Description: Join us for a discussion of the supplemental health landscape for accident, critical illness, STD, and hospital indemnity products. This session will include both the pricing actuary and the regulator perspectives on new approaches, trends, renewal rate strategies, the competitive market, state-specific requirements, and more!!Attendees will learn about changes in the market that will help them price products, evaluate new approaches used in the voluntary market, and identify the issues that will make their products successful.

Description: "Spread pricing is a pricing methodology where pharmacy benefit managers (PBMs) bill a payer one price but reimburses the dispensing pharmacy a lower price for the same prescription drug. PBMs have historically relied on spread pricing as a revenue source. However, a growing number of states are introducing and passing legislation prohibiting spread pricing for Medicaid and commercial clients. In addition, new entrants to the PBM and mail-order pharmacy space are disrupting the market by offering services that promote increased transparency and member satisfaction. Expect updates on recent legislative trends and market disruptions targeted towards increasing PBM drug pricing transparency. By attending this session, you will have a better understanding of how changing legislation and market disruptions may impact current pricing methodologies."

Description: Listen to pre-eminent healthcare actuaries present their pitch for how they'd fix US healthcare (whatever the pitch thinks 'fix' means) if they were supreme policy maker for a day. No idea is too big, and no healthcare actuary's dream is too small.

Description: Attendees will learn what the Health Equity Index is, how it will be calculated, how it affects quality and Star metrics for Medicare Advantage plans, and how this could change the industry as a whole moving forward.

Description: With the 2024 presidential election one week in the rear-view mirror, actuaries and health policy experts will discuss the potential health policy implications in the next four years in relation to the election results. Focus will be on the changing dynamics within Affordable Care Act (ACA) marketplaces with the knowledge benefit of the next president having administrative experience in the ACA environment. Session attendees will be well-equipped to discuss the post-ACA health policy implementation of presidents Biden and Trump, recent policy proposals, and potential legislative/regulatory changes as a result of the 2024 election outcomes.

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: "Advancing health equity is one of the five strategic objectives outlined in the CMS Innovation Center's strategic objectives for the next ten years and is an increasing area of focus across many states. Focus in on recent developments in addressing Medicaid beneficiary needs related to social determinants of health (SDOH), health-related social needs (HRSN), and health disparities and inequities in Medicaid. Several states have introduced non-traditional benefits into their programs in recent years to address these areas, such as various types of housing supports, nutrition-related benefits, and enhanced/advanced case management support. Expect a discussion on the benefits introduced recently in states such as AZ, CA, MA, NC, and OR, including funding considerations around these benefits as well as the 1115 demonstration waiver authorities granted to these states to allow coverage for these non-traditional health care services.

Description: Session 4E: Sometimes The Second is Better than the First - Round 2 for the ACA

Description: The Medicare Advantage (MA) program is facing challenges in the coming years due to a number of headwinds: Star rating program changes, the Inflation Reduction Act (IRA), revenue pressures, mergers/acquisitions, and risk score model changes, just to name a few.

Description: Gene therapy is a quickly evolving field and will continue to grow as a risk concern for many health plans, stop loss insurers and reinsurers. Currently, there are only two approved gene therapies in the U.S., but that number is expected to escalate starting in the fall of 2022. Revisit the experience plans have had with the first two gene therapies, discuss plan design and network considerations in light of gene therapy, and discuss the actual composition of the near-term pipeline along with a range of modeled financial impacts and considerations for payers.