Description: Conditions and required solvency standards of federal waiver to PSOs to provide Medicare+Choice products. Effect on providers, beneficiaries and employers. Issue No. 36

Description: The article gives actuaries an introduction to Academy Health, the notable health policy research organization.

Description: Praise and critisicm of ERISA. Items affecting ERISA The Patient Access to Responsible Care Act of 1997 PARCA, Consumer Bill of Rights, Expansion of Portability and Health Insurance Coverage Act of 1997 EPHIC. Issue No. 35.

Description: A review of the 2009 Health Spring Meeting, which included speakers & sessions on the future of the SOA, U.S. health care reform, claims data issues & improvements, predictive modeling, underwriting principles, employer stoploss, cost trends, LTD & disability, and mental health parity regulations.

Description: Two Medicare risk funding provisions that were radically changed by the BBA of 1997 funding variations by geographic area and risk adjustment. Issue No. 36

Description: The chairperson reports on Health Section activities: papers by the joint workgroups with the AAA's Health Practice Council to inform the public and congressional staff, papers on capital requirements under proposed health care reform and on proposed taxing of Cadillac plans, new research on IBNR reserving methods and on measuring the quality and efficiency of health care delivery systems.

Description: The big event of 2023 is the launch of multiple Humira biosimilars, which began in January with the arrival of Amgen’s Amjevita on the market. The launch of Amjevita kicks off the process of changing the specialty drug marketplace in the United States. The expectation of the full impact of this big event is very hopeful, but there is still uncertainty several months after its beginning. Humira is the highest-selling drug in the world and has been since 2013 (Figure 1)—except for when COVID-19 projects temporarily surpassed it. The world is eagerly awaiting the launch of multiple biosimilar drugs to compete with Humira and hopefully bring more competitive pricing to the benefit of payers and patients everywhere.

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: Rick Foster, chief actuary at the Centers for Medicare & Medicaid Services discusses public policy

Description: A look at the career and accomplishments of Julia Philips, the only health actuary employed at the Minnesota Department of Commerce. She believes her learn-by-doing attitude has allowed her to build a career she enjoys, which includes her to work to promote consumer protection, volunteer with many organizations, and implement health reform.