Description: In this video Matt Emery, FSA, MAAA, CERA delves into advancing Value-Based arrangements between plans and providers to uplift healthcare services. These initiatives aim to cut costs, refine coding accuracy, bolster quality measures, streamline care coordination, and enrich member benefits. Success hinges on engaging members effectively, executing robust cost strategies, utilizing predictive models, targeting specific populations, structuring payment plans, and optimizing data exchange for superior healthcare outcomes and enduring partnerships. Contributors: Matt Emery FSA, MAAA, CERA; Mitchell Momanyi FSA, MAAA; Jon Forster ASA, MAAA

Description: The Society of Actuaries (SOA) has recognized the University of Waterloo and the University of Manitoba as University-Earned Credit (UEC) Centers of Actuarial Excellence (CAE). With this UEC designation, students at these universities can earn credit for designated SOA exams by attaining a required score on university coursework.

Description: The health insurance industry has historically used several factors to develop premium rates. Many of these, e.g. gender rating, have been largely eliminated from health insurance rating practices by regulations as the Patient Protection and Affordable Care Act (ACA) because they were determined as inequitable. However, several other factors still remain as differentiators in premium rates charged to individuals and groups. In conjunction with the SOA, researchers studied whether there could be ‘ghost’ rating factors, like race, ethnicity, or socioeconomic status, that are inherently included in some of these remaining allowable factors. Review results and opportunities for future research. By attending this webcast, you will be challenged to think about traditional rating factors in a different way. Rather than focusing on whether certain factors are sound based on the underlying claims cost, this session will focus on whether or not these factors are impacting certain socioeconomic or racial/ethnic groups disparately.

Description: This session is open to all, but targeted to pension actuaries looking to understand the mechanics of how PRT is priced by life insurance actuaries, as well as life insurance actuaries who wish to understand how the stream of expected benefit payments and Accrued Benefits Obligation is calculated by Retirement Actuaries. Pension Risk Transfer involves two distinct disciplines of the actuarial profession. To date, understanding the other side of Pension Risk Transfer has been limited. This session will attempt to clarify the mechanics of the other side of PRT and explain how an actuarial model consolidating the two separate sides can be built. Panelists will include a retirement consulting actuary who helps retirement plan sponsors bring their pension plans to market to purchase PRT, as well as an experienced life insurer who works to price PRT.

Description: The cell and gene therapy marketplace is quickly evolving and continues to grow as a risk concern for governments, health plans, stop loss insurers and reinsurers. In this webinar, we discuss currently approved tissue, cell and gene therapies, the near-term pipeline, uptake considerations, case management processes, plan document and contract considerations, risk mitigation processes and programs, and network considerations.

Description: In this presentation, actuaries and data scientists from Cleveland Clinic and Milliman discuss the development of a sepsis prediction model using machine learning. Presented with a unique challenge of handling massive amounts of data for near real-time risk scoring, the team took their model development to the cloud and delivered a product in less than a week through a unique virtual engagement.

Description: CMS has pioneered innovative strategies for Medicare and Medicaid to address Social Determinants of Health (SDOH). Employers can learn from these models to implement similar approaches for their employee populations. Learn how employers can understand and address SDOH, the incentives for doing so, and the broader benefits.

Description: ReMark's Global Consumer Study delivers 10 key insights to empower customers. Insurers can design products that meet customers' needs and enhance client experiences and add significant value to their business. At the same time with new products being launched seemingly continuously, it is important to take a step back and assess risk throughout the product management cycle.

Description: In discussing the contemporary reactions to this regulation, as well as how EU-based insurance firms adapted to the shift, this segment will invite us to question our assumptions on the role of gender-based pricing in the future of the industry. In the latter half of the presentation, we will delve into the challenges faced by LGBTQ+ individuals when accessing life, health, and auto insurance.

Description: The SOA Board of Directors is beginning an important new project to review aspects of the organization's governance structure. This initiative aims to ensure that the SOA’s governance framework is well-positioned to support the organization's long-term success and effective implementation of its strategic plan.