Description: The Inflation Reduction Act represents the most significant changes to the Part D program since its inception 20 years ago. The implications will not only alter the benefits offered by Medicare Advantage (MAPD) and Prescription Drug Plans (PDP) but will alter the Part D cash flows and the seasonality of such amounts for interim reporting periods. In this session, we will provide a brief overview of the IRA changes and dive into how the changes could impact the 2008 Medicare Part D Accounting Practice Note.

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: Two years ago, before COVID-19 changed everything about how we provide and receive health care, telehealth was largely provided by third-party vendors to treat a narrow range of acute one-and-done conditions. The value proposition was simple: a fast and easy member experience would drive satisfaction and engagement; high member satisfaction and engagement would drive health plan savings and member retention. Clearly, from the perspective of utilization, telehealth—as a viable alternative to in-person care during a pandemic—worked. And with COVID-19’s nudge—or was that a push?—toward cultural acceptance, the health care system is in a better position to capitalize on telehealth’s original promise of expanded access, lower cost and better outcomes than it was two years ago. But in the wake of the pandemic, it is just as clear to us that if telehealth is to live up to its full potential, some changes are needed. The rest of this article presents five ideas for improving the delivery of telehealth going forward.

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: Join us for a discussion of the supplemental health landscape for accident, critical illness, STD, and hospital indemnity products. This session will include both the pricing actuary and the regulator perspectives on new approaches, trends, renewal rate strategies, the competitive market, state-specific requirements, and more!!Attendees will learn about changes in the market that will help them price products, evaluate new approaches used in the voluntary market, and identify the issues that will make their products successful.

Description: Frist Quarter 2022 updates on tax issues involving: IRS publication of 7702 60-month avg. applicable federal interest rates, OECD Global Minimum Tax, final Foreign Tax Credit regulations issued by Treasury and IRS, Final Regulations on Tax Issues Associated with LIBOR Transition issued by Treasury and IRS, and the Multistate Tax Commission Partnership Project focusing on insurer investment partnerships.

Description: "Spread pricing is a pricing methodology where pharmacy benefit managers (PBMs) bill a payer one price but reimburses the dispensing pharmacy a lower price for the same prescription drug. PBMs have historically relied on spread pricing as a revenue source. However, a growing number of states are introducing and passing legislation prohibiting spread pricing for Medicaid and commercial clients. In addition, new entrants to the PBM and mail-order pharmacy space are disrupting the market by offering services that promote increased transparency and member satisfaction. Expect updates on recent legislative trends and market disruptions targeted towards increasing PBM drug pricing transparency. By attending this session, you will have a better understanding of how changing legislation and market disruptions may impact current pricing methodologies."

Description: Comparison of domestic and international PFML programs

Description: Climate change will lead to an increase in the frequency and severity of many weather-related hazards. In turn, these hazards will impact health outcomes for individuals. Explore examples of this connection with a climate scientist, including how the increase in wildfire severity in the western U.S. is expected to drive a 40% increase in organic carbon aerosols by 2050 and howheat stress will impact vulnerable populations and workers in non-air-conditioned environments. Investigating these relationships will increase literacy on disproportionate impacts of climate change-related health outcomes. Presenters will illustrate the disproportionate impacts by geographically analyzing climate change signals and comparing them with socioeconomic data. Last but not least, you will learn about the evolution in both voluntary and required disclosures for payors and the landscape of why understanding climate risk is relevant for many payors.

Description: Data science is being used to create more algorithms used across a variety of applications, including underwriting and pricing. As data science gains traction, it is imperative that we as actuaries consider the ethical implications of use of these algorithms. This session will discuss techniques for evaluating whether your algorithms are inadvertently making biased decisions and considerations for ensuring that your algorithms minimize risk of making biased decisions. Learn to identify potential ethical issues with their algorithms and techniques to address them.