Description: In this session, we will provide examples and highlight real-world analytics that have been done to compare providers of tertiary and quaternary (T/Q) services (i.e., complex and potentially rare conditions). We also will address the need for analytics like this, who the potential audiences are, the data necessary to complete an analysis, and we will walk through actual case studies.

Description: The presenters will discuss current focuses in behavioral healthcare (MH/SUD). This may include cost and utilization trends, access to care, modalities of care (e.g., telehealth, app-based solutions, etc.), and other hot topics. The attendees will hear perspectives related to the overall landscape of behavioral healthcare in the US and how that impacts actuaries.

Description: Unique Data Analysis Techniques to help plans find that 1% edge in opportunity and value. The discussion will vary from a conversation on members who are at high catastrophic risk to provider networks and referral patterns. The goal of the session will be to help show ways plans can create savings through outside-the-box techniques.

Description: Underwriting smokers just got a lot more interesting. New research reveals that tobacco’s mortality is surprisingly durable and tenacious. Mortality is now shown to hover at 200% for years after a reported incidence of nicotine dependency, and smoking turns many common and manageable conditions into serious comorbidities with compounded mortality impact.

Description: With a decade of experience, mature Affordable Care Act (ACA) marketplaces continue to undergo significant changes amidst record enrollment levels. State activity has ramped up and similar themes have emerged. For example, an increasing number of states have either established or are considering operating their own exchange.

Description: Learn about the health care cost and utilization impacts of provider consolidation and shortages in the U.S. You will get an overview from a recent SOA research paper of the recent trends of, reasons for, and impacts of consolidation and shortages, as well an overview of the involvement of private equity's role in consolidation and shortages.

Description: Court is in session and you are the jury! Follow along as challenging aspects of actuarial professionalism are explored in a court-like setting. Deliberate among your peers based on what you already know from your own experience as well as what you learn in this session, and then deliver your verdict accordingly.

Description: In this session, we will examine AM Best's credit rating methodology, the evaluation of Enterprise Risk Management (ERM) Programs for insurers, and how ERM evaluations are incorporated into ratings. AM Best staff will present the results of a study of AM Best-rated health insurers' ERM programs.

Description: "This video introduces viewers to the foundational principles and advanced techniques of risk-based hedging using derivative instruments. Presented by seasoned actuary Andres (Andy) Montes, the video explores key hedging concepts, including Delta, Gamma, Vega, and Rho hedging, as well as strategies such as Liability-Driven Investment (LDI), dynamic hedging, and macro hedging. It highlights the relevance of hedging for actuaries working with insurance and pension liability portfolios and emphasizes the importance of mathematical models and technical skills. The session also addresses practical challenges like transaction costs, model risk, and liquidity constraints, aiming to equip actuaries with tools to better manage financial risk. Contributors: Andres Montes, ASA, MAAA; Fiona Fan, FSA, MAAA; Emilia Bruera, FSA; Jon Forster, ASA, MAAA"

Description: Please join us for the first webcast in the Long-Term Care (LTC) Section's 2025 series, providing a high-level overview of the LTC insurance market. This webcast will explore the current market size, highlight key players, and review the latest product innovations. We'll also touch on emerging trends in administrative technology, legal and regulatory developments, evolving consumer needs, and product design. Designed to set the stage for deeper dives into these topics in future SOA webcasts, newsletters, and podcasts, this webcast is for anyone seeking to stay informed on the latest developments shaping the LTC industry.