Description: In this presentation, actuaries and data scientists from Cleveland Clinic and Milliman discuss the development of a sepsis prediction model using machine learning. Presented with a unique challenge of handling massive amounts of data for near real-time risk scoring, the team took their model development to the cloud and delivered a product in less than a week through a unique virtual engagement.

Description: As health insurance self-funding becomes more popular among smaller group sizes, risk is evolving for the MGUs, stop loss writers, and reinsurers that cover them. Assessing more small groups at lower attachment points means rethinking traditional stop loss underwriting techniques.

Description: Following her first 100 days as the CMS Administrator, Chiquita Brooks-LaSure released her six strategic pillars for the agency. The Center for Medicaid and CHIP Services (CMCS) followed these pillars and laid out their priorities for states under the Biden-Harris administration. With these priorities established, recent 1115 submissions from several large states, including California, Massachusetts and New Jersey, may give insight to how CMS will operationalize their vision under this program authority. This session will include presentation from state policy staff who have led recent 1115 waiver proposals.

Description: Are Accelerated Underwriting (AU) programs performing as expected? As mortality experience will (hopefully) be slow to emerge, it is pivotal that we look at alternative methods of monitoring early performance. From random hold outs, to post-issue APS's, and post-issue prescription profiles, explore popular monitoring techniques and lessons learned so far. Focus on confusion matrices that provide an early indication of mortality slippage relative to fluid-based underwriting decisions. Finally, explore statistical methods to determine what constitutes credibility and identify opportunities to think about mortality slippage more robustly.

Description: Learn more about the predictive modeling that was applied to industry data for the lapse and mortality experience in the post-level term period. Novel approaches were taken to model the shock lapse, subsequent lapse, and mortality experience. Observe a demonstration of the Tableau tool, which was built to allow users to analyze data on their own.

Description: You’ve written the position papers, updated the models, and designed the required disclosures, but you may be wondering how to explain the results during interim financial reporting periods to company management as well as other stakeholders. This session will explore ways to adapt existing management reporting and offer ideas for new metrics. We will explore various methods for analyzing DAC amortization patterns, market risk benefit reserve patterns, and Liability for Future Benefits (LFPB) movements. In addition, this session will explore ways to integrate changes in LDTI with business planning and other broader business issues such as product pricing considerations and reinsurance strategy.

Description: "Risk adjustment (RA) is a key component for CMS Medicare Advantage program and California Medicaid Managed Care program. While both RA programs follow generally accepted basic principles at a high level, their underlying methodologies and assumptions are also quite different. Due to recent events such as COVID-19 Public Health Emergency and Medicaid redetermination delay and restart, it adds complexity to Risk Adjustment. This is a hot topic in the industry and has significant impact to health plans. Keeping current with risk adjustment program changes and understanding the commonalities and differences of these two government risk adjustment programs is important to our health actuaries. Compare these two risk adjustment programs so you can learn key elements of a risk adjustment program, similarities and differences in methodology and assumptions , as well as special considerations due to serving different populations."

Description: An attorney and a statistician will discuss the latest on GenAI, the AI regulation and litigation affecting the use of AI in insurance.

Description: How are regulation and innovation intertwined? How do we regulate AI/ML in the insurance industry? We will cover how regulators are striking the balance between protection of their constituents and supporting innovation. We will zoom into the case of Predictive Analytics and the regulatory attempt at avoiding undue discrimination. Let's discuss what this really means.

Description: The importance of storytelling in financial communication and its role in conveying complex financial reporting results and insights to diverse stakeholders cannot be denied.