Description: This is a brief report that summarizes recent changes in the prevalent medical loss ratio methodologies and also looks at some of the more recent experience of health insurers that filed medical loss ratio reports.

Description: Health insurance company assets and liabilities have evolved since the Patient Protection and Affordable Care Act (ACA) was signed into law in March 2010. The ACA fundamentally rearranged how commercial health insurance is funded by integrating federal premium subsidies and pass-throughs together with a marketplace interwoven with transfer payments among stakeholders. The impacts of these programs can be seen in specific accounting items on the balance sheets of health insurance companies over the past 10 years. Their emergence follows three primary trends: (1) balance sheet items tend to be larger and take longer to settle, (2) there are more interactions among items, and (3) the final settlement amounts are more uncertain.

Description: ACA risk adjustment has now been in play for years. The original intent of risk adjustment was to help stabilize the market through measuring risk levels of each issuer. However, the risk adjustment program may have introduced additional uncertainty due to annual market shifts and model changes, making risk adjustment estimation is a difficult task. This article analyzes the results over time, including impacts from market changes and model changes.

Description: This session will present the findings published in the report released by the SOA on the March 23, 2020, the 10th anniversary of the ACA.This session will provide an assessment and commentary on the viability of the individual and Medicaid marketplaces under the ACA since its inception. Observations will be based on a data-driven analysis of the associations between market characteristics and measureable outcomes indicative of viability. Viability will be measured in the context of achieving the ACA's goal of providing sustainable access to affordable healthcare to the uninsured and underinsured, and will be considered from the perspectives of various stakeholders.

Description: An introduction to the ACA@10 Strategic Initiative, which examines the impact of the Affordable Care Act 10 years after its passage.

Description: The SOA is pleased to make available a research report providing insight and considerations for the actuarial profession in assessing the potential risk and opportunities of MACRA to both provider and payer organizations.