Description: Provides an overview of developments in the healthcare market including provider billing practices. Provides an overview of the Government Finance Officer’s Association (GFOA) in New York on Dec. 6, 2018

Description: Managed care networks are important to control rising health care costs . these need to be priced appropriately to produce the right results for all stakeholders . This includes analysis of utilization and costs for both in and out of network claims . A variety of risk and administrative service options exist for entities assuming such risk .

Description: Tax considerations in structuring and pricing long-term care transactions. Includes consideration around the form of reinsurance and the unified loss rules applicable to stock transactions where they is a bargain purchase (also known as a tax basis step-down)

Description: Update on Affordable Care Act topics, including Section 1332 waivers, Association Health Plans, silver loading and cost sharing reductions.

Description: According to the Actuarial Standards Board’s Actuarial Standard of Practice No. 49 (ASOP 49), actuarially sound Medicaid managed care capitation rates will include a provision for underwriting gain in order to provide compensation for the risks assumed by an MCO. However, there is no generally accepted method for quantifying underwriting gain in managed Medicaid capitation rates. This article discusses a new model developed to address this void and calculate underwriting gain. The model was developed by researching existing financial literature and performing a statistical analysis of industry data to build out a framework that can be leveraged to estimate underwriting gain.

Description: Feature article discussing the power of psychosocial data.

Description: Review of events and highlights from the Spring 2019 SOA Health Meeting in Phoenix, AZ.

Description: This article, another in the popular series devoted to tax basics, provides an overview of how the Employee Retirement Income Security Act of 1974 (ERISA), the law governing employment-based retirement and health plans, impacts the use of annuities in pension and 401(k) plans. The article explains which types of plans are subject to ERISA, and which are not; why the concept of "plan assets" is critical; what duties an insurance company or distributor might take on when an annuity is placed with a retirement plan; and finally what disclosures may be required. The article also includes a brief introduction to terminal funding annuities. This article is intended for those with no prior experience in ERISA. Because the vast majority of retirement assets are saved originally in employment based plans like pension and 401(k) plans, understanding the basics of ERISA is important for anyone who will have a career in annuities and life insurance.

Description: Summary of the modeling-related sessions from some of the major 2018 Society of Actuaries (SOA) meetings: Life & Annuity Symposium, Health Meeting and the Valuation Actuary Symposium.

Description: As sponsored by the Canadian Institute of Actuaries (CIA), Casualty Actuarial Society (CAS), and Society of Actuaries (SOA), the study looks at causes of insolvency and decisions made by management, regulators, and policyholders over the life cycle of the insolvency. Further, this study considers ways the profession can be equipped to prevent or mitigate future insolvencies. In addition to directly benefitting the profession, the work is also intended to assist other insurance industry practitioners in understanding the complexities of insurance company solvency and the benefit of keeping the actuarial profession in the forefront of company management, operations, and regulatory communication