Description: The Medicare Advantage (MA) program is facing challenges in the coming years due to a number of headwinds: Star rating program changes, the Inflation Reduction Act (IRA), revenue pressures, mergers/acquisitions, and risk score model changes, just to name a few.

Description: Gene therapy is a quickly evolving field and will continue to grow as a risk concern for many health plans, stop loss insurers and reinsurers. Currently, there are only two approved gene therapies in the U.S., but that number is expected to escalate starting in the fall of 2022. Revisit the experience plans have had with the first two gene therapies, discuss plan design and network considerations in light of gene therapy, and discuss the actual composition of the near-term pipeline along with a range of modeled financial impacts and considerations for payers.

Description: The American Academy of Actuaries Health Solvency Subcommittee and the NAIC Health Risk-Based Capital (E) Working Group are in the process of analyzing and reviewing the H2-Underwriting Risk component and the managed care credit calculation in the health risk-based capital (HRBC) formula. Come learn what changes are ahead! While RBC is designed for solvency issues, also come hear about other ways health insurers manage their capital and surplus levels. Are others doing something you should try?

Description: This article discusses the court cases dealing with the severability of the individual mandate from the Affordable Care Act. Severability is related to essentiality, and actuarial input was relied upon to determine essentiality. The article concludes with lessons that actuaries should learn from the legal proceedings.

Description: Virtual - Session 5B: ACA Risk Adjustment Reboot - Fresh Insights From the 2024 Report and State-Specific Dynamics

Description: Knowing Dan and seeing him live his life in the community makes me a better Medicaid actuary. My experience as a Medicaid actuary makes me a better brother and guardian to Dan. I want to share our story and offer you our unique perspective on the Medicaid LTSS system through real-life examples. In this session, attendees can expect to learn about the following questions:

Description: It's your first full day of productive learning! Start it off right with a delicious breakfast and warm welcome.

Description: Gather with members and non-members in the China actuarial community to discuss recent topics and related issues in areas such as macroeconomic sharing, pension, investment, product strategy, and more.

Description: Discussion of recent developments in the taxation of noncoordinated benefits such as fixed indemnity, hospital indemnity, and specified disease insurance policies. Developments include a recent Chief Counsel Advice Memorandum and proposed triagency rulemaking that would impact non coordinated benefits.

Description: This study of socioeconomic inequalities in mortality builds on a previous report in which we identified a large and growing gradient in life expectancy between 1982 and 2019 across U.S. counties classified into 10 socioeconomically homogeneous categories. In this report, we seek to identify the particular causes of death contributing to the growing disadvantage in mortality between populations in the least and most affluent deciles as previously defined.