Description: This session will examine bias from a social science perspective. It will discuss the three types of systemic biases using the National Institute of Standards and Technology (NIST) model. The NIST model details the three types as historical bias, societal bias, and institutionalbias. The session will also provide several examples of each type to provide a framework for identifying the social structure of bias.

Description: Among the many impacts of the Inflation Reduction Act’s redesign of Medicare Part D will be a change in Part D cash flows. Plan sponsors have always had to balance the seasonality of prescription drug costs against reimbursement at various times from monthly subsidies, risk score true-up payments, rebates, manufacturer contributions, and CMS settlements, but the IRA is changing the pattern of cash flows in 2024, 2025, and beyond. Moreover, the risk-adjusted portion of CMS revenue is likely to grow in 2025, even as the Part D risk score model changes.

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: The session will provide attendees with a framework of what goals to think about when building and utilizing a predictive modeling framework in New Sales and Renewal Underwriting mid-market, level funding, balance funding, and self-funding group health business.

Description: The is a comprehensive report on the development of an Underwriting Margin Model for Medicaid Managed Care programs, published by the Society of Actuaries. It includes disclosures, methodology, results, sensitivity analyses, and technical instructions for actuaries setting rates for Medicaid managed care programs.

Description: The Health Care Cost Institute (HCCI) recently released their annual health care cost and utilization report on February 13, 2020. This report illustrates employer group commercial health care costs and trends from 2014 – 2018.

Description: Society of Actuaries Research Brief Impact of COVID-19, May 15, 2020

Description: This report provides highlights of a weekly survey of practices regarding the mitigation of the spread of COVID-19 in the U.S. during the second half of February 2021 along with comparisons to prior half-month time periods. The survey asks about the degree to which the respondents perceive that people in their community are following 21 common mitigation practices. The responses are separated by state and compared to state level statistics regarding the level of COVID-19 infections from the Johns Hopkins COVID database for the same time period.

Description: In this paper we propose a model that can be used to analyze correlated claims data. In the process we introduce a class of multivariate generalized Poisson distributions. Then we present posterior distributions of its parameters. These distributions are difficult to manipulate, so we employ Markov chain Monte Carlo methods to draw random numbers from posteriors and predictive distributions. We present a collection of EXCEL VBA functions and subroutines to perform the simulations.

Description: In this session, the presenters will discuss (1) results from a recent study of credibility applications in the pricing of group long term disability business, (2) morbidity experience from individual disability business, and (3) lessons can be learned from each line of business.