Description: A look back at 2024, reviewing and highlighting the things that the SOA Health Section Council accomplished, including education, research, webcasts, networking, and a new Health Section Council action plan that will be used on an ongoing basis to target, track, and measure areas of focus for the council, to better serve membership.

Description: In this session, we will delve into the application of survey data analytics to extract valuable insights from public survey datasets. The discussion will start with the basics of survey design, sampling practices, and estimation of key statistics. Three case studies will be presented: one in the realm of population health and another in medical economics, both demonstrating the use of either SAS or R to perform the survey analytics.

Description: The coming wave of biosimilars could dramatically affect prescription drug costs and benefit strategies over the next several years. The launch of many Humira biosimilars in 2023 is the Big Event that will largely determine the impact of the biosimilar wave. Payers have many decisions to make about coverage and formulary tiers. What factors will drive payer decision-making?

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: Model design is an important part of being an actuary, and the SOA highlights the importance of the actuarial control cycle of model design, evaluation and monitoring. What tools are at our disposal for these steps? When should we be concerned or excited about model performance? Can we, and should we, use machine learning tools to assist with model improvement or development?

Description: There are many ways to actively utilize BE approaches – and implementing these important tools can help insurers in many ways.

Description: PBMs are positioned in the healthcare delivery system as the only entity that is not regulated for profitability. The Commercial Fully Insured Health Insurance Plans are heavily regulated by the State Insurance Commissioner who allows only 2%-3% profit margin. The self-funded Health Plans are regulated by ERISA fiduciary responsibility that prohibits excessive compensation. PBMs are classed as a service provider and are not regulated by either. This allows PBMs to implement large, unreasonable mark ups for profit. PBMs are massive commercial entities, states are trying to sue under antitrust law. PBMs found a sweet spot in the regulation. Large Insurance Carries understood that and either acquired large PBMs or merged with them. It is likely that a combination of measures will be needed to regulate PBMs. The most direct approach would be for Congress to pass a law establishing PBM as a fiduciary under ERISA just like an “investment advisor” providing advice for a fee. Establishing PBM as a fiduciary will help Courts and other Federal Agencies ensure that PBMs do not unfairly retain rebates and inflate the prices of Rx drugs sold to employer health plans, and the US population in general.

Description: The SOA has been continuing to highlight the importance of societal purpose across the global actuarial profession, and as a way to attract and retain the next generation of amazing exam candidates and young members. This session will highlight the variety of activities that the SOA and actuaries of all ages are involved in to further drive the profession's societal purpose.

Description: In 2018, the Financial Accounting Standards Board (FASB) adopted significant revisions to the U.S. GAAP insurance accounting literature, via Accounting Standards Update (ASU) 2018-12. The title of ASU 2018-12 is “Targeted Improvements to the Accounting for Long-Duration Contracts,” and as a result, a common acronym for ASU 2018-12 is LDTI (long-duration targeted improvements).

Description: The momentum in value-based care has produced an opportunity for actuaries to become pioneers in health care