Description: This three-part series provides an overview of the rapidly evolving and dynamic gene and cellular therapy landscape, from the clinical, historical, and risk transfer perspectives. It covers the actuarial considerations in pricing cell and gene insurance and reinsurance, the value assessment of the therapies, manufacturer pricing, and reinsurance cost.

Description: On February 15, 2022, the Association Forum Health Care Collaborative, a collection of metropolitan Chicago based Healthcare associations, held its winter event. This virtual gathering featured two sessions titled: “Healthcare Policy Perspective” and “Megatrends and Tipping Points that will Define Success in the "New Normal".

Description: LIMRA, Reinsurance Group of America (RGA), the Society of Actuaries (SOA), and TAI have collaborated on an ongoing effort to analyze the impact of COVID-19 on the individual life insurance industry’s mortality experience and share the emerging results with the insurance industry and the public. The Individual Life COVID-19 Project Work Group (Work Group) was formed as a collaboration of LIMRA, RGA, the SOA, and TAI to design, implement, and create the study and to produce and distribute a variety of analyses. This report is the fifth public release from this collaboration and contains the results of a cause of death analysis focused on how the rates of death for various causes were impacted throughout the pandemic period through the first quarter of 2021.

Description: "Hear an overview of recent results and potential scenarios that may impact the future of the ACA market. Review recent reported industry level profitability before transitioning to a discussion of how current market dynamics may influence the future profitability of this segment. Results from microsimulation economic models will be presented to help illuminate market shifts. Issues that will be explored include how ICRA availability might influence individual decision making, as well as how a move to level funding is impacting the small group market. By attending this session, you will: Understand the recent average and variation of industry performance in the ACA market segment. Describe current policy and market forces that are expected to impact this segment. Explain the range of market scenarios that may result due to these forces."

Description: With the mandated health plan transparency files, health plans and providers are now able to substantially enhance their provider contracting efforts. Although the files are large and cumbersome they are market disruptors and provide new insights for provider contracting efforts. Explore a demonstration on the type of information now available and how it can be used to enhance this from both a health plan and health care provider perspective.

Description: Health equity is an issue on the minds of actuaries and policymakers across the health insurance market. As such, a tremendous amount of time and brain power has been invested in understanding and quantifying these issues in public and private programs alike. While the specific results of health equity studies vary widely from one program to the next, the findings tend to reveal complicated issues with no obvious, off-the-shelf solutions.

Description: This topic will explore current and upcoming changes to the risk adjustment models and strategies for payers and risk bearing providers to reduce/avoid headwinds and potentially come out on top in the years ahead. We will discuss the timeline, nature and motivation for changes as well as the anticipated associated impacts.

Description: On July 1, 2023, CMS began their latest Medicare Oncology program, Enhancing Oncology Model (EOM) which was the successor to the previous Oncology Care Model (OCM). Despite a high level of interest during the application period, this model has been met with limited participation, with only 44 participants at the start of the program.

Description: This session will present three utilized underwriting models that can be used for mid-size employer group medical renewals. Key assumptions will be discussed including a significant focus on the stop loss risk since that is the major insured risk.

Description: Actuarial Roles in Health