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: In this session, actuaries and data scientists will describe how the Cleveland Clinic has utilized large language models to support caregivers with difficult end of life conversations with patients and their loved ones. While artificial intelligence is often prefaced with words of caution, it can also be harnessed for good.

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: 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: The National Association of Insurance Commissioners (NAIC) project for the transition to a new real-world economic scenario generator (ESG) prescribed for principle-based reserve and capital calculations selected a vendor in the fall of 2020. The American Academy of Actuaries and other interested parties have been assisting the NAIC in this transition. Over the past four years, extensive analysis, model validation, and comparison work has been done. There have been many updates on the project but few opportunities to obtain an in-depth understanding of the new features of the new ESG and its impact on reserves and capital. Practitioners are very interested in the questions: - How different are the scenarios from the Academy/Society of Actuaries ESG and the new NAIC ESG? - How different are the models and techniques used to create the scenarios in both generators? - Is there a significant difference in capital and reserve requirements for model office tests between the two ESGs? - Are there concerns with the new NAIC ESG? The session addresses each of these questions in detail. At the conclusion of the session attendees will appreciate the key differences between the model structure and scenario performance of the two ESGs and will understand the differences in capital and reserve requirements for model office tests across the two ESGs. Attendees will also learn how the initial yield curve fitting differs between the models, about fund mapping considerations, and the interpretability of parameters in the new NAIC model.

Description: This session will highlight the growing significance of climate risk for insurance companies, emphasizing how to prepare for regulatory requirements as well as the impacts on financial stability and operational resilience within the industry. Attendees will gain insights specifically addressing climate risk within insurance operations including enhancing governance structures, ensuring regulatory compliance, identifying and monitoring metrics and key risk indicators, and conducting scenario analyses. Through real-world case studies and perspectives from both life and property and casualty practitioners, participants will leave equipped with practical strategies to navigate the complexities of climate risk management, foster transparency and accountability, and effectively address the urgent challenges posed by climate risk within their organizations. Learning Objectives: - Understand the evolving landscape of climate risk and regulatory requirements for climate risk disclosure - Gain insights into effective approaches and current best practices that actuaries and risk modelers may use in performing qualitative and quantitative climate risk scenario analyses - Learn practical strategies for integrating climate risk considerations into insurance operations