Description: Session 7D: Medicare Coverage of GLP-1's - Trimming the Fat

Description: This session will cover the treatment of various forms of reinsurance under Valuation Manual-20 (VM-20). Speakers will discuss the implications of various types of reinsurance agreements on the calculation of principle-based reserves (PBR). This will include coinsurance and modified coinsurance, guaranteed and non-guaranteed yearly renewable term (YRT), as well as financial reinsurance.

Description: This session will include examples of healthcare claims and market data to be used for educational purposes to highlight trends in the insurance industry. It will also highlight opportunities to enforce existing laws around fraud and abuse, and areas for regulators and legislators to focus to address this growing problem. Finally, it will discuss recent law changes and highlight areas requiring additional regulatory intervention. Expect discussions of recent claim issues and laws in the healthcare market as well as emerging issues in healthcare. The presentation will be beneficial to healthcare professionals working for health insurers, healthcare providers, auditors, regulators and healthcare providers and will also cover professionalism related topics for actuaries.

Description: Come learn how Maryland is leading the charge in improving affordability for its individual market enrollees. Learn about the success of the state's 1332 reinsurance program and additional initiatives including further Medicaid expansion, additional state and CSR subsidies, and eligible population expansions.

Description: The Child Tax Credit and Social Security have demonstrated how simple rules based cash transfer programs can significantly lower poverty. Discover information from a paper that describes how the expansion of Social Security can more effectively and efficiently reduce poverty than the current alphabet of anti-poverty programs.

Description: Over the course of ImpAct conference, we have taken you on a journey to understand the impact of climate change to the insurance industry. We have examined the risks to the industry both on a short and long term. We looked at tools and approaches, both on the liability and asset sides, to address this emerging risk. Evidences have shown, not only the need to incorporate climate risks is pressing, as an industry, we shall recognize the responsibilities to lead the evolution. This session aims to put everything together and explore progress on company's enterprise risk management (ERM) process to incorporate climate risks and enterprises' attempt to provide sustainability information to audiences in need. We will discuss the latest development in international standard on sustainability disclosure. We will diagnose the challenges on implementation and effort to resolve them. We will compare the requirements and latest developments across different jurisdictions and possible cross learning among them. To conclude, we will land on what opportunities are available to the actuarial community! At the end of this session, participants will be able to: - Discover requirements on sustainability reporting standards across different jurisdictions - Appreciate the challenges and progress to integrate climate risks in company's ERM approaches - Comprehend actuaries' opportunities and responsibilities to contribute

Description: Artificial intelligence (AI) presents numerous opportunities in the insurance and financial industries. It also comes with heightened model, operational, legal and compliance, financial, and data risk. In this session, we will discuss speculation that emerging AI capabilities have sparked the fourth industrial revolution, examine what is different about this most recent round of capabilities, and examine why industry experts warn about the heightened risks the use of AI presents. We will review a framework - which includes AI ethical principles, standards, and best practices - to govern the use of AI. This will include a cross-reference of relevant Actuarial Standards of Practice as well as industry guidance like the NAIC Model Bulletin on the Use of AI Systems by Insurers. This framework will help actuaries and insurance professionals gain confidence that - if governed appropriately - we can reap the vast rewards of using AI systems in our industry.

Description: "Spread pricing is a pricing methodology where pharmacy benefit managers (PBMs) bill a payer one price but reimburses the dispensing pharmacy a lower price for the same prescription drug. PBMs have historically relied on spread pricing as a revenue source. However, a growing number of states are introducing and passing legislation prohibiting spread pricing for Medicaid and commercial clients. In addition, new entrants to the PBM and mail-order pharmacy space are disrupting the market by offering services that promote increased transparency and member satisfaction. Expect updates on recent legislative trends and market disruptions targeted towards increasing PBM drug pricing transparency. By attending this session, you will have a better understanding of how changing legislation and market disruptions may impact current pricing methodologies."

Description: The Inflation Reduction Act represents the most significant changes to the Part D program since its inception 20 years ago. The implications will not only alter the benefits offered by Medicare Advantage (MAPD) and Prescription Drug Plans (PDP) but will alter the Part D cash flows and the seasonality of such amounts for interim reporting periods. In this session, we will provide a brief overview of the IRA changes and dive into how the changes could impact the 2008 Medicare Part D Accounting Practice Note.

Description: Discover an update on recent developments affecting U.S. retirement plans, such as regulatory guidance, new legislative proposals, recent court cases and recent trends. Experienced pension actuaries will share their perspectives on these issues and the impact on plan sponsors.