Description: Argues that reinstatement of CSR (cost-sharing reduction) reimbursements by federal government will have destabilizing effect on individual market.

Description: This article makes organizations entering the MA market aware of the star rating climate, as well as short- and long-term star rating & revenue considerations.

Description: Recently completed experience studies and research studies from the SOA.

Description: This article is an update on the No Surprises Act, which is a U.S. Act aimed to reduce the risk that a person unexpectedly receives out of network charges for their health care visits.

Description: Key Health Issues for 2003, as identified by the Health Benefit Systems Practice Advancement Committee HBSPAC and the Health Section Council HSC of the Society of Actuaries, which will have their top priority attention.

Description: This article outlines and summarizes research from Swiss Re about the prevalence of the Health Protection Gap throughout Asia, with a particular focus on China. Authors Robert Burr and David Zhang share key statistics on the scope of the gap, which is more than 800Bn USD in China alone, and discuss the role that technology and private-public partnership can play in reducing this gap over time. Readers will come away with an understanding of the scale of the problem within the Asia region as well as new ideas on how to solve similar problems within their own region.

Description: This is a discussion of the medical loss ratio, the confusion and debate over the calculation method under the new MLR requirement, and the opportunities it presents to consulting actuaries.

Description: The PPACA imposed a market share-based health insurance provider fee, known as the "Section 9010 Fee", "Health Insurer Fee", or simply the "HIF", on each “covered entity” with net premiums written in excess of $25 million that is engaged in the business of providing health insurance coverage for U.S. health risks. This article provides background information to help unpack the language behind the Section 9010 Fee and highlights a few areas of special interest including merger and acquisition-related issues, application of the Section 9010 fee to expatriate plans, and considerations regarding fee administration.

Description: NAIC Health Update from quarterly meeting. Issue No. 42.