Description: The time has arrived for ASU 2018-12, otherwise known as Long-Duration Targeted Improvements (LDTI). For health insurance products, the ASU will require considerable efforts to make the necessary changes to valuation systems, procedures, assumptions, and/or methodologies in order to be in compliance. This session is designed to cover LDTI implications specific to carriers of long-term care and supplemental health products, including changes to how attained age rated products will be approached, allocating and discounting the claim liability (IBNR), and how the treatment of Profits Followed by Losses (PFBL) will evolve under LDTI. By attending this session, you will be able to: • Understand LDTI’s key impacts on long-duration health insurance products. • Recognize the treatment of attained age rated products under LDTI. • Comprehend the requirements of allocating the claim liability to cohorts. • Grasp the requirements pertaining to the discounting of the claim liability. • Understand how PFBL will evolve under the new standard.

Description: In the game of chess, both players have perfect knowledge of the board. In poker, however, players deal with asymmetric information as well as the fact that your opponent can lie. There is an old expression that smart people are “playing chess when their opponents are playing checkers.” However, playing chess when your opponent is playing poker is a recipe for disaster (for the chess player, that is). Parameter risk is more akin to poker than chess, and it is often overlooked in favor of volatility risk in stop loss and reinsurance pricing. Unlike volatility risk, however, parameter risk does not necessarily decrease as the group size increases. Understanding the impact of parameter risk can help avoid mispricing the risk at hand as well as the impulse to provide false precision. False precision can lead to poor underwriting decisions and financial losses. In this session, the presenters will provide examples of parameter risk as well as potential solutions to incorporate when building simulation models. By attending this session you will be able to recognize potential areas of parameter risk and understand techniques to incorporate parameter risk in simulation modeling.

Description: In the time since the original proposal to move healthwriting companies from the blue blank to the orange blank, there have been several incremental updates to the blue blank by the NAIC Blanks Working Group to integrate portions of the orange blank into the blue blank. Meanwhile, the NAIC RBC Working Group has issued their proposal to change the health test for comment and appear to be moving forward with the proposal to revise the health test. This would obligate companies that write predominantly health business onto the orange blank rather than the blue blank, which they have historically used for reporting. Discover background of the revised health test, the incremental updates to the blue blank that have been implemented recently, additional incremental updates proposed for upcoming blue blanks, and the current status of the Health RBC Working Group proposal to revise the health test. Hear observations about companies that have opted to 'take the plunge' and move to the orange blank ahead of the revised health test as well as companies that have opted to remain on the blue blank and incrementally update as new requirements are integrated into the Blue blank. By attending the session, you will be able to: • Understand the context of the initiative to revise the NAIC health test. • Summarize the recent changes to the blue blank implemented by the Blanks Working Group that integrate portions of the orange blank into the blue blank. • Summarize the upcoming proposed changes to the blue blank by the Blanks Working Group that integrate additional portions of the orange blank into the blue blank. • Summarize the current status of the Health RBC Working Group proposal to revise the health test. • Provide industry perspective on companies that have opted to move to the orange blank ahead of the revised health test and companies that have opted to remain on the blue blank until the NAIC requires it.

Description: The rules governing the framework of Affordable Care Act (ACA) marketplaces continue to be refined at the state and federal level. The catalyst for such changes has been a desire to improve markets, which has been primarily informed by data and experience in the ACA's first decade. This session will feature a panel of consulting actuaries, a state policy advisor who has influenced ACA legislation, and an attorney deeply involved in ACA risk adjustment litigation. Discussion will include new federal proposals, efforts to strengthen enforcement of rating compliance, new actuarial insights from public data, and the anticipated future implications for ACA markets. By attending this session, you will be able to: • Understand what precipitated risk adjustment lawsuits and how proposed federal rules address these concerns. • Identify how state regulators are addressing premium misalignment between metal levels and shaping local policies. • Develop new insights on publicly available data. • Understand the implications these policy changes will have on the future of pricing health insurance benefits, consumer value and enrollment distributions in ACA marketplaces. • Understand the primary factors leading to ACA market success.

Description: This session series is sponsored by Hannover Re Session 2 - COVID-19: Financial Impacts and Re-shaping Risk and Capital Management Practices COVID-19 has posed significant challenges to health insurers and providers to meet profit targets and maintain strong balance sheets and capitalization levels. As a result, companies are facing an ever-increasing need to better integrate their risk and capital management practices across the enterprise and evaluate a broader set of tools to manage and optimize their capital and liquidity needs. This second session of the COVID-19 series will help you examine the financial impact that COVID-19 has had on the health industry and review how companies are evolving their financial and capital management practices to achieve their strategic goals. It will also outline how structured reinsurance has emerged as an increasingly utilized form of managing capital. By attending this session, you will be able to explain how COVID-19 has impacted the financial performance and capitalization of the health insurance industry, and will gain a basic understanding of alternative ways of managing and optimizing capital, including the use of structired reinsurance.

Description: Review recent incidence trends based on incidence data from 2005 to 2015. Examine proposed modifiers with IDIVT 2013 incidence tables and its impact on active life reserves. By attending this session, you will be able to: • Understand how your company experience compares vs. Industry. • Identify potential LDTI impacts based on industry experience. • Develop incidence modifiers for pricing and projections based on industry experience.

Description: Currently there are ten states in the U.S. —Rhode Island, California, New Jersey, New York, Washington, DC; Washington, Massachusetts, Connecticut, Oregon and Colorado —that have enacted Paid Family Leave. Paid Family leave is an employee funded state insurance program that provides wage replacement to eligible workers when they take time off of work to care for a seriously ill family member or to bond with a new child. Who pays the taxes? The employer or the employee? How will this effect short term disability benefit offerings in the work place? How does a Paid Family Leave plan get implemented? Is it up to the employee to file for the benefit through the unemployment office or does the employer file? At the state level, how is paid family leave reserved for? How is it administered? What job protections are there? How does this work with the Family Medical Leave Act? Get these and more questions answered. By attending this session, you should have an understanding of the state Paid Family Leave programs, what it means to future short term disability plans, and how the state accounts for this program.

Description: The supplemental health market is changing. Carriers are looking to simplify claims processes, proactively identify missed claim opportunities, and reduce barriers to claim payment. As a result, more and more companies are looking at ways to use data from medical diagnostic and treatment codes. Take an introductory look at the most used medical codes—ICD (9 and 10), CPT, and HCPCS. Discuss the history and purpose of each code system and decipher the structure. Dive into how medical codes can be used in the supplemental health market (automatic claims adjudication, fraud identification, pricing), as well as common pitfalls encountered when using medical coding. By attending this session, you will have a basic understanding of the different types of medical codes, their actuarial applications, and common pitfalls.

Description: Wellness programs are being piloted across the long-term care industry. Review what types of programs exist, when they are deployed, and how to measure their success. By attending this session, you will be able to navigate the hurdles faced by insurers in implementing a successful intervention program for long-term care insurers.

Description: Session 2– Going Deeper through examples InsurTech (1) identifies a pain point to the industry, (2) brings a technology solution to address the shortcoming with a (3) business model that makes sense for all. Expect an illustration of this three-point structure through a handful of start-ups from various backgrounds (health, life, general operation) dealing with various aspects of the insurance value chain (acquisition, risk management, back-office…).