Description: The document is a research call for proposals seeking researchers to produce a report on the uses of synthetic medical claims data for actuaries. It outlines the background, purpose, research objectives, proposal requirements, selection process, and conditions for submission.

Description: Medicare Advantage Organizations (MAOs) have made dramatic changes to the benefits and plan premiums they've offered members over the past years. Hear about information on the changes to benefits and plan premiums offered over the past few years. Find out where these strategic items are currently (for CY2024 bid year) and get ideas on what might come in the next few years. Presenters will discuss recent proposals and rules from CMS that will impact the current and future landscape. They will also compare these items in relation to the fee-for-service (FFS) Medicare market. This session will help you gain a deeper knowledge of the Medicare Advantage, Prescription Drug Plan, and Medicare FFS landscape and walk away with some strategic thoughts on potential paths MAOs may take from here.

Description: Discuss the dramatically changing provider landscape, as well as the innovative solutions being leveraged by providers to address the intriguing opportunities and complex challenges. Among the questions to be answered are the following: How can providers capitalize on employers’ desire to contract directly with local providers? What's the path for providers to develop employer stop-loss (ESL) capabilities to maximize network value/impact? Can providers create a risk portfolio including ESL for local employers, their own employee plan, and other delegated risk arrangements such as Medicare Advantage? How can captive insurers support a provider's risk strategy?

Description: Are you a health actuary affected by recent developments in business practices and accounting standards that have created situations in which you may be involved in estimating balances under accounting rules that differ from those typically used by insurers? In this session you will learn about situations where non-insurance accounting regimes may intersect actuarial practice, with an intended focus on two particular topics.

Description: Hear a summary of the discussion from the Health Section's Pharmacy Partnership Forum in March 2023 entitled 'Reimagining Pharmacy Financing' where a multi-disciplinary group of clinicians, health economists, academics, and actuaries met and discussed the following questions: How do we define the value of prescription drugs? How do we measure the value of prescription drugs? How do we scalably and meaningfully apply the answers?

Description: Description of the design and purpose of the military health system and Veterans Health Administration's programs. Covers the types of benefits offered and how these programs differ from typical commercial health systems.

Description: Cell and Gene Therapy (CGT) are life-changing treatments where conditions such as cancer, hemophilia, spinal muscular atrophy and blindness are being cured. These are great for individuals and society, but the treatment costs are expensive which is bad for payers and reinsurers. This article explores ways for health reinsurance actuaries to participate in the space and evaluate the risk associated with these treatments

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: The National Association of Insurance Commissioners (NAIC) is working on changes to the health risk-based capital (RBC) formula. Will your RBC ratio improve or deteriorate under the new formula? And what can you do about it?