Description: Traditional Medicare [TM] has many coverage gaps and no out-of-pocket maximum. Most members must purchase a Medicare Supplement Plan and a Part D plan for pharmacy coverage. Over 50% of members have opted for a Medicare Advantage [MA] plan that replaces TM and the need to purchase a Supplement and (in most cases) a Part D plan. All this for less cost to the member, but at a greater overall cost to the federal government even though MA plans provide TM benefits for less than it costs the government. The attendee will learn why this occurs. However, given these facts, the focus of the session will be on the future of Medicare: namely, should the parameters regarding MA bids and payments be limited to what is paid for TM, or can we take the best administrative techniques of MA and TM to provide more robust benefits for all Medicare members at a cost no greater than the government is currently paying? Or is there an even better idea?

Description: State Medicaid agencies have been implementing value-based payment (VBP) models for the last decade and are increasingly exploring advanced population-based payment (PBP) models that increase flexibility, predictability, and accountability for participating provider organizations. PBP models show promise in advancing Medicaid priorities, but are still in the early stages of development, and model design and implementation challenges remain. This article from the Center for Health Care Strategies explores the fundamentals of VBP and how PBP - a particular type of payment model - can help Medicaid agencies achieve goals related to care transformation and quality improvement, revenue stability, and controlling cost of care.

Description: How to effectively retain top talent is a challenge that all employers face and an area in which employee benefits have been playing an increasingly important role. Traditionally, the market has been very competitive, with generic products mainly focused on outpatient and inpatient medical reimbursement, Term Life cover and accidental benefits. For large multinationals, employee benefits are often tailor-made solutions arranged via international brokers whereas small to medium-sized enterprises (SMEs) are more likely to utilize standard packages offered by insurance companies via agents. This article explores the evolution of employee benefits in Asia.

Description: Examines the trends affecting the distribution system for the industry's products, and the regulatory and tax environment in which life companies operate. Also looks briefly at the state of competition in the industry.

Description: In late 2021, U.S. Congress passed the Consolidated Appropriations Act (CCA), which requires group health plans and health insurers to submit information regarding the costs of prescription drug costs and other health care services each year to the federal government. Learn how this data can be useful to anyone responsible for forecasting and budgeting.

Description: CMS launched the value-based insurance design (VBID) model in 2017, allowing health plans to offer innovative supplemental benefits and incentives to beneficiaries to use high-value services specific to their health care needs or socioeconomic position. CMS's stated goal is to encourage health plans to implement strategies that focus on health equity. The model has evolved over time and has grown tremendously in popularity over the years since it was introduced.

Description: Hear highlights from recently published and upcoming Society of Actuary (SOA) Research Institute reports, Including work on specialty pharmacy and the long-term impacts of COVID-19. Join us as we focus on the financial impacts of these issues as well as trends and other actuarial considerations.

Description: Join us as we explore how recent innovations & future changes in the American worksite will impact the future of the Critical Illness product

Description: Actuarial Perspectives on COVID-19: June 10 Twitter Chat with the Society of Actuaries

Description: This session will review the latest developments in the Affordable Care Act (ACA) marketplace, including a discussion of hot topics, challenges, and opportunities on the horizon. Specific topics will include cost-sharing reductions (CSR) loading and the impact on subsidized rates across states (e.g., mandated loading in NM), the interaction of American Rescue Plan (ARP) subsidy expansion, and the impact once ARP-enhanced subsidies end.