Description: Managed Care Risk-Based Capital new formula for HMOs and BCBS plans, modification of disability income, LTC and stop loss factors, market uses of RBC, company use of RBC Issue No. 37.

Description: This article provides an overview of the Own Risk and Solvency Assessment (ORSA) model act, and of enterprise risk management (ERM). Compared to other actuarial disciplines, health actuaries have not historically focused as much on ERM. But health coverages do have risks that can threaten an insurer's solvency, and ORSA (now in force in most states) will force health insurers to beef up their ERM capabilities.

Description: Discusses various aspects of allowing a health insurance policy approved in one state to be sold in another state without the latter's approval or oversight.

Description: This article makes organizations entering the MA market aware of the star rating climate, as well as short- and long-term star rating & revenue considerations.

Description: An analysis of health insurance cost and benefit trends using January 1, 2011 data from state employee medical plan renewals.

Description: Financial reconciliation is critical to a successful Medicare Advantage (MA) bid. Reconciliation should be routinely revisited as new information arises.