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: Join mental health experts (e.g., providers, academics) as they engage in an interview-style conversation designed to inform you about the current state of mental health in the U.S. and potential pathways for improving mental health care and mental health insurance benefits. Through discussion of plan design, provider network, provider reimbursement and other relevant channels, you'll find ways you can use these channels to help enhance an individual's access to care, improving their health and overall quality of life.

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: Session 2D: Thinking Local - The ‘Oh Wows’, and 'Oh Nos' of Medicare Advantage for Regional Plans

Description: Session 10C: Redesigning the U.S. Health Care System - You Vote

Description: Lunch Session - Celebrating 15 years of the ACA: Texas’ Legislative Journey and Market Success

Description: At the conclusion of the session, attendees will be able to understand the potential for using global population health mortality and morbidity data in actuarial contexts. Using the Global Burden of Disease project as a resource, this session will discuss how novel population health research can be used to complement and fill in the gaps of existing input data sources for actuarial analysis and modeling. Presenters will share the latest academic research on the topics of demography, life expectancy, health-adjusted life expectancy, causes of death and disability, comprehensive disease incidence and prevalence metric, measures of disease burden for patients and populations, modifiable risk factors where there are opportunities to make interventions and improve health outcomes, and disparities between and within populations. This research is globally comprehensive and comparable between different markets and disease areas. The session will cover the motivation and purpose of GBD, a brief description of the models used, and dive deep on some selected use cases in actuarial contexts. Audiences will leave with: 1. Understanding challenges and opportunities in measuring disease burden comprehensively and consistently 2. Understanding relevant health metrics, including the drivers of future mortality and morbidity 3. Ideas for applications of epidemiological research in your work

Description: This session will review the latest developments in the Affordable Care Act (ACA) marketplace, including a discussion of hot topics, challenges, and opportunities on the horizon. Specific topics will include cost-sharing reductions (CSR) loading and the impact on subsidized rates across states (e.g., mandated loading in NM), the interaction of American Rescue Plan (ARP) subsidy expansion, and the impact on ARP-enhanced subsidies end.

Description: Traditional Medicare [TM] has many coverage gaps and no out-of-pocket maximum. Most members must purchase a Medicare Supplement Plan and a Part D plan for pharmacy coverage. Over 50% of members have opted for a Medicare Advantage [MA] plan that replaces TM and the need to purchase a Supplement and (in most cases) a Part D plan. All this for less cost to the member, but at a greater overall cost to the federal government even though MA plans provide TM benefits for less than it costs the government. The attendee will learn why this occurs. However, given these facts, the focus of the session will be on the future of Medicare: namely, should the parameters regarding MA bids and payments be limited to what is paid for TM, or can we take the best administrative techniques of MA and TM to provide more robust benefits for all Medicare members at a cost no greater than the government is currently paying? Or is there an even better idea?