Description: T3: TAXING TIMES TIDBITS

Description: The article provides an overview of the federal tax treatment of long-term care insurance contracts, including a brief history of the tax treatment of long-term care insurance, the requirements that must be satisfied in order to be treated as qualified long-term care insurance under the Internal Revenue Code, and a brief discussion of qualified long-term care combination products and chronic and terminal illness accelerated death benefits offered under life insurance contracts.

Description: CPT, NCCI, ICD, CCI, DRG, APC, PTP – understanding healthcare claims involve a dizzying array of code sets and payment methodologies, and yet the claim form is the intersection of health plan affordability, provider payment, and data analysis. This webcast will cover: • The code sets used in medical coding • Types of correct coding policies implemented by CMS and commercial payers • Payment integrity strategies to drive health plan affordability • Data analytics approaches leveraging medical coding knowledge

Description: This session explores the far-reaching changes to how clinical data will be sourced, processed and consumed in many payer use cases including risk adjustment, quality measurement, care management, claims adjudication, prior authorizations, and other payer functions. Robust, interoperable data exchange is a prerequisite for value-based care. Clinical data will be increasingly accessible to augment administrative (claims) data via standardized Fast Health Interoperability Resources (FHIR, pronounced 'fire'), at a fraction of the cost of a accessing a traditional medical record and in real-time. On May 1, 2020, HHS issued a final rule implementing interoperability and the patient access provisions of the 21st Century Cures Act of 2016, although enforcement has been delayed into 2021 because of the COVID-19 pandemic. The new regulations promote, “HHS’s vision and strategy for achieving a health information ecosystem within which all individuals, their personal representatives, their health care providers, and their payers are able to send, receive, find, and use electronic health information in a manner that is appropriate, secure, timely, and reliable to support the health and wellness of individuals through informed, shared decision-making, as well as to support consumer choice of payers and providers.”Once enforcement begins, CMS and the Office of the National Coordinator for Health Information Technology (ONC), have the authority to mandate adoption of interoperability requirements, and also penalize payers and providers for non-compliance or the delay and withholding of data.This ‘digital transformation’ of the clinical data ecosystem has far-reaching implications for enabling technologies including Natural Language Processing (NLP) and entire segments of services and vendors. It will eliminate many departmental barriers, duplication and error sources for health plans and impact every department and the underlying economics of delivering and managing care.

Description: Explore how certain actuarial roles should be reserved under defined benefit plans for more than 50 years during the Reserved Roles for Actuaries in Defined Contribution Plans webcast. This online event will be focused on actuaries and defined contribution (DC) plan actuaries and how they have been spotlighted by the pension industry due to their roles. Join us to discover which roles under DC plans could be reserved for actuaries by plan sponsors or through legislation.

Description: There are practical and conceptual aspects underlying (re)insurability. Practically, something or someone is insurable if an insurer is willing provide insurance coverage at a price the applicant is willing to pay. In contrast, a conceptual view of (re)insurabiity incorporates a range of more complex factors usually considered in the insurance process. This article discusses these two approaches.

Description: Reunite with members and non-members in the China actuarial community to discuss recent topics and related issues in areas such as macroeconomic sharing, IFRS 17, product strategy, cross-border communication and discussion, and more. Advance your career through learning and networking opportunities, and share your experiences in the finance and insurance industries, as well as other fields related to actuarial science.

Description: As the size of the life reinsurance market in Bermuda has grown to over half a trillion dollars at the end of 2021, more and more actuaries are getting involved with this 21 square mile North Atlantic island in one way or the other. Come explore a fundamental understanding of the Bermuda solvency framework and an overview of its upcoming changes.

Description: Explore the value and cost of prescription drugs, how they should be defined and measured and the effects various stakeholders in the pharmacy ecosystem can have on these factors in the latest webcast. You'll investigate the impact of coverage, formulary and rebate negotiations and related benefit design. Find out how actuaries can answer questions related to the prescription drug industry, in addition to improving the access, quality and affordability of prescription drugs in the United States. Join us for this webcast and come learn about value-based contract design, negotiations, implementation and administration for prescription drugs.

Description: An overview of bias and fairness in machine learning models, as they apply to use cases in life insurance.