Description: The session will provide attendees with a framework of what goals to think about when building and utilizing a predictive modeling framework in New Sales and Renewal Underwriting mid-market, level funding, balance funding, and self-funding group health business.

Description: This research report provides an evaluation and synthesis of the methodologies and data samples used on characterizing health care fraud.

Description: Hot topics for Medicare, including enrollment trends, enticing benefits, risk score projections, market strategy trends, formulary considerations, STAR rating changes, and COVID implications including vaccine/testing requirements Proposed/enacted changes to Part D from the Build Back Better (BBB) Act-CMS’s commitment to advancing equity in health and health care for all individuals Discussion of removing barriers to equal opportunity, health disparities, and closing health equity gaps, including collecting more and improved data on beneficiaries’ race, ethnicity and social determinants of health By attending this session, you will be further prepared for current and future changes in the Medicare Advantage program. Gather additional insight into future trends in policy changes and cost spending and to be more equipped to adapt to changes in the marketplace.

Description: Address how Medicare and Medicaid are integrated in DSNP plans, including: - Coordination of benefits - Model of Care - Care Coordination - Licensure - Difference between DSNPs and MMP plans - Pricing Assumptions - New proposals for more integration By attending this session, you will be able to understand how DSNP plans are integrated between Medicaid and Medicare and what CMS is doing to integrate them further.

Description: This introduction to Captive Insurance Companies will provide an overview that includes the history of captives, different types of captives, common applications, how captives work, why employers form or join a captive, and a Medical Stop Loss Group Captive case study.

Description: Yi-Ling Lin, FSA, MAAA, FCA, started the SOA’s Predictive Analytics Certificate Program to keep pace with the impact big data and predictive modeling is having on the health care industry

Description: Explore a brief overview of federal income taxation of health insurers and selected technical tax topics during this panel discussion webcast. You'll dive into the evolution of heath insurers and healthcare-related services and the arising questions regarding their risk-bearing activities, as well as whether or not certain types of healthcare businesses qualify as "insurance companies" for federal income tax purposes. Also, expect to learn about loss reserves for guaranteed renewable contracts and how they can affect insurance company tax status. This webcast will continue to highlight how the IRS challenges loss reserves of health insurers as the panelists review the status of tax cases, IRS guidance and recent IRS activity regarding "margins."

Description: This session will examine bias from a social science perspective. It will discuss the three types of systemic biases using the National Institute of Standards and Technology (NIST) model. The NIST model details the three types as historical bias, societal bias, and institutionalbias. The session will also provide several examples of each type to provide a framework for identifying the social structure of bias.

Description: An overview of key considerations for benefit triggers in critical illness products

Description: This article on IPV focuses on IPV during the COVID-19 pandemic