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: More and more providers are desiring risk-based contracts instead of traditional FFS-based contracts. This session is intended to outline some of the actuarial best practices in risk-based contracting related to the many flavors of the CMS ACO programs, as well as Commercial risk-based contracts.

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: The process of setting initial and renewal premium rates for small group medical block of business using risk characteristics. Presents three pricing schemes and compares profitability Following the Curve, Lowest Best Rate and Highest Worst Rate.

Description: Presentation on estimating rates of early-onset Alzheimer's Disease. This document contains incident rates, critical illnese insurance information, adverse selection, and more.

Description: In this article, the author discusses the Georgia Uninsured Working Group and their recommendations on solutions for the uninsured in Georgia through new HRA/HSA laws. Issue No. 59

Description: This article relates the health insurance industry to baseball retain & grow business while making a profit, competition, additional product offerings, evaluating risks. Issue No. 59

Description: News from the American Academy of Actuaries

Description: The entire issue of Health Watch.

Description: When setting reserves, multiple methods are often used in the creation of the reserve estimate. Judgment is warranted to combine these different estimates into a final recommendation. This paper describes two techniques that can be used to combine these estimates that may result in better accuracy and lower variance.