Description: Stakeholders in a specific state (Minnesota) were interviewed about the potential value -- and obstacles -- of a catastrophic backstop program to handle long term care (LTC) financing needs. The design would entail a payroll deduction which would produce a fund to pay LTC expenses once a deductible period (of 1 to 4 years, depending on income) was reached. This design was believed to encourage enrollees to cover the front end better than done today, whether by private insurance or other means.

Description: With there being over 11 million undocumented immigrants in the United States, some states are considering or have expanded Medicaid-like coverage to this population. Healthier Oregon launched in July 2022 to provide such benefits, and now covers more than 20,000 Oregonians. Hear about the structure of the program, along with its capitation rate build (which integrates federal participation for emergency and pregnancy-related services), risk corridor design, and related policy and implementation considerations. After attending this session, you will gain an understanding of the actuarial, regulatory and practical considerations for covering this population through managed care.

Description: Learn more about Health Care Sharing Ministries (HCSMs) and their functionality as health insurance. These nonprofit companies pool money from participating members to assist with members' healthcare coverage. Further exploring HCSMs, some of the offered arrangements of this plan operate differently and with a unique regulatory framework. HCSM enrollment has grown 1000% since solidification as a law in the ACA. By signing up for this webcast, you can discover why HCSMs are becoming a key component of the individual market in some states.

Description: Actuary Dave Dillon describes his role volunteering his time as a teacher in higher education, including the rewards and challenges that teaching offers. He discusses the importance of being attentive to his audience’s pre-existing knowledge and adapting his presentations accordingly. His work as a teacher typically encompasses three distinct domains: 1) acquainting young students with the actuarial profession, 2) educating non-actuaries about public policy issues related to health insurance (including the Affordable Care Act), and 3) instructing current actuaries on advanced methodologies and principles within the field. Recently he taught a health insurance course for actuarial science graduate students at Georgia State University and lectured at Boise State University’s master's program in Population & Health Systems Management. In every teaching and mentoring opportunity, actuaries can contribute to the expansion and prosperity of the profession and are encouraged to pursue these endeavors.

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: Savings from biosimilars have accelerated significantly in the past few years. There has been a number of relatively recent biosimilar launches that can help to shape our expectations of the financial impact that could result from this year’s big event. Savings from biosimilars have accelerated significantly in the past few years. There has been a number of relatively recent biosimilar launches that can help to shape our expectations of the financial impact that could result from this year’s big event.

Description: The article first tries to determine a consensus view of what social security should accomplish and then tries to measure how well the current level of benefits succeeds in meeting these goals. Assessing benefit adequacy is an essential element in putting the overall program on a sound financing footing.