Description: Explore a brief overview of federal income taxation of health insurers and selected technical tax topics during this panel discussion webcast. You'll dive into the evolution of heath insurers and healthcare-related services and the arising questions regarding their risk-bearing activities, as well as whether or not certain types of healthcare businesses qualify as "insurance companies" for federal income tax purposes. Also, expect to learn about loss reserves for guaranteed renewable contracts and how they can affect insurance company tax status. This webcast will continue to highlight how the IRS challenges loss reserves of health insurers as the panelists review the status of tax cases, IRS guidance and recent IRS activity regarding "margins."

Description: This session will focus on long term disability insurance reserving practices. It will address current practices in calculating claim reserves and may include topics such as the following: Relevant Actuarial Guidelines, Studies used to evaluate claim termination experience and reserve margins, Estimation of future offsets, Mortality improvement

Description: Virtual - Session 2C: Innovative Care Models for Medicare & Medicaid Dually - Eligible Populations

Description: Welcome and Keynote

Description: This session will be centered around the roles and responsibilities of a valuation actuary. Learn the best practices of health actuaries, along with technical considerations and professionalism issues surrounding the calculation and reporting of health liabilities and reserves. This session will focus on key actuarial liability and reserve provisions, including Claims Unpaid and Premium Deficiency Reserves. In this session, explore new ideas about calculation methods and the importance of the underlying assumptions. You will also learn best practices and practical applications concerning reserve calculation discuss best practices regarding the preparation of an actuarial memorandum supporting a Health Annual Statement. This will include key considerations from the American Academy of Actuaries' Practice Note about documenting and supporting the actuarial calculations. The discussion will also present views and considerations from both the insurer's and the regulator's perspectives.

Description: In this session, you will learn about key cost drivers in pharmacy trends, including but not limited to: New high-cost drugs, including gene therapies, that treat rare and/or expensive conditions such as spinal muscular atrophy (SMA), inherited retinal disease, hemophilia A and B, Duchenne muscular dystrophy (DMD), sickle cell anemia and cerebral adrenoleukodystrophy (CALD) Other cost drivers in the prescription drug category, including the emergence of GLP-1s, digital therapeutics, targeted immunomodulators, accelerated approval drugs and expanded indications The implications of the end of the COVID-19 Public Health Emergency (PHE) on the costs of COVID-19 vaccines, testing and treatment claims Downward influences on pharmacy costs, such as the availability of new generic drugs and biosimilars Emerging trends in pharmacy benefits manager (PBM) contracting, the initial portion of this discussion will be led by a pharmacist and former state pharmacy director.

Description: Since the Affordable Care Act implemented minimum loss ratio provisions for health plans, several states have passed or at least considered minimum loss ratio regulation for dental plans. While such regulations are intended to improve insurer efficiency and promote value to consumers, they can have unintended negative consequences if the unique characteristics of the dental insurance market are not considered. Learn about this hot topic, including loss ratio basics, recent legislative activity in the dental loss ratio space, how dental differs from medical, and why those differences are critical to account for when trying to regulate loss ratios in that market.

Description: Review a recently completed research project for a multi-stakeholder data consortium on social determinants of health (SDOH). In this project, claims, external SDOH data, geospatial analysis, and machine learning models were used to examine several questions: How to identify SDOH vulnerabilities? How sensitive are the findings with respect to provider coding pattern variations? How much variability in cost can be explained by SDOH vs. morbidity? What are the key risk drivers revealed by machine learning models? The session will review the methodology and main findings from this project.

Description: In this panel discussion, actuarial leaders in the stop-loss marketplace provide their perspectives on recent stop-loss trends. Learn about the most current issues facing self-funded plans and their stop-loss coverage. Take part in a deeper discussion on this topic and more at Oysters, Beers & Large Claim Solutions on Tuesday, June 27, from 4:30-5:30 p.m. PT. This happy hour, featuring drinks and tasty Pacific Northwest oysters will include a discussion on the large claims impacts on the health care market.

Description: Focus on how innovative health care organizations develop their value proposition for their intended buyers. Presenters will share information about their specific solution and the methods used to derive credible savings estimates, ROI, and performance guarantees. Learn about data utilized, the methods deployed, advantages, disadvantages, and buyers' reaction. This session is expected to be technical, highly informative, and interactive with audience members.