Description: This paper identifies and discusses issues affecting retirees’ abilities to successfully navigate medical insurance choices after their employer retiree medical insurance group benefit plan has been terminated and replaced by an outsourced health reimbursement account (HRA) providing accessibility to a stipend through eligible medical insurance claims submissions.

Description: Medicare Advantage Organizations must consider influences both internal and external to the adjudication process as they review and use data for bid preparation

Description: Discussion of recent laws and regulatory changes that have provided Medicare Advantage plans greater flexibility in benefit offerings and plan designs.

Description: CMS provides a significant, and growing amount of information that can be leveraged by actuaries. Between the public use and research files CMS makes publicly available large amounts of information that can be assimilated to begin to understand the who, what, when, where, and how of Medicare. This session will focus on the depth and breadth of data available, summarize any restrictions on the use of the data, and identify areas where access to the new data can provide more meaningful insights than CMS's historical data sets.