Description: Employers who purchase disability insurance are increasingly interested in obtaining assistance with broader absence management services. At the same time, paid family leave is gaining in popularity both as a government-mandated benefit and in the context of private insurance plans. The speakers in this session review recent developments in the full spectrum of leave programs, including plan design, pricing and administration.

Description: You’ve built or updated a predictive model. Is it any good? How can you interpret and understand its predictions? How does it compare to alternative models? This session will look at traditional and non-traditional ways of validating predictive models, with examples from case studies.

Description: The Triple Aim is a vision to improve the health of populations, create a better quality of life, and reduce per capita spending for the benefit of communities.(http://www.ihi.org/Topics/TripleAim/Pages/default.aspx) While much public attention on wellness has focused on topics such as obesity and smoking, it would be beneficial if greater emphasis was placed on raising the bar of oral health. The mouth plays an important role in overall health and wellness. Routine oral care helps prevent dental problems and appears to positively affect chronic conditions before they develop into complex, more expensive ones. This purpose of this session is to increase awareness of the importance of oral health, the consequences of poor oral health, and the link with socioeconomic characteristics. This session will explore and highlight studies completed in this space by both researchers and payers. Actuaries interested in learning more about the impact of oral health and overall health, relevant interventions that have been undertaken, areas for potential financial savings, and issues relating to public policy applicable to oral health would benefit from attending this session.

Description: The proposed session will introduce Outcome Based Risk Sharing Arrangements (“OBRSA”) between health insurance payers (“payers”, including insurance companies, health plans, sponsored employers, and government programs) and pharmaceutical manufacturers (“pharma”), and it’s intended to meet the needs of actuaries who focus on pharmacy benefits and risk sharing arrangements. The covered content will include (1) the background of OBRSAs, definitions, stakeholders, and OBRSA’s role in shifting the system from volume-based toward value-based; (2) conflicting perspectives about OBRSAs between payers and pharma (cultural and methodological); (3) identification of incentive gaps between payers and pharma, and incentive alignment between them; (4) barriers to implement OBRSAs; (5) limitations and considerations of OBRSA implementation; and (5) hypothetic OBRSA examples.

Description: This session will explore the various methods of determining the credibility levels that are given to various size employer groups and Medicare plans. The background and theory of the methods that have commonly been used will be explained and then some new data-driven research in the area and possible alternatives will be discussed.

Description: Direct Primary Care (DPC) is a newer model of primary care delivery in which patients or employers pay for care directly on a membership basis; insurance and other third-party payment is not used. Early studies show significantly improved patient health outcomes and lower expenditures for DPC patients compared with similar patients receiving traditionally delivered primary care. Additional research is needed to better understand physician perspectives about the model and the role of patient selection in early results.In this session we discuss research projects that may shed light on the DPC model and on whether early results indicate more about the model or about the patients who use it.We discuss an SoA research project that interviews DPC physicians to better understand their views about the model and its early results. We also discuss a paper that analyzes characteristics of patients who receive primary care from a DPC physician and compares them to characteristics of patients who receive primary care in more traditional ways. This cross-sectional study surveys all adult patients of a convenience sample of several DPC practices. Variables include demographics, socio-economic status (SES), type of additional coverage (if any), whether DPC fees are paid by an employer, and self-reported health status. The Medical Expenditure Panel Survey is the main source of comparison data. For a given cohort of demographics and additional coverage, we determine whether DPC patients have similar health status, demographics and SES as non-DPC patients. This study will provide insight into the degree of selection into DPC by observable patient characteristics.

Description: The demand for outside actuarial expertise continues to exist, driving demand for independent actuarial consultants. We will hear from experienced actuarial entrepreneurs on why they chose this career, the pluses and minuses of this career, and what to consider to improve the odds of success as a consultant.

Description: Join the Education and Research Section for a review of current E&R work for the year, including the 2019 Actuarial Research Conference. This breakfast is open to all meeting attendees free of charge. If you plan to attend, you must register in advance.

Description: Multiple perspectives will be provided on the factors that are driving global interest rates in today's economic environment. Presenters will discuss the historical evolution of interest rates in developed markets, the shifting landscape in the current environment and what savers (particularly insurers and annuity providers) can do with this information. There will also be some discussion on the general macroeconomic environment and credit condition

Description: The presenters explain the current state of model risk management in the insurance industry and shares insight on some of the best practices and common themed challenges. They also explore where model risk management is headed going forward and what a more optimal framework would look like.