Description: This session will include examples of healthcare claims and market data to be used for educational purposes to highlight trends in the insurance industry. It will also highlight opportunities to enforce existing laws around fraud and abuse, and areas for regulators and legislators to focus to address this growing problem. Finally, it will discuss recent law changes and highlight areas requiring additional regulatory intervention. Expect discussions of recent claim issues and laws in the healthcare market as well as emerging issues in healthcare. The presentation will be beneficial to healthcare professionals working for health insurers, healthcare providers, auditors, regulators and healthcare providers and will also cover professionalism related topics for actuaries.

Description: "Spread pricing is a pricing methodology where pharmacy benefit managers (PBMs) bill a payer one price but reimburses the dispensing pharmacy a lower price for the same prescription drug. PBMs have historically relied on spread pricing as a revenue source. However, a growing number of states are introducing and passing legislation prohibiting spread pricing for Medicaid and commercial clients. In addition, new entrants to the PBM and mail-order pharmacy space are disrupting the market by offering services that promote increased transparency and member satisfaction. Expect updates on recent legislative trends and market disruptions targeted towards increasing PBM drug pricing transparency. By attending this session, you will have a better understanding of how changing legislation and market disruptions may impact current pricing methodologies."

Description: This session will be centered around the roles and responsibilities of a valuation actuary. Learn the best practices of health actuaries, along with technical considerations and professionalism issues surrounding the calculation and reporting of health liabilities and reserves. This session will focus on key actuarial liability and reserve provisions, including Claims Unpaid and Premium Deficiency Reserves. In this session, explore new ideas about calculation methods and the importance of the underlying assumptions. You will also learn best practices and practical applications concerning reserve calculation discuss best practices regarding the preparation of an actuarial memorandum supporting a Health Annual Statement. This will include key considerations from the American Academy of Actuaries' Practice Note about documenting and supporting the actuarial calculations. The discussion will also present views and considerations from both the insurer's and the regulator's perspectives.

Description: Climate change will lead to an increase in the frequency and severity of many weather-related hazards. In turn, these hazards will impact health outcomes for individuals. Explore examples of this connection with a climate scientist, including how the increase in wildfire severity in the western U.S. is expected to drive a 40% increase in organic carbon aerosols by 2050 and howheat stress will impact vulnerable populations and workers in non-air-conditioned environments. Investigating these relationships will increase literacy on disproportionate impacts of climate change-related health outcomes. Presenters will illustrate the disproportionate impacts by geographically analyzing climate change signals and comparing them with socioeconomic data. Last but not least, you will learn about the evolution in both voluntary and required disclosures for payors and the landscape of why understanding climate risk is relevant for many payors.

Description: Since the Affordable Care Act implemented minimum loss ratio provisions for health plans, several states have passed or at least considered minimum loss ratio regulation for dental plans. While such regulations are intended to improve insurer efficiency and promote value to consumers, they can have unintended negative consequences if the unique characteristics of the dental insurance market are not considered. Learn about this hot topic, including loss ratio basics, recent legislative activity in the dental loss ratio space, how dental differs from medical, and why those differences are critical to account for when trying to regulate loss ratios in that market.

Description: The Special Financial Assistance (SFA) program included in the American Rescue Plan Act (ARPA) will provide grants to some of the more troubled multiemployer plans. While this is a welcomed relief for many multiemployer plans facing insolvency, plenty of challenges remain in the implementation of the funds and ability to maintain solvency after the SFA funds are fully utilized. Explore the challenges and opportunities from the pension relief provisions.

Description: "Advancing health equity is one of the five strategic objectives outlined in the CMS Innovation Center's strategic objectives for the next ten years and is an increasing area of focus across many states. Focus in on recent developments in addressing Medicaid beneficiary needs related to social determinants of health (SDOH), health-related social needs (HRSN), and health disparities and inequities in Medicaid. Several states have introduced non-traditional benefits into their programs in recent years to address these areas, such as various types of housing supports, nutrition-related benefits, and enhanced/advanced case management support. Expect a discussion on the benefits introduced recently in states such as AZ, CA, MA, NC, and OR, including funding considerations around these benefits as well as the 1115 demonstration waiver authorities granted to these states to allow coverage for these non-traditional health care services.

Description: Join us for an insightful webcast as we delve into the far-reaching implications of the recent Supreme Court decision to overturn Chevron deference. This landmark ruling, which previously granted federal agencies significant leeway in interpreting ambiguous statutes, is set to reshape the landscape of healthcare policy.

Description: It's your first full day of productive learning! Start it off right with a delicious breakfast and warm welcome.

Description: The Society of Actuaries will be offering this webinar series intended to educate and investigate aspects of life insurance, annuity, and long-term care product tax compliance. Developed by the Taxation Section, participants will be brought up to date on recent Internal Revenue Service (IRS) guidance and learn about the newest tax issues related to product design and administration. Legal, IRS and product development experts will provide vital insights into the challenges of developing and administering products within the requirements of the Internal Revenue Code (IRC) and allow ample opportunities for questions and information exchange. This session will feature legal, tax, actuarial and compliance experts. Recent legislative changes will be emphasized, including the Consolidated Appropriations Act changes to IRC Section 7702 and other items/questions that experts have seen increased industry activity.