Description: This introduction to Captive Insurance Companies will provide an overview that includes the history of captives, different types of captives, common applications, how captives work, why employers form or join a captive, and a Medical Stop Loss Group Captive case study.

Description: Risk Adjustment continues to be a hot topic in Health Insurance since its emergence. This mechanism came into being as a means of reducing the risk of selection, particularly in marketplaces where underwriting is not allowed, and rating factors are significantly restricted. Risk adjustment serves to adjust premiums to reflect the risk of individual members or overall members as a whole within a particular cohort of a health plan. Risk adjustment is not perfect, as it does not perfectly predict future costs or perfectly adjust for the differences in expected costs. Different marketplaces have different challenges with risk adjustment.

Description: This is a Request for Proposals (RFP) issued by the SOA Research Institute (SOARI) seeking research studies related to anxiety, depression, and their impact on mortality in the United States.

Description: The resumption of Medicaid redeterminations following the conclusion of the COVID-19 Public Health Emergency (PHE) represents a significant disruption across multiple lines of business in the health care market. While there has been much uncertainty regarding the timing and pace of the resumption of redeterminations, 2023 is beginning to bring clarity to the myriad questions posed by states, employers, managed care organizations (MCOs), and other interested stakeholders. Begin with a brief review of the latest developments regarding the end of the PHE and resumption of Medicaid redeterminations. Then, transition to a panel discussion on the various impacts that key stakeholders are starting to see, and expectations for short-term and long-term impacts to programs, plans, and businesses.

Description: The Society of Actuaries (SOA) published its first COVID-19 research brief on March 10, 2020, followed by regular updates and expansions through June 12, 2020. The comprehensive report included a section of Key Statistics. This report provides updates to some of the data from the Key Statistics section of the brief and additional related data, organized by geography.

Description: This paper helps the audience understand the actuary’s role in estimating the financial impact of primary care programs. In addition, the paper can be used by actuaries to think about key issues when estimating the financial impact of their employers’ and clients’ own primary care programs.

Description: This report summarizes thoughts and questions about the impact of COVID-19 on working in retirement, phased retirement and how the definition and timing of retirement may change. It provides a synthesis of the expert input mentioned above and offers background on related research results. It also describes other issues for further consideration. T

Description: This study estimates the number of COVID-19 confirmed cases and reported deaths by hospital referral regions (HRR) using Johns Hopkins University COVID-19 data by U.S. county and the Dartmouth Atlas Project division of counties into HRRs.

Description: There are growing concerns that the Asian bird flu virus will evolve into a form that can be transmitted from human to human, thus unleashing a new global flu pandemic. This article uses the Spanish flu epidemic and the German life insurance portfolio to analyze the additional claims expenditure due to a pandemic.

Description: The coming wave of biosimilars could dramatically affect prescription drug costs and benefit strategies over the next several years. The launch of many Humira biosimilars in 2023 is the Big Event that will largely determine the impact of the biosimilar wave. Payers have many decisions to make about coverage and formulary tiers. What factors will drive payer decision-making?