Description: Join our exciting panel of health actuaries, ready for any challenge! Got an ACA puzzle? We've got the answers! Tackling a valuation dilemma? We're here to crack it! Facing a professionalism quandary? We'll navigate the complexities! Dealing with regulatory worries? We're your guiding light! Every question is welcome - there's no such thing as a silly question! Learning Outcomes: - Attendees will have the opportunity to get answers to their questions.

Description: The Inflation Reduction Act (IRA) introduced major changes to the Part D program. This session will unpack the impact of IRA's benefit redesign in 2025 premiums, costs, and beneficiary choices, and the implication of drug price negotiation in 2026. We will discuss how Part D plans are adapting to these changes, lessons learned from the 2025 bids, and what we can expect in 2026 after the price negotiation of the top ten Part D drugs.

Description: While we are eight miles from Capitol Hill and a week away from the 2024 presidential election, actuaries and health policy experts will discuss the campaign platforms of the major parties and presidential candidates and the potential health policy implications in the next four years. Focus will be on the changing dynamics within ACA marketplaces with the knowledge benefit of both major party candidates having presidential administrative experience in the ACA environment. Session attendees will be well-equipped to discuss the post-ACA health policy implementation of Presidents Biden and Trump, recent policy proposals from both sides of the political aisle, and potential legislative/regulatory changes on the horizon.

Description: The cost of prescription drugs is top of mind for consumers, payers, and policymakers. While there have been many efforts to reduce pharmacy costs over the years, the problem remains. This begs the question “Where do we go from here?”. While each of the many policy proposals currently on the table help some people some of the time, none seem to address the root causes of rising prescription drug benefit costs.

Description: The Social Security Disability Insurance (SSDI) program is a major source of income protection for disabled Americans. Private disability plans, especially group long-term disability plans, typically offset for SSDI benefits, so the programs are closely related.

Description: Listen to this discussion on a variety of subjects related to disability reserving (e.g. runoff analysis, estimating SSDI offsets). Case studies will be used to examine the potential impact of different approaches to these assumptions and experience studies on reserve estimates.

Description: While the higher general inflation in the broader U.S. economy hasn't emerged in the healthcare market (yet); there is expectations for it to have a lagged impact especially as the full impact of COVID on suppressed utilization emerges. As the healthcare system transitions past COVID, overall costs are expected to trend higher due to overall inflationary pressures as well as new treatments such as the highly anticipated new gene and cell therapies often with costs over millions of dollars.As costs rise, more companies are looking to self-insure their health insurance to control cost increases and are leveraging innovative stop loss programs including captives. Captive insurance markets have seen significant growth and diverse implementations allowing companies to self-fund while managing the risk of large claims and increasing costs. Payers are also looking to control costs and implement value based payment schemes to bend the trend curve and manage costs. Medicare has also adopted new value based payment programs (ACO Reach) which will impact commercial payers and are important to understand. Come gain an understanding of the historical and projected future medical cost drivers including the projected impact of new therapies and then impact on the stop loss markets. Additionally, you'll gain a deeper understanding on how recent innovations in the stop loss market such as the growth in the captive market, level funded and aggregate only products have helped employers manage their costs and overall risk profile.

Description: Advancements in machine learning modeling as well as new sources of data coming to the fore help feed the burgeoning industry of InsurTech applications in underwriting. By attending this session, you will learn about the latest developments in InsurTech applications in life/health insurance underwriting.

Description: Today's provider reimbursement landscape

Description: En el seminario hablaremos sobre los nuevos flujos de tarificación, y nos enfocaremos en la inclusión del análisis geográfico en el proceso de modelado para optimizar la extracción del riesgo en modelos de Machine Learning.