Description: Join in and learn to describe the changes in provider contracting that are emerging in the post-COVID marketplace. Examples include: - Carrier transparency files - Increase sophistication of provider negotiators - Additional sources of data - Market issues increasing urgency - Demanding new contracting models

Description: The health insurance industry has historically used several factors to develop premium rates. Many of these, e.g. gender rating, have been largely eliminated from health insurance rating practices by regulations as the Patient Protection and Affordable Care Act (ACA) because they were determined as inequitable. However, several other factors still remain as differentiators in premium rates charged to individuals and groups. In conjunction with the SOA, researchers studied whether there could be ‘ghost’ rating factors, like race, ethnicity, or socioeconomic status, that are inherently included in some of these remaining allowable factors. Review results and opportunities for future research. By attending this webcast, you will be challenged to think about traditional rating factors in a different way. Rather than focusing on whether certain factors are sound based on the underlying claims cost, this session will focus on whether or not these factors are impacting certain socioeconomic or racial/ethnic groups disparately.

Description: "Examine the impact of traditional deductibles on health care equity and the need for innovative plan designs. You will learn about the limitations of consumer-driven health care costs broadly today, as well as alternative cost-sharing approaches that have been successful in driving consumerism without exposing members to high costs. By attending the session, you will be able to: Have a clearer understanding of the issues surrounding deductibles Be equipped with practical ideas for creating more equitable and effective cost-sharing solutions Assess the feasibility and potential impact of implementing these solutions for your own organization"

Description: In this presentation, actuaries and data scientists from Cleveland Clinic and Milliman discuss the development of a sepsis prediction model using machine learning. Presented with a unique challenge of handling massive amounts of data for near real-time risk scoring, the team took their model development to the cloud and delivered a product in less than a week through a unique virtual engagement.

Description: The Tri-Agency published the final rule on short-term limited duration insurance and fixed indemnity coverage at the beginning of April. We’ll break down the new rule, approaches to complying with the new requirements, and what implications it could have for the supplemental health market moving forward.

Description: Explore the dynamic intersection of health insurance data and diverse industries beyond traditional health insurance providers. This session will delve into how life science companies, pharmaceutical manufacturers, device manufacturers, and others leverage health insurance data to drive innovation and decision-making.

Description: This session will focus on the latest regulatory changes impacting commercial dental plans, including recent developments in Minimum Loss Ratio Requirements (MLR) and the potential inclusion of adult dental services as an Essential Health Benefit (EHB).

Description: Challenges of Provider Reimbursement

Description: "The script is for a Medicare session by the Society of Actuaries, led by Danica Turner, which introduces how revenue works on Part D. It covers the various cash flows and subsidies that Part D plans receive, including direct subsidies, federal reinsurance, and low-income subsidies. The session also explains the different phases of coverage and the upcoming changes due to the Inflation Reduction Act in 2025. The goal is to provide a high-level understanding of the revenue and payment calculations for Part D plans.

Description: Hear an overview of recent results and potential scenarios that may impact the future of the ACA market. Review recent reported industry level profitability before transitioning to a discussion of how current market dynamics may influence the future profitability of this segment. Results from microsimulation economic models will be presented to help illuminate market shifts. Issues that will be explored include how ICRA availability might influence individual decision making, as well as how a move to level funding is impacting the small group market.