to understand the subsidy implications. The article highlights some surprising and likely unintended results that will be interest to issuers, employers, consumers, regulators and policymakers. Actuaries can add expertise to their clients and to the public discussion with a proper understanding of the subsidy calculations and the resulting implications.

Description: Panelists discuss employers' perspective of defining strategies to identify best-in-market opportunities. From the Record of the Society of Actuaries, Vol. 24, No. 1.

Description: This article discusses the history of the Sun Life of Canada inserting a question about smoking in their life insurance applications. Actuary John M. Bragg used the Sun Life mortality ratios, supplemented by other data from life companies, from the Cancer Society, and from the U.S. Surgeon General, to construct his non-smoker and smoker mortality tables and to produce his Health Insurance Report which was the starting point for companies that have introduced smoker/nonsmoker differentials for health insurance.

Description: This article describes methodologies for detection and deterrence of Medicare fraud. It also describes the validation of PRIDIT for fraud detection in Medicare.

Description: Part 1 of a 2-part series exploring implementation issues for the Mental Health Parity and Addiction Equity Act of 2008 MHPAEA. Part 2 addresses the new enforcement safe harbor, how the regulations could impact the business of behavioral health care and the impending decisions for payors, employers, providers, and insureds.

Description: This article discusses the advantages, logistical concerns, and pricing formulas of implementing a TNHP, in which members pay less for treatment from providers who meet higher quality and cost-effectiveness standards.

Description: In this interview Dr. Reinhardt shares his thoughts on the role he believes actuaries should take in the health care system reforms.

Description: Recent health care reform activity has highlighted the importance of Clinical Integration in improving the quality, safety, efficiency and reimbursement infrastructure of the health care system. This article discusses relevance and implication of regulatory measures, implementation and data issues, and provides an end-to-end example.