Description: The ACA’s Medical Loss Ratio Provisions

Description: Introduction to the ACA @ 5 publication

Description: Pricing Small Group Medical Coverage Renewal Pricing regression to the mean, blending of experience and manual rates, small group reform laws. Issue No. 40.

Description: Discussion that developing credibility factors for group health insurance can be accomplished empirically through the use of stochastic models with appropriate parameters and fairly readily obtainable data, without the need for unrealistic assumptions.

Description: Risk adjustment is used to adjust the revenue stream to health insurers that sell ACA eligible plans and Medicare Advantage plans. This article compares and contrasts these risk adjustment programs.

Description: This article contains excerpts from the first three articles that were released through the strategic initiative - Commercial Health Care: What’s Next?

Description: Joe Wurzburger, Staff Fellow at the SOA, shares his views and insights about the health care industry in general and the Health Section's role in particular.

Description: Discusses effect of allowing companies to sell health insurance policy in any state, if approved in one state, without requiring approval in any other state.

Description: The medical scheme approach adopted by several African countries has failed to meet the needs of those in informal employment and rural communities. This is partly due to affordability amongst these individuals as well as a lack of awareness of how healthcare financing products work. Community based healthcare organisations have achieved greater levels of success in this regard by carefully incorporating the peculiarities of communities in benefit design and involving community members in the management of these healthcare solutions. There are lessons to be garnered from the countries where these have been implemented with some level of success. Even as countries aim towards universal health coverage, observing the unique needs of different communities within a country is essential to ensure resources are utilised efficiently and that healthcare needs are targeted effectively.