Description: Part II of a two-part series discussing individual market evolution from before the ACA through President Trump's first term.

Description: This article is an update on the No Surprises Act, which is a U.S. Act aimed to reduce the risk that a person unexpectedly receives out of network charges for their health care visits.

Description: Recap of Q&A sessions held to discuss the findings and methodology of a SOA study on the cost of the newly insured under the ACA.

Description: This is a discussion of the medical loss ratio, the confusion and debate over the calculation method under the new MLR requirement, and the opportunities it presents to consulting actuaries.

Description: The PPACA imposed a market share-based health insurance provider fee, known as the "Section 9010 Fee", "Health Insurer Fee", or simply the "HIF", on each “covered entity” with net premiums written in excess of $25 million that is engaged in the business of providing health insurance coverage for U.S. health risks. This article provides background information to help unpack the language behind the Section 9010 Fee and highlights a few areas of special interest including merger and acquisition-related issues, application of the Section 9010 fee to expatriate plans, and considerations regarding fee administration.

Description: The SOA’s research objective is to provide guidance to state exchange officials and administrators, federal officials and administrators, and actuaries assisting states and health plans. The goal of the project is to estimate the morbidity and/or cost for newly insured individuals in the individual market (and to some degree, the small group exchange) relative to the morbidity and/or cost for the current commercially insured population. This analysis will primarily focus on the individual, non-group market. In order to plan for the impact that these currently uninsured individuals will have on the health insurance markets, it will be important to understand their costs relative to the costs for people already enrolled, for whom many health insurers have experience and data.

Description: A call for essays issued by the SOA Health and Long Term Care Sections on the visions for the future of the U.S. health care system.

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

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