Description: Discussion of insolvency provision added to reinsurance agreements to insure the continuation of benefits during HMO insolvency, Issue No. 39.

Description: Article discusses what happends when an insurer fails, role of the guaranty association and what is an ideal insolvency. From Health Section News, August 2000, Issue No. 38.

Description: This article provides an in-depth discussion of how subsidies are an integral part of affordability for individual health insurance under the Affordable Care Act, and, ultimately, impact the viability of the market.

Description: Profile of the Health Section.

Description: A new statistical approach is presented for calculation of Incurred But Not yet Paid, IBNP, claim amounts. It is based on two new variant methods, the Simple Projected Paid Lag method and the Regressed Projected Paid Lag method.

Description: Examines the question of whether health-care costs, or health insurance costs, are in crisis.

Description: This is Part 2 of 2 on changes affecting Medigap insurers. It focuses on marketing and regulatory differences between Medigap and Medicare Advantage that affect the competitiveness of Medigap plans.

Description: 2014 marked a new beginning for small group(SG) health insurance market ushered in with adjusted community rated products priced from a single risk pool. It was anticipated that the mandated pooling of the risk would result in higher rates, especially for healthier groups. It is the aim of this article to show whether that view bears out in the actual market rates and if it is higher, then by how much. The article provides a point in time(1st quarter 2025) comparison of premium rates under two segments of the small group market, namely Qualified Health Plans(QHP) available under the small group ACA market versus self-insured Multiple Employer Welfare Arrangements(MEWA) plans.

Description: Essay where payers desiring to optimize health gains per dollar spent should avoid “across the board” cost sharing, and instead implement a “value based” design that removes barriers/provides incentives to encourage desired behaviors for patients and providers.

Description: A Regulatory Perspective on Rate Review Before and After the Affordable Care Act