Description: Health care has changed rapidly over the past couple of years. The pandemic has shifted consumer behavior in how and where they receive health care as well as consumer attitudes toward health care. Payers continue to design innovative solutions in responses to their patient’s needs and expectations. These changes in consumer behaviors and the responses by payers are expected to impact both health care cost and utilization. Discuss changes in health care that have emerged due to the pandemic and how they are expected to influence actuarial assumptions. Explore epidemiological models commonly used in the industry, the considerations when using these models, as well as the challenges with regards to gathering and interpreting relevant experience data. By attending this session, you will be able to: Identify shifts in consumer behavior that have emerged from the pandemic and describe how payers are responding to new patient expectations. Discuss how these post-pandemic changes by consumers and payers influence medical spending. Determine which actuarial assumptions are impacted and how and if the impact is expected to be temporary or permanent. Discuss considerations taken by actuaries and challenges faced when modelling actuarial assumptions post pandemic.

Description: The COVID-19 pandemic will have a lasting impression on all forms of life, annuity, and A&H insurance. Individual and group disability insurance are no exception. Examine how U.S. group and individual disability insurers have been impacted by the pandemic and how they are preparing for an uncertain future. Oliver Wyman will team up with experts from the insurance industry to discuss insights on the impact of COVID-19 on disability insurance, including results from Oliver Wyman’s 2022 industry survey. Learn about the past, current, and future expected impacts of COVID-19 on: - Claim experience (including mortality, incidence, recovery and SSDI offsets) - Reserving - Scenario testing - Insurer operations (e.g., claims adjudication, recertification) - Sales and persistency By attending this session, you will be able to: - Understand how disability insurers have been impacted by the pandemic across multiple facets. - Identify where and how U.S. disability insurance carriers are adapting to the new and evolving environment. - Discover how carriers see disability insurance evolving as the COVID-19 pandemic continues.

Description: ACA risk adjustment is intended to "bridge the gap" between allowed rates and actuarial rates. If risk adjustment methodology is not bridging that gap & becomes an additional input to pricing formulae, it is not serving its intended purpose.

Description: The supplemental health market is changing. Carriers are looking to simplify claims processes, proactively identify missed claim opportunities, and reduce barriers to claim payment. As a result, more and more companies are looking at ways to use data from medical diagnostic and treatment codes. Take an introductory look at the most used medical codes—ICD (9 and 10), CPT, and HCPCS. Discuss the history and purpose of each code system and decipher the structure. Dive into how medical codes can be used in the supplemental health market (automatic claims adjudication, fraud identification, pricing), as well as common pitfalls encountered when using medical coding. By attending this session, you will have a basic understanding of the different types of medical codes, their actuarial applications, and common pitfalls.