Description: Diabetes mellitus type 2 is an excellent model for assessing the setup of medical coverage in the U.S. health care system. It is a chronic disease that has genetic, behavioral and other medical causes, and causes many complications over the long term. From Financing Chronic Care Monograph, M-HB05-1.

Description: After the bid process, desk review, rebate reallocation, an “enjoyable” audit, and open enrollment; the Medicare plan year starts. Throughout the year, organizations find it pertinent to get an accurate picture of their Part D liability as reinsurance, LICS (Low Income Cost-Sharing) subsidy, and risk corridors are accrued. Attendees will learn about the basics of Part D accruals, how future accrual amounts are estimated based on patterns in the data, and how bid assumptions versus actual results impact plan sponsor profitability. We will also discuss financial statement treatment of these items. Real-life examples from bids to outcomes will be provided to enhance the discussion. Ultimately, attendees will come away with a deeper understanding how their bid assumptions play out, and how they can use Part D accruals to plan for future bid development.

Description: Provides an overview of developments in the healthcare market including provider billing practices. Provides an overview of the Government Finance Officer’s Association (GFOA) in New York on Dec. 6, 2018

Description: A summary recap of the recent SOA Health Conference held in Dallas, TX in June of 2025. With the intentional use of AI to assist with the summary, this article gives a good overview of the recent conference with personal commentary from one of the attendees.

Description: Description and layout of the Group Medical Claims Database from the 1997–1999 Group Medical Insurance Database and Analysis Report.

Description: The article documents the efficacy of infra-low frequency neurofeedback regarding how it improves patient no show rates, decreases mental health symptoms by 40% or more, and self-harm and suicidal ideations.

Description: This article provides an overview of critical illness insurance: history, product description, and the three primary ways to offer critical illness coverage in the United States. This article also contains an illustration of an issue age premium rate calculation, as well as product features and rating applications specific to the various types of critical illness coverage.

Description: Under the Affordable Care Act (ACA), groups with 50 or less full time employee equivalents will eventually be subject to the ACA’s modified community rating rules. While some groups will see lower premiums than they would have without the ACA, others will see significant premium increases. Many of the latter type opted for transitional relief beginning in 2014 to avoid the ACA as long as possible. With the end of transitional relief approaching in 2018, what will these groups do? One option will be to self-insure using a product generically termed Level Funding.

Description: Results of an SOA survey regarding the expectation for 2015 accruals for 3Rs and cost sharing reduction payments