Description: In this session, we will address the current landscape of the standalone Medicare Part D market and the challenges to its sustainability. Specifically, we will discuss some headwinds for plan sponsors due to the Inflation Reduction Act and future considerations for prescription drug plan (PDP) benefit design and pricing.

Description: This game-style session will test your knowledge on several topics related to Supplemental Benefits. Our panel of carrier representatives will offer a range of industry perspectives, and our live studio audience will learn new industry insights and have some fun!

Description: Those with ADL and/or cognitive needs and their family caregivers are in great need of support across their acute medical and long-term care custodial requirements. Today many entities are supporting families with integrated care delivery and financing approaches.

Description: The true cost of a drug and its therapeutic outcome is impacted by a myriad of factors. This session will utilize case studies in high-cost, chronic diseases to illustrate to participants what factors can be critical to evaluating the true cost of a pharmaceutical intervention. Differing from session one, session two will focus on site of care, buy-and-bill aspects, and the differences between a medical and pharmacy benefit and how these factors ultimately impact the total cost of patient care.

Description: Mental health and VBC have individually been buzzwords within the health community for many years, but rarely together. In this ‘ask the expert’ forum nothing is off limits, but these scintillating topics are a guarantee: unabated demand for mental health services post-pandemic, decreasing provider supply, rising provider burnout, access to care, management of chronic conditions, & medical/behavioral integration concepts including data fragmentation.

Description: This session will explore a solution to manage health expenses, a bit like the retirement risk managed by the three-legged stool, that is coming from government benefits, employer pension plan, and registered retirement savings plan. The solution could be called a Registered Health Savings Account (RHSA), and could then complement public coverage, and group insurance coverage

Description: The Centers for Medicare and Medicaid Services (CMS) implemented significant changes to the Medicare Star Ratings that are expected to result in cost savings to CMS. The 2024 Star Ratings were recently released in October 2023 which was the beginning of these changes where future changes will impact 2026 and 2027 Star Ratings.

Description: This session is intended to provide an update on past, current, and future studies done by the SOA GLTD Experience Committee. This includes an update on the ongoing Group LTD Incidence Survey including the nature of the study, goals, timelines, data submissions, and current status.

Description: As health insurance self-funding becomes more popular among smaller group sizes, risk is evolving for the MGUs, stop loss writers, and reinsurers that cover them. Assessing more small groups at lower attachment points means rethinking traditional stop loss underwriting techniques.

Description: When actuaries and consultants evaluate various pharmaceuticals for inclusion in an employer’s benefits offering, it can be commonplace to look at the advertised list price, or WAC (wholesale acquisition cost), between products and use that as a primary driver in the evaluation process.