Description: The ACA’s Medical Loss Ratio Provisions

Description: Introduction to the ACA @ 5 publication

Description: Large claims have always been a major source of volatility in health care claims experience. In this session, the presenters will discuss techniques for analyzing large claims, predicting large claims and measuring the associated risk. The presenters will also discuss the early results of the SOA 5/50 research project which will examine the 5% of the population that accounts for 50% of the health care costs.

Description: Ignite-style presentations feature presenters who get 20 slides, which automatically advance every 15 seconds. The result is a fast and fun presentation which lasts just five minutes.The first portion of this session will feature public health experts doing Ignite-style presentations on various public health topics. Then stick around for the second portion when all of the presenters will take part in a moderated, talk-show-style discussion. You'll get a chance to ask your questions and dig deeper into the topics you just heard about. Be prepared for a fast-paced, thought-provoking session that you'll remember long after it ends!

Description: This document provides key findings from the 2007 Risks and Process of Retirement Survey related to health and long-term care risks in retirement.

Description: This is a final report to help individual health plans evaluate and manage their potential exposure during a specific pandemic. It examines the potential impact of pandemic influenza on different payers in the U.S. health care system.

Description: In this, the second step, Sibson engaged the vendor and actuarial communities to solicit input on the actuarial model for determining the impact of various environmental, lifestyle and behavioral risk factors. The goal was to understand the extent to which actuaries currently use models around wellness, refine the above conceptual model, and better understand the potential uses of, and value to, the actuarial and vendor communities that would use such a model. We sought to understand the potential applications and sources of data for the actuarial model. We gathered input on how the model would best suit the professional needs and help shape the future role of the actuary. Lastly, we gathered feedback on the above conceptual model.

Description: Risk adjustment is used to adjust the revenue stream to health insurers that sell ACA eligible plans and Medicare Advantage plans. This article compares and contrasts these risk adjustment programs.

Description: Chapter 5 simulates the risk adjustment process within a hypothetical purchasing alliances using four different risk assessment methods. From A Comparative Analysis of Methods of Health Risk Assessment, M-HB96-1.

Description: Three appendices: Selected Readings, Summary of Data Preparation and Data Issues, and Detailed Results on Predictive Accuracy. From A Comparative Analysis of Methods of Health Risk Assessment, M-HB96-1.