Description: The dental and dental insurance industries continue to experience significant innovation advancements in a variety of areas including claims, customer acquisition, teletechnology applications, AI for dental disease progression and more. These advancements are occurring at the dental office as well as within dental insurance companies. Hear about some of the latest innovations in the dental and dental insurance spaces andl gain an understanding as to how cutting-edge developments will impact dental actuarial.

Description: This report presents Phase 2 of the 2024 IDEC Study, analyzing individual disability income (IDI) claim recovery and mortality rates from 2006-2014. It expands Phase 1's scope—previously limited to 90-day elimination and To Age 65-70 benefit periods—to include additional elimination and benefit periods, examining variations by diagnosis, occupation class, claim year, and gender.

Description: The Society of Actuaries (“SOA”) Research Institute is the research arm of the SOA, providing objective, data-driven research that brings together tried and true practices and future-focused approaches to address societal challenges and business needs. The Institute provides trusted knowledge, extensive experience and new technologies to help effectively identify, predict and manage risks.

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: Critical illness insurance is a popular supplemental health insurance product in the U.S. market. This article discusses how carriers have recently sought to add value by expanded the benefits offered in their critical illness products. Specifically, the article discusses the consumer need and development considerations of adding benefits for autism Spectrum Disorder, Mental health disorders, Specified Disease Coverage, and enhance Cancer Coverage to a critical illness contract.

Description: Keynote Speaker: J.D. Kleinke, Author and Medical Economist J.D. Kleinke has been instrumental in the creation of four health care information organizations; has served on the Boards of several health care companies; and spent many years advising both sides of the political aisle on non-partisan, practical approaches to health policy and legislation.

Description: Healthcare risk adjustment methodologies have become increasingly complex, largely due to the belief that complexity enhances accuracy. However, a disconnect exists between how healthcare risk is assessed and how payments are adjusted. This article explores the stark difference between measuring the accuracy of a risk assessment model at a member level, and that of a risk adjustment mechanism at the health plan level. I show that a highly simplified approach that does not use diagnosis codes can have similar accuracy on risk adjusted payments to models that do. These findings suggest that accuracy is not a barrier to developing simpler risk adjustment methodologies, which can improve payment accuracy and reduce the financial incentive for coding diagnoses.

Description: Article discussing how the pursuit of value-based care as a consequence of health care reform laws such as the Affordable Care Act (ACA) and the Medicare Modernization Act has accelerated the use of risk adjustment and what it means to actuaries.

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: The SOA’s Individual Disability Experience Committee (IDEC) has reviewed industry experience for both claims incidence and terminations. Based on this review, the committee has published two reports with experience modifiers that when applied to the 2013 IDIVT table best fit experience from 2005 to 2015. During this session, the factors and their development will be reviewed as well as their impact on active and disabled life reserves.