Description: There is no “industry standard” approach to managing the vega (volatility) risk inherent in Variable Annuity Guarantees, Fixed Indexed Annuities and other equity-linked obligations. In this session, we will introduce and analyze a range of reinsurance solutions, including full vega risk retention, full vega risk transfer and more sophisticated or custom structures that split the vega risk between the insurer and the reinsurer in various ways. We will also explore other approaches in bespoke risk coverage and show the impact of different assumptions on a generic “VA Guarantee Cost Estimate” that has been developed by Munich Re.

Description: In this session, a company will share its experience on managing risks underlying the equity-linked insurance guarantees and what lessons were learned over these years as it adapted its strategies to suit the current market environment.

Description: Representing a large indexed annuity writer, the speakers will discuss the growth and evolution of the market for index annuity products. Moreover, the challenges that growth has introduced and how those challenges are being met. While much of the market consists of simple, accumulation-oriented S&P 500 based strategies with 0% return floors, a significant portion of industry sales come from more complex products with highly customized index strategies and other features, such as living benefit guarantees. Attendees will gain a broad understanding of the indexed annuity market, product and features, operational difficulties in risk management arising from product design, and how actuarial and hedge professionals are managing these issues.

Description: The proposed revisions to the variable annuity statutory framework and the FASB targeted improvement for long duration contract, motivate life insurance companies to re-evaluate their hedging strategy. Recently proposed revisions of AG 43/VM-21 and C3 Phase II, reward companies that have a clearly defined hedging strategy, if the companies can demonstrate that the valuation model and capital model can estimate real hedge performance accurately. The speakers of this session will discuss the hedging implication of the proposed AG 43/VM-21 and C3 Phase II framework. Additionally, methodology computational requirements, back-testing results under different economic scenarios and the resulting hedge credits of different hedging strategies will be compared, including explicit dynamic hedge and implicit dynamic hedge. The speakers will also touch on the impact of rebalance frequency on the performance of dynamic hedge. Case studies will be presented to provide guidance on practical implementation.

Description: This event is intended to provide an opportunity for members of the Actuary of the Future and Predictive Analytics and Futurism sections to network with other members, as well as a format to provide an opportunity to discuss hot topics in either/both sections. It is intended for actuaries registered in either section, as well as those interested in either section.

Description: This session will review the challenges the Affordable Care Act has faced since its enactment in 2010 and will look forward to where it’s headed in the future. Panelists will discuss current ACA legislative and regulatory activities as well as ongoing ACA litigation.

Description: Intended for actuaries interested in understanding more about the Medical Loss Ratio and the impact Quality Improving Activities (QIA) and fraud reduction expenses have on the rebate calculation. This session will focus on what expenses qualifies as QIA, examples of programs from major carriers, current regulations and the differences between commercial, and Medicare, and Medicaid requirements.

Description: Recently, actuaries have become more involved in formulary decisions due to high and variable pharmacy cost and utilization trends. How can actuaries and pharmaceutical manufacturers work together to better predict the market while covering key drugs? What discussions are currently taking place between manufacturers and payers? Is there value in these discussions that actuaries are missing? This presentation will provide both actuarial and manufacturer perspectives in order to create a mutual understanding that will begin to direct future conversations to benefit both stakeholders.

Description: In the current value-based care marketplace, there are various reimbursement models that tie payments for care delivery to the quality of the care provided. The purpose is clear – change reimbursement to focus on value by rewarding better outcomes and lower spending. However, implementation it is complex, and many challenges emerge during this transition for both providers and payers.Providers often lack sophisticated actuarial capabilities or clear understanding of the connection between finance and clinical operations. For these reasons, they enter risk arrangements without knowing how to strategically manage and mitigate risks and fully transfer the reimbursement changes into clinical decisions. For payers, a truly viable value-based payment model that rewards the most valuable providers needs a multidisciplinary approach and a solid financial model. Such a model also requires transparency and a clear transitional road map for providers to encourage participation and collaboration. In this session, we will discuss lessons learned through case studies of working with both providers and payers on value-based care issues. We will illustrate the current state of the complex financial structures by presenting examples of value-based financial models, feasibility analyses, and strategies to design a payment model beneficial to both providers and payers. We will also explore the clinical collaboration necessary to make it all work, as well as present some best practice strategies to facilitate strong payer-provider collaboration.

Description: Medicare-Advantage Organizations (MAOs) are often under intense pressure to increase revenue. The ACA dramatically changed the incentives by which MAOs achieve financial success. With benchmark rates growing only as fast as FFS Medicare rates, many MAOs rely on risk scores and quality bonuses as their primary source of additional revenue.There are a not insignificant number of MAOs that are either under scrutiny by federal investigators, exposed to whistleblower lawsuits, and some even paying large penalties to resolve False Claims Act liability for providing inaccurate risk adjustment information (e.g., $270 million paid by Healthcare Partners/DaVita Medical Holdings in October 2018).Is it possible to operate a risk adjustment program that is both compliant with applicable federal regulations and sub-regulatory guidance yet still generate the revenue to ensure that Medicare-Advantage plans are financially viable in the marketplace? The presenters believe that not only is true compliance (as opposed to the mere appearance of a compliance program) a requirement for success, it is a necessary pre-condition for both MAO profitability and to ensure that risk scores are an accurate representation of member morbidity.