Description: Telehealth continues to be a story of unrealized potential than realized success. Find out what's pushing telehealth forward as a means of remote healthcare and the challenges its facing. Discuss questions, including: - Telehealth's role in expanding access to mental healthcare is clear, but what about other conditions? - Was access expanded for all patients or do modern delivery methods leave some patients behind - How do telehealth costs compare to in-person costs? - What happens to the value proposition if unit cost savings is off the table?

Description: The rules governing the framework of Affordable Care Act (ACA) marketplaces continue to be refined at the state and federal level. The catalyst for such changes has been a desire to improve markets, which has been primarily informed by data and experience in the ACA's first decade. This session will feature a panel of consulting actuaries, a state policy advisor who has influenced ACA legislation, and an attorney deeply involved in ACA risk adjustment litigation. Discussion will include new federal proposals, efforts to strengthen enforcement of rating compliance, new actuarial insights from public data, and the anticipated future implications for ACA markets. By attending this session, you will be able to: • Understand what precipitated risk adjustment lawsuits and how proposed federal rules address these concerns. • Identify how state regulators are addressing premium misalignment between metal levels and shaping local policies. • Develop new insights on publicly available data. • Understand the implications these policy changes will have on the future of pricing health insurance benefits, consumer value and enrollment distributions in ACA marketplaces. • Understand the primary factors leading to ACA market success.

Description: Hot topics for Medicare, including enrollment trends, enticing benefits, risk score projections, market strategy trends, formulary considerations, STAR rating changes, and COVID implications including vaccine/testing requirements Proposed/enacted changes to Part D from the Build Back Better (BBB) Act-CMS’s commitment to advancing equity in health and health care for all individuals Discussion of removing barriers to equal opportunity, health disparities, and closing health equity gaps, including collecting more and improved data on beneficiaries’ race, ethnicity and social determinants of health By attending this session, you will be further prepared for current and future changes in the Medicare Advantage program. Gather additional insight into future trends in policy changes and cost spending and to be more equipped to adapt to changes in the marketplace.

Description: The health insurance industry has historically used several factors to develop premium rates. Many of these, e.g. gender rating, have been largely eliminated from health insurance rating practices by regulations as the Patient Protection and Affordable Care Act (ACA) because they were determined as inequitable. However, several other factors still remain as differentiators in premium rates charged to individuals and groups. In conjunction with the SOA, researchers studied whether there could be ‘ghost’ rating factors, like race, ethnicity, or socioeconomic status, that are inherently included in some of these remaining allowable factors. Review results and opportunities for future research. By attending this session, you will be challenged to think about traditional rating factors in a different way. Rather than focusing on whether certain factors are sound based on the underlying claims cost, this session will focus on whether or not these factors are impacting certain socioeconomic or racial/ethnic groups disparately.

Description: This webcast will focus on recently published health research which examines the impacts of social determinants of health on oral health outcomes as well as on chronic kidney disease progression. Participants will gain insights on how different aspects of social determinants of health can impact how healthcare is delivered as well as the impact on health care costs.

Description: Regression to the mean (RTTM) is inflating your health care intervention evaluations if you are not carefully managing it's omnipresent and significant impact RTTM is the statistical phenomenon which arises when comparing sequential data points when an initial observation is extreme or an outlier, and states that with no other intervention, future observations will be closer to the average. Members who had high costs last year will, on average, have lower costs this year, even in the absence of any intervention or clinical program, simply by 'regressing' to the mean. This means that if your clinical programs are simply targeting members who had adverse medical experience last year, you’re targeting the wrong people. And if your savings methodologies are simply last year’s costs minus this year’s costs, the savings are inflated. By attending this session, you will be able to identify situations where RTTM will be a significant factor, how to eliminate it's impact when performing retrospective evaluations, how to identify prospects for clinical intervention with RTTM in mind, and more.

Description: Informal caregiving is a major source of long-term care (LTC) and long-term supports and services (LTSS) more broadly. The benefit of informal caregiving is appreciated by those receiving it, and most caregivers find purpose in their work. The costs of caregiving fall on employers, other family members, the health care service sector, stakeholders in the LTSS system, and most importantly the caregivers themselves. Providing support to these caregivers can therefore benefit employers, employees, and their families, as well as the many payors of formal LTSS. Hear from three experts in caregiving who will provide their perspective about how to support information caregivers — operationally and financially — to help them succeed in their purpose. Understand benefits this support can have to the other stakeholders in today’s LTSS system. By attending this session, you will be able to: • Explain the importance of informal caregivers to stakeholders in the LTSS system, including the impact to payors and employers. • Describe the challenges informal caregivers face, and paths to success and avoiding burnout. • Discuss potential future financial solutions that may benefit caregivers, including employee programs and insurance opportunities.

Description: Currently there are ten states in the U.S. —Rhode Island, California, New Jersey, New York, Washington, DC; Washington, Massachusetts, Connecticut, Oregon and Colorado —that have enacted Paid Family Leave. Paid Family leave is an employee funded state insurance program that provides wage replacement to eligible workers when they take time off of work to care for a seriously ill family member or to bond with a new child. Who pays the taxes? The employer or the employee? How will this effect short term disability benefit offerings in the work place? How does a Paid Family Leave plan get implemented? Is it up to the employee to file for the benefit through the unemployment office or does the employer file? At the state level, how is paid family leave reserved for? How is it administered? What job protections are there? How does this work with the Family Medical Leave Act? Get these and more questions answered. By attending this session, you should have an understanding of the state Paid Family Leave programs, what it means to future short term disability plans, and how the state accounts for this program.

Description: For decades the negotiated prices between health care providers, insurance carriers, and networks have been tightly-guarded trade secrets. That's quickly changing. Health care price transparency is now bipartisan-supported law. Gag clauses have been banned. Starting in January 2021 hospitals were subject to new rules requiring disclosure of the payment rates they receive from health plans to both consumers and the general public. So far, compliance has been mixed. Similar rules for payers become effective later in 2022 and 2023 for health plans and consumers. While entrenched interests are doing their best to stall transparency, unless the laws change, transparency is going to happen and will rock the commercial health insurance market, providing the long awaited opportunity for meaningful health care cost reductions. Learn more about price transparency laws and regulations, examine rocky implementation to-date, and discuss the role of self-insured employers in leading the market changes that will emerge from price transparency. By attending this session, you will be able to: - Name the applicable price transparency laws and rules. - See transparency as more than a list of new compliance requirements and consumer tools. - Anticipate that the downstream impacts of transparency on commercial health insurance will be profound. - Appreciate the increased power of self-insured employers.

Description: In summer 2021, the SOA Research Institute’s Mortality and Longevity Strategic Research Program sponsored a webcast examining individual life and group life emerging mortality in a COVID-19 world. Since then, Delta and Omicron coronavirus variants have fueled waves of the virus in the U.S., boosting the total number of COVID-19 deaths since the beginning of the pandemic to near the 1 million mark. Hear an update and insights into how the life insured population is faring during COVID-19 by discussing the findings from two recent SOA Research Institute initiatives. LIMRA, Reinsurance Group of America (RGA), the Society of Actuaries (SOA) and TAI have collaborated to analyze the impact of COVID-19 on the individual life insurance industry’s mortality experience. Additionally, the SOA Research Institute has surveyed insurers to gather a high-level view of U.S. Group Term Life Insurance mortality results during the COVID-19 pandemic, comparing them to pre-pandemic mortality levels. The Group Term Life industry mortality results will be presented with monthly data through March 2022.