Description: Knowing Dan and seeing him live his life in the community makes me a better Medicaid actuary. My experience as a Medicaid actuary makes me a better brother and guardian to Dan. I want to share our story and offer you our unique perspective on the Medicaid LTSS system through real-life examples. In this session, attendees can expect to learn about the following questions:

Description: The Variety of Short-Term Group and Health Benefits

Description: Disability and group life products can pose challenges for the valuation actuary due to the long-tail runout of traditional disability and group life waiver of premium claims, and due to the sensitivity of the reserves to small changes in assumptions. This session addresses a number of issues of interest to actuaries who work with these products, including recent experience trends and the new 2023 Group Life Waiver Valuation Table. Attendees will learn about best practices in the valuation of these products.

Description: The session is based on an article of the same name featured in the January, 2023 issue of Health Watch. It gives a step-by-step method of how to apply the average paid PMPM method to calculate IBNR with zero run-out, as opposed to current methods, which generally require a three-month run-out period. Methods for obtaining confidence intervals for the IBNR estimates will also be discussed.

Description: Explore the role of inflation across health products, including medical plans, disability, and long-term care. Explore various drivers of cost trends, wage increase, and cost of care. Understand their role in the pricing and valuation of a product and how to manage the risk.

Description: Discuss changes in group life waiver of premium claim recovery and mortality experience since the 2005 table was released, the development of the 2023 table, and the new statutory valuation standard approved by the National Association of Insurance Commissioners (NAIC).

Description: Attendees will hear examples of individuals with medical conditions which are either being treated by gene therapy or have gene therapy treatments in development. Attendees will learn about what gene therapy is, current development methods, treatment efficacy, and expectations for future gene therapy treatments. We will explore funding challenges for gene therapy and potential methods to manage costs for gene therapy treatments.

Description: This session will explore a solution to manage health expenses, a bit like the retirement risk managed by the three-legged stool, that is coming from government benefits, employer pension plan, and registered retirement savings plan. The solution could be called a Registered Health Savings Account (RHSA), and could then complement public coverage, and group insurance coverage

Description: Value-based care models have to date been focused on either broad, total-cost-of-care, primary care-based models; or on a limited set of episodes of care. This session will focus on initiatives to bring these concepts together for improved outcomes for patients and greater savings from an integrated solution.

Description: In this session, participate in a mock negotiation of a typical value based contract taking on the role of either provider or payer and solving for the various negotiation challenges, objections, risk mitigations, data requirements, etc. from either party. Attendees will learn best practices and ideal tools and workflows to engage in when supporting VBC negotiations and gain insights into the typical challenges to equitable and agreeable terms.