Description: The regulatory and market dynamics of the ACA's second decade are more predicable than the first. Come hear the latest information from industry experts on the emerging trends in ACA marketplaces. You'll also discover an understanding about emerging federal and state policy that will have pricing and financial implications. Finally, you'll get to learn what actuaries need to know to be well prepared for actuarial practice in the ACA's second decade. Key learning objectives include: - Comprehending the historical dynamics in the ACA's first decade which will shape the future - Understanding the changing national premium landscape for 2024, the 11th year of ACA marketplaces - Having a strong grasp on how the ACA's second decade will differ from the first from an actuarial perspective

Description: Join us for a discussion of the supplemental health landscape for accident, critical illness, STD, and hospital indemnity products. This session will include both the pricing actuary and the regulator perspectives on new approaches, trends, renewal rate strategies, the competitive market, state-specific requirements, and more!!Attendees will learn about changes in the market that will help them price products, evaluate new approaches used in the voluntary market, and identify the issues that will make their products successful.

Description: Among the many impacts of the Inflation Reduction Act’s redesign of Medicare Part D will be a change in Part D cash flows. Plan sponsors have always had to balance the seasonality of prescription drug costs against reimbursement at various times from monthly subsidies, risk score true-up payments, rebates, manufacturer contributions, and CMS settlements, but the IRA is changing the pattern of cash flows in 2024, 2025, and beyond. Moreover, the risk-adjusted portion of CMS revenue is likely to grow in 2025, even as the Part D risk score model changes.

Description: Join us as we explore Medigap claims assumptions and more. What has been driving cost increases? Does the trend vary by market? How are area factors determined? What opportunities exist for niche carriers? This session will provide a fresh experience-based perspective on key pricing considerations and leave you with food for thought as you manage your business.

Description: The world has shrunk and there is no going back. In today’s post-pandemic business landscape, actuaries are frequently being asked to collaborate or lead within multicultural teams dispersed across the globe. The question is, how should companies go about maintaining a sense of team connection across teams that are geographically and demographically different?

Description: After 10 years, the Affordable Care Act (ACA) risk adjustment program has evolved as the ACA has evolved. In recent years the Centers for Medicare and Medicaid Services (CMS) has focused on predictive accuracy over compensating for actuarial risk and has failed to address systemic issues such as insolvencies that created suboptimal outcomes for the ACA markets.

Description: This session will share insights on how to effectively evaluate and price the management high-cost claimants from three views: clinical, payer, and provider. Can predictive analytics help with underwriting? What are effective clinical mitigation strategies? Can VBC arrangements be used to reduce total cost of care, and how can that be priced in?

Description: This session will focus on the introduction to Medicare Research Identifiable File (RIF) data and how you can turbocharge strategic decision-making for Medicare stakeholders. Through real-world examples, we unravel the practical applications of this data for plan sponsors, pharmacies, pharmacy benefit managers (PBMs), and drug manufacturers.

Description: How is extreme weather impacting you? If you live in California, you may have been impacted by the atmospheric rivers unleashing record-breaking rain and snow last winter. If you live in Canada or near Canada, you may have been impacted by the wildfires raging last spring. NASA has declared that the summer of 2023 was the hottest on record.

Description: 2025 Health Meeting Call for Proposals