Description: Session 8E: Cowboy Up - Strengthening ACA Rule Enforcement in Texas and the Dusty Trail to 2026

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: 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: 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: 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: 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.

Description: Since the Affordable Care Act implemented minimum loss ratio provisions for health plans, several states have passed or at least considered minimum loss ratio regulation for dental plans. While such regulations are intended to improve insurer efficiency and promote value to consumers, they can have unintended negative consequences if the unique characteristics of the dental insurance market are not considered. Learn about this hot topic, including loss ratio basics, recent legislative activity in the dental loss ratio space, how dental differs from medical, and why those differences are critical to account for when trying to regulate loss ratios in that market.

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: This session will be centered around the roles and responsibilities of a valuation actuary. Learn the best practices of health actuaries, along with technical considerations and professionalism issues surrounding the calculation and reporting of health liabilities and reserves. This session will focus on key actuarial liability and reserve provisions, including Claims Unpaid and Premium Deficiency Reserves. In this session, explore new ideas about calculation methods and the importance of the underlying assumptions. You will also learn best practices and practical applications concerning reserve calculation discuss best practices regarding the preparation of an actuarial memorandum supporting a Health Annual Statement. This will include key considerations from the American Academy of Actuaries' Practice Note about documenting and supporting the actuarial calculations. The discussion will also present views and considerations from both the insurer's and the regulator's perspectives.