Description: Virtual - Session 1D: Pharmacy Risk Mitigation - Pricing, Programs, Pools, and Performance Guarantees

Description: A panel of leading reinsurance executives will provide an overview of the health reinsurance market that explores existing reinsurance transactions reported under Schedule S, large claim research drawing insight from the latest five-year Merative Commercial MarketScan Research Database, stop-loss reinsurance options for Accountable Care Organizations (ACOs), and other reinsurance applications being seen in the market.

Description: A panel of leading reinsurance executives provide perspective on topics to include cell and gene therapy, structured reinsurance, reinsurance demand for value based care arrangements, and how reinsurers view a variety of risk transfer opportunities.

Description: Over the last 10 years, Artificial Intelligence (AI) healthcare foundation models have made tremendous strides when it comes to delivering highly accurate predictive results when compared to traditional models. This is especially true for models developed and trained on the ‘language’ of healthcare. When trained on healthcare data sequences (claims, EHR, CPT, ICD, pharmacy, lab, etc.), these models deliver far more accurate results as to WHAT beneficiary-level health events will occur and even WHEN they will occur.

Description: Session 1G: Rethinking Catastrophic Claims - Strategies for Sustainable Stop-Loss Pricing

Description: This three-part series provides an overview of the rapidly evolving and dynamic gene and cellular therapy landscape, from the clinical, historical, and risk transfer perspectives. It covers the actuarial considerations in pricing cell and gene insurance and reinsurance, the value assessment of the therapies, manufacturer pricing, and reinsurance cost.

Description: This session will present three utilized underwriting models that can be used for mid-size employer group medical renewals. Key assumptions will be discussed including a significant focus on the stop loss risk since that is the major insured risk.

Description: Session 6G: Stop Loss Market Trends

Description: While the higher general inflation in the broader U.S. economy hasn't emerged in the healthcare market (yet); there is expectations for it to have a lagged impact especially as the full impact of COVID on suppressed utilization emerges. As the healthcare system transitions past COVID, overall costs are expected to trend higher due to overall inflationary pressures as well as new treatments such as the highly anticipated new gene and cell therapies often with costs over millions of dollars.As costs rise, more companies are looking to self-insure their health insurance to control cost increases and are leveraging innovative stop loss programs including captives. Captive insurance markets have seen significant growth and diverse implementations allowing companies to self-fund while managing the risk of large claims and increasing costs. Payers are also looking to control costs and implement value based payment schemes to bend the trend curve and manage costs. Medicare has also adopted new value based payment programs (ACO Reach) which will impact commercial payers and are important to understand. Come gain an understanding of the historical and projected future medical cost drivers including the projected impact of new therapies and then impact on the stop loss markets. Additionally, you'll gain a deeper understanding on how recent innovations in the stop loss market such as the growth in the captive market, level funded and aggregate only products have helped employers manage their costs and overall risk profile.

Description: Session 8A: ORSA for Health Plans - Using ORSA to Drive Health Plan Risk Strategy