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?

Description: Methods and assumptions used in the valuation of savings by external care vendors

Description: The Brazilian private health care market ended 2010 with US $48 billion worth of premium. This already makes it Latin America’s largest health care market and sixth in the world ranking. This article provides information on the market and opportunity for growth.

Description: This article discusses the potential characteristics of health care reform and the associated impact on small insurance companies.

Description: Authors demonstrate the use of the claim reserve run-out test for the long-term A&H products. They present the method of this test and show a numerical illustration to depict interpretations of testing results.

Description: Results of an SOA survey regarding the expectation for 2015 accruals for 3Rs and cost sharing reduction payments.

Description: A discussion of outrageous, criminal and soft fraud in health insurance.

Description: Update on Affordable Care Act topics, including Section 1332 waivers, Association Health Plans, silver loading and cost sharing reductions.

Description: This article explores the changing risk profile between the transitional Affordable Care Act (ACA) period (2014-2016) and under the final ACA period (beyond 2017) for the individual market. Actuaries are in a unique position to help facilitate the change from the current ACA period to the final period when health plans will have to take on substantially more risk.

Description: SOA 2012 Health Meeting Interview with Chairperson Daniel Bailey