Description: This article is an update on the No Surprises Act, which is a U.S. Act aimed to reduce the risk that a person unexpectedly receives out of network charges for their health care visits. This is Part 2; Part 1 was featured in Health Watch's Sept 2024 issue.

Description: This report is a discussion of the significant challenges involved in attempting to research with robust analysis the impact of disparities in health care access, cost and quality of care on financial wellness across racial, ethnic, socioeconomic and other demographic groups in the U.S. for reasons other than or in addition to income, wealth or employment status.

Description: The SOA Research Institute along with the International Section, and the Social Insurance and Public Finance Section are pleased to make available a research report that compares international and domestic mandated paid family and medical leave programs. Special thanks to both Sections for their sponsorship of this effort.

Description: Come check out a diverse panel of health actuaries available to help guide you around the track for any question you may have. An ACA question - we have it covered! A valuation question - we will find a solution. A professionalism issue - we will make a ruling! A regulatory concern - we will help guide the way! No question is off limits! There are no stupid questions!

Description: Misalignment in value-based care approaches between payers and market segments (Medicare, Medicaid, self-funded employer groups, and commercial insurance) creates significant headwinds and friction for health care providers seeking to succeed in an environment that is moving toward more value-based care models and payment approaches. However, while multi-payer approaches in value-based care are critical to eliminating these misalignments, uptake in such programs has been lagging for a variety of reasons. Hear about lessons learned from a selection of specific multi-payer initiatives to understand what went well and what challenges were encountered in expanding these initiatives more broadly. You should be able to walk away from this session with an appreciation of the potential for multi-payer approaches and the challenges faced in gaining traction with them.

Description: After 10 years, the Affordable Care Act (ACA) risk adjustment program has evolved as the ACA has evolved. In recent years the Centers for Medicare and Medicaid Services (CMS) has focused attention on predictive accuracy over compensating for actuarial risk and has failed to address systemic issues such as insolvencies that created suboptimal outcomes for the ACA markets.

Description: Insurance commissioners and deputy insurance commissioners will discuss current topics including health care reform, life insurance issues, risks in the major medical markets, voluntary products and other topics.

Description: Small companies face numerous challenges and opportunities when developing supplemental health insurance products. This is particularly true because of the competitive nature of these products and the innovations happening in the supplemental health market. This article explores the challenges regarding rating, the volatile regulatory environment, product flexibility, and distribution. In addition, the article identifies competitive advantages that small companies may have in the supplemental health market.

Description: Virtual - Session 3C: Clear as Mud - The Impact of Price Transparency

Description: Guidance and a model for actuaries to use when performing their professional services related to Medicaid (Title XIX) and Children’s Health Insurance Program (CHIP or Title XXI) managed care capitation rate setting.