Description: While states face a wide variety of circumstances and have implemented diverse approaches to the MOE phase-out, we revisit the conversation to discuss emerging experience across stakeholders as we examine the operationalization of the PHE unwinding as it relates to this major disruptor in the distribution of the healthcare enrollment.

Description: With there being over 11 million undocumented immigrants in the United States, some states are considering or have expanded Medicaid-like coverage to this population. Healthier Oregon launched in July 2022 to provide such benefits, and now covers more than 20,000 Oregonians. Hear about the structure of the program, along with its capitation rate build (which integrates federal participation for emergency and pregnancy-related services), risk corridor design, and related policy and implementation considerations. After attending this session, you will gain an understanding of the actuarial, regulatory and practical considerations for covering this population through managed care.

Description: Understand the role of food based interventions in health care. Learn the difference between produce prescription and medically tailored meals. Review new policies that will affect Medicare and Medicaid populations. Evaluate the possibility of health cost savings due to these interventions.

Description: The Task Force for Climate Related Financial Disclosures (TCFD) guidance has become the basis for the majority of climate related disclosure requirements, both in the US and around the world. Climate Risk management practices and disclosures are evolving rapidly and companies are at a wide array of stages on the journey to begin addressing climate risk. Actuaries can play a central role in helping understand and manage climate-related risks, but how do you get started?

Description: The SOA is seeking researchers to explore considerations within the LGBTQ+ community impacting employer-based health benefit designs. Review details on the background, research objectives, proposal requirements, selection process, submission guidelines, and project conditions.

Description: This debate-style presentation focuses on metrics used to measure and manage insurance companies. Changes in accounting bases (LDTI, IFRS17, etc.) challenge historic metrics to be adjusted or replaced to accommodate new regimes. The long-duration nature of revenue recognition and profit emergence is unique to the insurance industry, and there is no debating the importance of accounting regimes to facilitate earnings recognition and comparability. However, insurers face challenges from the inherent mismatch between capital measures and accounting profits. This mismatch creates competing interest when it comes to both management decisions and executive compensation. To provide guidance, experts offer their unique perspectives and opinions to a debate of emerging best practices in accounting KPIs, cash-based metrics, and executive incentives. The discussion will be guided by probing questions, such as: - What challenges are faced by external users of financial statements? - Accounting changes did not impact business economics, so why discuss metrics? - What are examples of historic and emerging accounting and cash-based metrics? - How can insurers implement best practices in financial reporting? At the conclusion of the session, attendees will have an improved appreciation for actuarial valuation, specifically, the critical role that our interpretation of results plays in the broader financial system.

Description: Cost is a key outcome metric used by actuaries and others to determine the value of a benefit or program in health insurance. However, typically, costs assessed include only the direct costs of the program, not any indirect costs or savings, such as those associated with reduced spending on other services.

Description: This article is an update on the No Surprises Act, which is a U.S. Act aimed to reduce the risk that a person unexpectedly receives out of network charges for their health care visits. This is Part 2; Part 1 was featured in Health Watch's Sept 2024 issue.

Description: Description of US Social Security COLA effective December 2024 and other automatic adjustments effective for 2025

Description: Stakeholders in a specific state (Minnesota) were interviewed about the potential value -- and obstacles -- of a catastrophic backstop program to handle long term care (LTC) financing needs. The design would entail a payroll deduction which would produce a fund to pay LTC expenses once a deductible period (of 1 to 4 years, depending on income) was reached. This design was believed to encourage enrollees to cover the front end better than done today, whether by private insurance or other means.