Description: The health insurance industry has historically used several factors to develop premium rates. Many of these, e.g. gender rating, have been largely eliminated from health insurance rating practices by regulations as the Patient Protection and Affordable Care Act (ACA) because they were determined as inequitable. However, several other factors still remain as differentiators in premium rates charged to individuals and groups. In conjunction with the SOA, researchers studied whether there could be ‘ghost’ rating factors, like race, ethnicity, or socioeconomic status, that are inherently included in some of these remaining allowable factors. Review results and opportunities for future research. By attending this session, you will be challenged to think about traditional rating factors in a different way. Rather than focusing on whether certain factors are sound based on the underlying claims cost, this session will focus on whether or not these factors are impacting certain socioeconomic or racial/ethnic groups disparately.

Description: How does mortality experience impact earnings under the new GAAP financial framework? This article discusses how to isolate key components from financial models related to decrements, as well as how to handle the changes in the financial reporting landscape including: the aggregation of insurance policies into cohorts, dynamic reserving, and the limitations imposed by caps and floors. Looking at the components of earnings, such as the present value of benefits, expenses, and premiums, and how these elements interact is critical to form a comprehensive earnings story.

Description: Cost sharing reduction (CSR) payments are offered to low-income individual insurance buyers under the ACA. After October 2017, the difference in costs between the standard silver plan and CSR variants were defunded. To cover the costs of defunding, insurers have increased rates either through "broad loading" or "silver loading." States are approaching this adjustment differently, which is leading to some interesting differences between states. This article will review these differences.

Description: It is with great pleasure that we announce the winner of the “2024 Best Article” in Reinsurance News. Amongst a pool of exceptional articles, the article “What Does the Future of Mortality Look Like?” submitted by Adam Jedynak and Connie Cheng was chosen by the jury as the victorious submission. The article appeared in the June 2024 issue of Reinsurance News. It explores recent shifts in mortality, including post-COVID excess mortality, and looks at the impact of medical advancements and societal changes on mortality.

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: Panel discussion of managers of actuaries discussing do's and don'ts of managing actuaries in a virtual world. When employees no longer come into the office five days per week, eight hours each day, how do you maintain productivity, team building, morale? How do you facilitate team work and ensure camaraderie is improved? The great reset, not the great resignation! As employees figure out if they want to be 100% remote, or 100% in the office, or somewhere in between, and employers determine their stance on in-office for virtual, the actuarial workforce is resetting itself with employees finding their lifestyle match with employers. Zoom, Teams, WebEx - 'you're on mute' might be the most used business phrase in the past 4 years! Managers can glean helpful insights that will make them more effective managing their actuarial teams.