Health Care Reform Challenge: An Actuarial Perspective
|
|
- Curtis Heath
- 5 years ago
- Views:
Transcription
1 Health Care Reform Challenge: An Actuarial Perspective Cori E. Uccello, FSA, MAAA, MPP Senior Health Fellow American Academy of Actuaries NCSL 2007 Annual Meeting August 7, 2007 Boston, MA NCSL Presentation, August 7,
2 Outline Risk pooling basics Issue and rating rules Ways to minimize adverse selection Premium rate setting process NCSL Presentation, August 7,
3 Risk Pooling Basics Risk pools are large groups of individuals (or groups) whose medical costs are combined to calculate premiums. Pooling risks together allows the costs of the less healthy to be subsidized by the healthy. In general, the larger the risk pool, the more predictable and stable the premiums can be. NCSL Presentation, August 7,
4 Risk Pooling Basics BUT, creating larger risk pools will not necessarily lower premiums. Must consider the size of the risk pool AND how it is comprised. If a pool attracts those with higher expected claims (i.e., adverse selection), premiums will be higher. Pools created as a by-product of membership in a group (i.e., group was created for purposes other than buying insurance) tend to be less subject to adverse selection. NCSL Presentation, August 7,
5 Risk Pooling Basics (cont.) Large employer groups Workers automatically obtain coverage as a side benefit to employment Small/medium size employers Workers automatically obtain coverage as side benefit to employment, but employers can move into and out of the insurance market Individual market Individuals enter insurance market for the express purpose of obtaining health insurance NCSL Presentation, August 7,
6 Issue and Rating Rules Balance the goals of access to health insurance and premium affordability Issue rule examples Guaranteed issue Allow underwriting Rating rule examples Pure community rating Modified community rating Experience rating NCSL Presentation, August 7,
7 Adverse Selection When medical insurance is voluntary, it is subject to adverse selection based on asymmetric knowledge of health conditions. Ways to minimize it or its effects: Mandate coverage Provide premium subsidies Default enrollment Penalty for delayed enrollment Risk adjustment NCSL Presentation, August 7,
8 The Rate Setting Process Measure prior health spending Adjust data to reflect the future Use data to project future costs NCSL Presentation, August 7,
9 Premium Components Claim costs Administrative costs Distribution costs Billing and enrollment Underwriting Claims adjudication and anti-fraud Product development Regulatory compliance Taxes, assessments, and fees Underwriting profit/contribution to surplus NCSL Presentation, August 7,
10 Claim Costs One method of calculating claim costs = ( Utilization Average Patient Frequency * Cost of Cost of Service Service Sharing Aggregated over all service categories ( NCSL Presentation, August 7,
11 Claim Costs (cont.) Vary by plan design (e.g., deductibles, copays, coinsurance, benefit limits) Higher cost sharing reduces plan spending Net outpatient share of spending Potentially lower utilization Specific benefits covered Different benefits will have different impacts on costs Limits on specific benefits must also be considered Coverage mandate vs. coverage offer mandate NCSL Presentation, August 7,
12 Bottom Line Premiums depend on many factors Enrollee population characteristics Plan design and benefit package State and federal regulations Risk pooling mechanism Administrative mechanisms NCSL Presentation, August 7,
The Shocking Truth Behind ACA Premium Changes: It s Complicated
The Shocking Truth Behind ACA Premium Changes: It s Complicated Audrey L. Halvorson, FSA, MAAA Chair, Rate Review Practice Note Work Group Cori E. Uccello, FSA, MAAA, MPP Senior Health Fellow May 17, 2013
More informationHealth Reform in the 21 st Century: Proposals to Reform the Health System. Committee on Ways and Means U.S. House of Representatives June 24, 2009
Health Reform in the 21 st Century: Proposals to Reform the Health System Committee on Ways and Means U.S. House of Representatives June 24, 2009 Statement Submitted for the Record by Cori E. Uccello,
More informationCommittee on Ways and Means U.S. House of Representatives. Hearing on Expanding Coverage of Prescription Drugs in Medicare.
Committee on Ways and Means U.S. House of Representatives Hearing on Expanding Coverage of Prescription Drugs in Medicare April 9, 2003 Statement of Cori E. Uccello, FSA, MAAA, MPP Senior Health Fellow
More informationNCOIL Spring Meeting. Putting A Premium on Health: The Affordable Care Act & Underwriting
NCOIL Spring Meeting Putting A Premium on Health: The Affordable Care Act & Underwriting Joyce E. Bohl, MAAA, ASA Member, Federal Health Committee March 8, 2014 Agenda Overview of rating Individual and
More informationComparing Health Benefit Plans: Demystifying Actuarial Equivalence
Comparing Health Benefit Plans: Demystifying Actuarial Equivalence John M. Bertko, MAAA, FSA American Academy of Actuaries Cori E. Uccello, MAAA, FSA, FCA, MPP Senior Health Fellow American Academy of
More informationThe Academy and Health Reform
The Academy and Health Reform Cori E. Uccello, FSA, MAAA, MPP Senior Health Fellow American Academy of Actuaries CAS Annual Meeting, Session C-25 November 10, 2010 Washington, DC Overview Key provisions
More informationAffordable Care Act: Potential Legislative and Administrative Actions
Affordable Care Act: Potential Legislative and Administrative Actions Shari Westerfield, MAAA, FSA Vice President, Health Practice Council Health Insurance and Managed Care (B) Committee Spring Meeting;
More informationWhat Every Actuary Should Know About Medicare From Structure to Reform
What Every Actuary Should Know About Medicare From Structure to Reform Cori E. Uccello, FSA, MAAA, MPP Senior Health Fellow, American Academy of Actuaries Thomas F. Wildsmith, FSA, MAAA Vice President
More informationAffordable Care Act: Potential Legislative and Administrative Actions
Affordable Care Act: Potential Legislative and Administrative Actions Shari Westerfield, MAAA, FSA Vice President, Health Practice Council Health Actuarial Task Force Spring Meeting; Denver; April 7, 2017
More informationThe Latest Findings on National Health Spending From CMS
The Latest Findings on National Health Spending From CMS Lekha S. Whittle, Economist Office of the Actuary, Centers for Medicare & Medicaid Services Moderator: Cori Uccello, MAAA, FSA, FCA, MPP Senior
More informationElection 2004: A Guide to Analyzing the Issues. The Questions Candidates Should Answer About... Americans Without Health Insurance
Election 2004: A Guide to Analyzing the Issues The Questions Candidates Should Answer About... Americans Without Health Insurance Election 2004: A Guide to Analyzing the Issues The Questions Candidates
More informationLubbock Chamber of Commerce: Working for Business. Believing in Lubbock. Every Day.
Lubbock Chamber of Commerce: Working for Business. Believing in Lubbock. Every Day. Eddie McBride, President Texas Association of County Auditors Healthcare General Information, New Legislation and Impact
More informationMassachusetts Risk Adjustment Program: Executive Summary
Massachusetts Risk Adjustment Program: Executive Summary Introduction Wakely Consulting Group, Inc. has been retained by issuers in the Massachusetts market to review the methodology of the Massachusetts
More informationSTATE HIGH RISK POOLS
STATE HIGH RISK POOLS Deborah Chollet, Senior Fellow Mathematica Policy Research October 3, 2008 Overview What is a high risk pool? Why high risk pools? Who can enroll? Why low enrollment? How could they
More informationIMPACT ON MEMBERS AND PREMIUMS OF COVERING THE COST OF THE UNFUNDED COST SHARING REDUCTION PROGRAM
IMPACT ON MEMBERS AND PREMIUMS OF COVERING THE COST OF THE UNFUNDED COST SHARING REDUCTION PROGRAM FEBRUARY 14, 2019 Kurt Giesa, FSA, MAAA Peter Kaczmarek, FSA, MAAA Contents Contents 1. Executive Summary...
More informationHealth Insurance Glossary of Terms
1 Health Insurance Glossary of Terms On March 23, 2010, President Obama signed the Patient Protection and Affordable Care Act (PPACA) into law. When making decisions about health coverage, consumers should
More informationRisk selection and risk classification, commonly known as underwriting,
A American MARCH 2009 Academy of Actuaries The American Academy of Actuaries is a national organization formed in 1965 to bring together, in a single entity, actuaries of all specializations within the
More informationRE: 2019 Medicare Supplement Rates for Modernized Plans
July 31, 2018 The Honorable Ralph T. Hudgens Georgia Insurance Department Seventh Floor, West Tower Floyd Building 2 Martin Luther King, Jr. Drive Atlanta, Georgia 30334 RE: 2019 Medicare Supplement Rates
More informationKeeping up with the new health care reform law 14376VAEENBVA Rev. 9/10 anthem.com
Keeping up with the new health care reform law Helping you better understand what to expect and when to expect it. 14376VAEENBVA Rev. 9/10 anthem.com 1 Staying up to date Here s a timeline of what you
More informationNFIB v. Kathleen Sebelius and its Impact on Employers: Healthcare Reform Revisited
July 5, 2012 NFIB v. Kathleen Sebelius and its Impact on Employers: Healthcare Reform Revisited The Patient Protection and Affordable Care Act (the Affordable Care Act ) imposes new requirements on individuals
More informationHealth Plan Financial and Statistical Report (HPFSR) Instructions
2017 (HPFSR) Instructions Completion and submission of this report is required by Minnesota Statutes, section 62J.38, and Minnesota Rules, chapter 4652. Division of Health Policy TABLE OF CONTENTS Statutory
More informationTexas Association of County Auditors On the Road Area Training January 16, 2014
Texas Association of County Auditors On the Road Area Training January 16, 2014 Health Care Reform: What Counties Need to Know Presented by: Texas Association of Counties Lisa McCaig, Employee Benefits
More informationThe Commonwealth Fund
www.wakely.com Analysis of Alternative Policy Decisions in Iowa s Individual Market May 25, 2019 Prepared by: Wakely Consulting Group Julie Andrews, FSA, MAAA Senior Consulting Actuary Michael Cohen, PhD
More informationCommon Managed Care Terms & Definitions
Contact Us: Email: info@emedbiz.com Phone: 561-430-2090 Fax: 561-430-2091 Website: www.emedbiz.com Common Managed Care Terms & Definitions Balance billing: The practice of billing a patient for the amount
More informationFinancial Reporting Implications Under the Affordable Care Act
Financial Reporting Implications Under the Affordable Care Act Laurel A. Kastrup, MAAA, FSA Chairperson, Health Practice Financial Reporting Committee Darrell D. Knapp, MAAA, FSA Member, Health Practice
More informationMedicare Reform Options
1 Medicare Reform Options Cori E. Uccello, MAAA, FSA, FCA, MPP Senior Health Fellow, Thomas F. Wildsmith, MAAA, FSA Chairperson, Medicare Steering Committee June 11, 2007 Noon 1:00 pm HC-7 Capitol Building
More informationArticle from: The Actuary Magazine. October/November 2014 Volume 11, Issue 5
Article from: The Actuary Magazine October/November 2014 Volume 11, Issue 5 THE ACA COST PREDICTABILITY QUESTION Will the exchange populations have sufficient cost predictability to allow insurance organizations
More informationACA impact illustrations Individual and group medical New Jersey
ACA impact illustrations Individual and group medical New Jersey Prepared for and at the request of: Center Forward Prepared by: Margaret A. Chance, FSA, MAAA James T. O Connor, FSA, MAAA 71 S. Wacker
More informationAnthem Blue Cross Life and Health Insurance Company Actuarial Memorandum Individual Rates effective September 1, 2010
Anthem Blue Cross Life and Health Insurance Company Actuarial Memorandum Individual Rates effective September 1, 2010 The purpose of this filing is to establish rates for the forms below and certify that
More informationMedicare and Patient Assistance
Medicare and Patient Assistance Sean M. Dougherty Senior Director Medicare Strategy & Patient Assistance Programs Government, Public Policy And Managed Markets Medicare and Patient Assistance Summary AstraZeneca
More informationArticle from: Health Watch. January 201 Issue 7
Article from: Health Watch January 201 Issue 7 Using the Minimum Value Calculator By Juan Herrera Juan Herrera, FSA, MAAA, is an actuary at Kaiser Permanente in Atlanta, Ga. He can be reached at juan.l.herrera@kp.org.
More informationSession 22 IF, ACA Transitional Solvency Risks. Moderator/Presenter: Samuel C. Vorderstrasse, FSA, MAAA
Session 22 IF, ACA Transitional Moderator/Presenter: Samuel C. Vorderstrasse, FSA, MAAA Presenter: Armen Garnikovich Akopyan, ASA, MAAA 2016 SOA Health Meeting Sam Vorderstrasse, FSA, MAAA Armen Akopyan,
More informationNavajo County Schools EBT
Navajo County Schools EBT Affordable Care Act (ACA) Update Aaron Polkoski Segal Consulting January 31st, 2014 Copyright 2013 by The Segal Group, Inc., parent of The Segal Company. All rights reserved.
More informationIMPLICATIONS OF THE AFFORDABLE CARE ACT FOR COUNTY EMPLOYERS
IMPLICATIONS OF THE AFFORDABLE CARE ACT FOR COUNTY EMPLOYERS Mississippi Association of Supervisors Annual Convention Biloxi, Mississippi June 20, 2013 Presented by Leslie Scott MAS General Counsel Group
More informationUNDERSTANDING HEALTH PLANS in the Health Insurance Marketplace
UNDERSTANDING HEALTH PLANS in the Health Insurance Marketplace Consumers Mutual Insurance of Michigan Jayson Welter, Legal and Chief Compliance Officer Holly Wilson, Regional Outreach Manager Consumers
More informationThe Affordable Care Act (ACA) What are the Financial Impacts to your Business? Presented For: Dallas CPA Society May 8 th, 2013
The Affordable Care Act (ACA) What are the Financial Impacts to your Business? Presented For: Dallas CPA Society May 8 th, 2013 Employer Questions Is the transitional reinsurance fee tax deductible? What
More informationShaping a Partnership in Voluntary Benefits ACA Solutions
Shaping a Partnership in Voluntary Benefits ACA Solutions Annual Survey of Americans' Views on Health Care and the ACA Finds Nearly Half of Remaining Uninsured are Unaware of the Individual Mandate or
More informationProvisions of the Medicare Modernization Act
Provisions of the Medicare Modernization Act Medicare Prescription Drug Modernization and Improvement Act of 2003 (MMA) Todd Whitney, FSA, MAAA Wakely Consulting Group Highlights of New Act New Rx Benefit
More informationIMPLEMENTATION OF HEALTH CARE REFORM
IMPLEMENTATION OF HEALTH CARE REFORM By Randall B. Weill, Esq. Since it became effective on September 23, 2010, implementation of the Patient Protection and Affordable Care Act of 2010 (Public Law 111-148),
More informationRising Health Care Costs: What s the Diagnosis?
Rising Health Care Costs: What s the Diagnosis? A Luncheon Briefing presented by the American Academy of Actuaries November 10, 2005 Moderator Cori Uccello, MAAA, FSA, FCA, MPP Senior Health Fellow, American
More informationAFFORDABLE CARE ACT: STATUS CHART Health Plans
AFFORDABLE CARE ACT: STATUS CHART Health Plans July 2017 TODD MARTIN, PARTNER 612.335.1409 todd.martin@stinson.com Table of Contents Page ACA Coverage Mandates... 1 ACA Insurance Market Rules... 5 ACA
More informationSTATE OF CONNECTICUT
STATE OF CONNECTICUT INSURANCE DEPARTMENT Finding of Facts Celtic Insurance Company Individual 2016 Off Exchange Rate Filing 1. This filing is a rate submission for the Celtic ACA-compliant individual
More informationHealth Care Reform Overview
Publication date: March 2014 Health Care Reform Overview for Large Group (51+) Plans The following chart provides a breakdown of key Affordable Care Act (ACA) provisions by year for large group plans,
More informationTRENDS IN THE LARGE EMPLOYER GROUP SPACE
SEAC 2013 Fall Meeting TRENDS IN THE LARGE EMPLOYER GROUP SPACE James MacDougall ACA Note: The information provided herein is not intended to provide legal and/or accounting advice and should not be relied
More informationESSENTIAL CRITERIA TO CONSIDER IN LONG-TERM CARE REFORM
ESSENTIAL CRITERIA TO CONSIDER IN LONG-TERM CARE REFORM LINDA CHOW, FSA, MAAA PRESENTER; MEMBER, LTC CRITERIA WORK GROUP CHRIS GIESE, FSA, MAAA PRESENTER; MEMBER, LTC CRITERIA WORK GROUP DAVID LINN MODERATOR;
More information2014 and Beyond. This timeline explains how and when the Affordable Care Act (ACA) provisions will be implemented over the next few years.
December This timeline explains how and when the Affordable Care Act (ACA) provisions will be implemented over the next few years. Get Covered Illinois, the Official Health Marketplace of Illinois While
More informationHealth Care Reform. Navigating The Maze Of. What s Inside
Navigating The Maze Of Health Care Reform What s Inside Questions and Answers on Health Care Reform Health Care Reform Timeline Health Care Reform Glossary Questions and Answers on Health Care Reform I
More informationUnderstanding the ACA: Rate Filing Review and Disclosure
Understanding the ACA: Rate Filing Review and Disclosure Joyce Bohl, MAAA, ASA Member, Rate Review Practice Note Work Group Brian Collender, MAAA, FSA Member, Rate Review Practice Note Work Group David
More informationHealth Care Reform. PPACA at 30,000 Feet. Coverage Expansions and Market Reforms
Health Care Reform Karl Ahlrichs, SPHR. Gregory & Appel April 19, 2013 www.bizlearning.net PPACA at 30,000 Feet Coverage Expansions and Market Reforms Temporary high risk pools; individual mandate, elimination
More informationConditional Award of the 2019 Seal of Approval (VOTE)
Conditional Award of the 2019 Seal of Approval (VOTE) EMILY BRICE Deputy Chief of Policy & Strategy MARIA JOY DAWLEY Senior Product Manager, Health & Dental Plans EDITH BOUCHER CALVAO, FSA, MAAA Actuary
More informationMinimum Value and Actuarial Value Determinations Under the Affordable Care Act
Minimum Value and Actuarial Value Determinations Under the Affordable Care Act Catherine Jo Erwin, MAAA, FSA Member, MV/AV Practice Note Work Group John Stenson, MAAA, FSA Chairperson, MV/AV Practice Note
More informationHealth Care Reform. Employer Action Overview
Health Care Reform Page 2 of 10 Health Care Reform Immediatemmediate Employer Action Required Notes Nursing Mothers Employers must provide a reasonable break time for employees who are nursing mothers
More informationPublic sector employers already face growing financial. How Public Sector Employers Can Manage Retiree Health Liabilities. Retirement Strategies
Retirement Strategies How Public Sector Employers Can Manage Retiree Health Liabilities Changes in the Governmental Accounting Standards Board (GASB) reporting requirements will increase the liabilities
More informationPatient Protection and Affordable Care Act of 2009: Health Insurance Market Reforms
Patient Protection and Affordable Care Act of 2009: Health Insurance Market Reforms Provision Notes Standards SUBTITLE C Quality Health Insurance Coverage for All Americans PART I HEALTH INSURANCE MARKET
More informationStatewide Medicaid Managed Care
Statewide Medicaid Managed Care Justin M. Senior Deputy Secretary for Medicaid Agency for Health Care Administration Senate Health Policy Committee March 4, 2015 As requested by the Committee, this presentation
More informationHEALTH FLEX PLAN PROGRAM
HEALTH FLEX PLAN PROGRAM Annual Report January 2016 Agency for Health Care Administration 2727 Mahan Drive, MS 45 Tallahassee, FL 32308 1-850-412-4502 http://www.floridahealthfinder.gov http://ahca.myflorida.com
More informationLiz Mason, CISR Employee Benefits Specialist John Dumbaugh Managing Partner
John Dumbaugh Managing Partner john@dumbaughinsurance.com 740.397.1234 740.398.9199 mobile John has worked in the insurance industry for 19 years and is currently working on his CIC designation (Certified
More informationR. Neil Vance, FSA Managing Actuary, NJDOBI Philadelphia Actuaries Club Feb. 19, 2008
R. Neil Vance, FSA Managing Actuary, NJDOBI Philadelphia Actuaries Club Feb. 19, 2008 This paper and talk are the opinions and analysis of the author. They do not reflect the point of view of the government
More informationMedical Loss Ratio (MLR)
Medical Loss Ratio (MLR) 1 Items to be Discussed The role of actuarial estimates and the MLR The federal rebate formula and rating with a single risk pool Developing premium rates using an MLR approach
More informationUnderstanding the Impacts of Health Care Reform on Employers : 2014 and beyond
2013 CliftonLarsonAllen LLP Understanding the Impacts of Health Care Reform on Employers : 2014 and beyond cliftonlarsonallen.com Peoria County Bar Association January 25, 2014 Deb Freeland Objectives
More informationIn The Public Interest
Article from: In The Public Interest July 2010 Issue 2 Principles of Actuarial Science and the New Health Care Reform Law By Mark Litow In late March of 2010, Congress passed and the President signed a
More informationHEALTH CARE REFORM: THE EMPLOYER PERSPECTIVE
www.bakerdaniels.com HEALTH CARE REFORM: THE EMPLOYER PERSPECTIVE Prepared and Presented by: Michael J. Nader Baker & Daniels LLP 111 East Wayne Street, Suite 800 Fort Wayne, IN 46802 260.460.1743 michael.nader@bakerd.com
More informationUsing Actuarial Science to Make Smarter Employee Benefit/Financial Decisions
Using Actuarial Science to Make Smarter Employee Benefit/Financial Decisions John Marshall, FSA, MAAA, Principal Windsor Strategy Partners August 29, 2018 Overview Traditional Actuarial Services Non-Traditional
More informationHealthcare Reform Better Care Reconciliation Act Repeal & Replace
BCRA AHCA American Health Care Act Healthcare Reform Better Care Reconciliation Act Repeal & Replace ACA HCR Affordable Care Act BCRA, AHCA and ACA On June 22, 2017, Senate Republicans released the Better
More informationRE: CMS-9929-P, Patient Protection and Affordable Care Act; Market Stabilization
March 7, 2017 The Honorable Tom Price Secretary U.S. Department of Health and Human Services Hubert H. Humphrey Building 200 Independence Avenue, SW Washington, DC 20201 RE: CMS-9929-P, Patient Protection
More informationEmployer Mandate: Employer Action Overview
HEALTH CARE REFORM Employer Mandate: Page 2 of 11 Immediatemmediate Employer Action Required Notes Nursing Mothers Employers must provide a reasonable break time for non-exempt employees who are nursing
More informationNorth Carolina Department of Insurance
North Carolina Department of Insurance North Carolina Actuarial Memorandum Requirements for Rate Submissions Effective 1/1/2019 and Later Individual Market Non-grandfathered Business These actuarial memorandum
More informationRSM THE POWER OF BEING UNDERSTOOD AUDIT I TAX I CONSULTING
THE POWER OF BEING UNDERSTOOD AUDIT I TAX I CONSULTING RSM Contents Independent Auditor's Report 1-2 Financial Statements Statutory statements of admitted assets, liabilities, and capital and surplus 3
More informationEnacted in March 2010 Makes significant ifi changes to health care system Implemented over several years
Health Care Reform: Top Employer Questions October 2013 Nancy Johnson Tommy Morris Agency LLC Introduction Health Care Reform Affordable Care Act Enacted in March 2010 Makes significant ifi changes to
More informationTHE AHP, SHORT-TERM DURATION AND HRA RULES: WHAT S THE LATEST?
THE AHP, SHORT-TERM DURATION AND HRA RULES: WHAT S THE LATEST? Panel Al Bingham, Chair, Academy Risk Sharing Subcommittee Joyce Bohl, Vice-chair, Academy Individual & Small Group Markets Comm. Juan Herrera,
More informationMEASURING THE IMPACT OF POINT OF SALE REBATES IN COLORADO S COMMERCIAL MARKET
MEASURING THE IMPACT OF POINT OF SALE REBATES IN COLORADO S COMMERCIAL MARKET FEBRUARY 2019 Anna Bunger, FSA, MAAA Jason Gomberg, FSA, MAAA Jason Petroske, FSA, MAAA Sharing Pharmacy May Lower Patient
More informationThe Affordable Care Act: Time to Prepare for 2014 and Beyond
The Affordable Care Act: Time to Prepare for 2014 and Beyond Howard Van Mersbergen Vice President of Employee Benefits, Christian Schools International Brian C. Meekhof Benefits Administrator, Christian
More informationComplying with Health Care Reform
Complying with Health Care Reform April 17, 2013 1 1 What Happened? In March 2010, Congress passed and the President signed health reform in: The Patient Protection and Affordable Care Act The Health Care
More informationActuarial Value under the ACA Kristi Bohn September 24, 2015
Actuarial Value under the ACA Kristi Bohn September 24, 2015 2 Small Group and Individual Overview Individual & Small Group Individual Markets Non-Grandfathered versus Grandfathered MNsure use at approximately
More informationProposed Affordability Schedule for Calendar Year 2018 (VOTE) MARISSA WOLTMANN Director of Policy and Applied Research
Proposed Affordability Schedule for Calendar Year 2018 (VOTE) MARISSA WOLTMANN Director of Policy and Applied Research Board of Directors Meeting, February 23, 2017 Today s Focus Background on the affordability
More informationNorth Carolina Department of Insurance
North Carolina Department of Insurance North Carolina Actuarial Memorandum Requirements for Rate Submissions Effective 1/1/2019 and Later Small Group Market Non-grandfathered Business These actuarial memorandum
More informationHealth Care Reform: The Financial Impact on the Employer
Health Care Reform: The Financial Impact on the Employer WP&BC August 15, 2012 1 1 Supreme Court Examines Constitutionality U.S. Supreme Court Ruling: June 28, 2012 Individual Mandate - Constitutional
More informationMYTHS & REALITIES OF HEALTH CARE REFORM
MYTHS & REALITIES OF HEALTH CARE REFORM The Florida Bar Solo & Small Firm Annual Conference January 25, 2014 Presented By: Kirsten Vignec Shareholder Introduction On March 23, 2010, the Patient Protection
More informationMEDICARE PART D PRESCRIPTION DRUG EVENTS (PDE) RECONCILIATION
MEDICARE PART D PRESCRIPTION DRUG EVENTS (PDE) RECONCILIATION 2-06-15 Presented by: Alexander Luong, Pharm.D. Candidate 2015 University of the Pacific Preceptor: Dr. Craig Stern, Pharm.D. MBA President,
More informationRick Curtis, President Institute for Health Policy Solutions
Promise and Pitfalls of Pool/Exchange and Tax Savings to Reach Working Uninsured Rick Curtis, President Institute for Health Policy Solutions The Changing Health Insurance Landscape The Center for Health
More informationHealth Care Reform Update
Health Care Reform Update Presented by David Hayes, FSA, MAAA Consulting Actuary Milliman - Atlanta November 16, 2012 Southeastern Actuaries Conference Fall 2012 Agenda This will be an general session
More informationStatus: Time: 12:00 pm. Date: 3/19/10
Federal Health System Reform 2010: An Update March 19, 2010 1 Status: Time: 12:00 pm. Date: 3/19/10 House votes: Saturday, Rules Committee 9:009 am Sunday, Floor consideration begins at 2:07 pm Process:
More informationComparison of ACA and STLD Coverage Requirements and Implications for the ACA Markets
April 6, 2018 Centers for Medicare & Medicaid Services Department of Health and Human Services Room 445 G, Hubert H. Humphrey Building 200 Independence Avenue SW Washington, DC 20201 Re: CMS 9924 P Short-Term,
More informationState of Florida Qualifying Status Change Event Matrix
A. Change in Enrollee s Legal Marital Status Marriage 1. Legally recognized marriage between two persons under any state or foreign law at the time the marriage was entered into by the parties. Common
More informationThe Affordable Care Act s Employer Mandate
The Affordable Care Act s Employer Mandate September 10, 2014 Starting in 2015, as you may by now have heard, the Patient Protection and Affordable Care Act (the Affordable Care Act or the Act ) generally
More informationSimple answers to health reform s complex issues facing every employer, and what you can do now to protect your business and your future.
Simple answers to health reform s complex issues facing every employer, and what you can do now to protect your business and your future. If you have any questions, please contact: Health Reform: A Guide
More informationThe Impact of the ACA on Wisconsin's Health Insurance Market
The Impact of the ACA on Wisconsin's Health Insurance Market Prepared for the Wisconsin Department of Health Services July 18, 2011 Gorman Actuarial, LLC 210 Robert Road Marlborough, MA 01752 Jennifer
More informationPart 3 Actuarial Memorandum
1. GENERAL INFORMATION Insurance Company Name Cigna HealthCare of North Carolina NAIC Company Code 95132 HIOS Issuer ID 73943 State North Carolina Market Type Individual Proposed Effective Date 01/01/2019
More informationThe Effect of the ACA on Self-Funded Plans & Free Market Providers PRESENTED BY: Maria Robles Meyers, Esq. Health Law Advisors, PLLC August 21, 2015
The Effect of the ACA on Self-Funded Plans & Free Market Providers PRESENTED BY: Maria Robles Meyers, Esq. Health Law Advisors, PLLC August 21, 2015 Glossary of Terms You have been provided a glossary
More informationHealth Care Reform Pay or Play Rules Applicable to Colleges and Universities. May 17, Patrick M. Allen
Health Care Reform Pay or Play Rules Applicable to Colleges and Universities May 17, 2013 Patrick M. Allen Health Care Reform: An Overview Phase I: 2010 2013 New patient protections Administrative changes
More informationHealth Care Reform Update:
Health Care Reform Update: The Employer Mandate and Other Considerations for 2013 February 13, 2013 Today s Agenda Health Care Reform three new concepts Strategic Decisions for Employers in 2013 - Will
More informationHEALTH CARE REFORM 2010 An explanatory summary from Cho Chan, Updated May 2010
HEALTH CARE REFORM 2010 An explanatory summary from Cho Chan, Updated May 2010 The long battle for this Health Care Reform finally came to an end, and the Reform became law in March 2010. The History On
More informationHealth Insurance Exchange Summit West. Employer Health Insurance Exchange Strategies
www.pwc.com Health Insurance Exchange Summit West Employer Health Insurance Exchange Strategies November, 2013 Agenda Key strategic considerations for employers How to play and when to pay Bending the
More informationHealth Care Reform Timeline Last Updated: March 12, 2014
Health Care Reform Timeline Last Updated: March 12, 2014 On March 23, 2010, President Obama signed into law the Patient Protection and Affordable Care Act ( PPACA or ACA or Health Care Reform ). Health
More informationIndividual Insurance Market Performance in Mid- 2018
October 2018 Issue Brief Individual Insurance Market Performance in Mid- 2018 Rachel Fehr, Cynthia Cox and Larry Levitt Despite concerns about the stability of the individual insurance market under the
More informationIllinois Municipal League 97 th Annual Conference
Illinois Municipal League 97 th Annual Conference Health Care Reform Panel Jay Dee F. Shattuck, CAE Shattuck & Associates Consulting, Inc Shattuck & Associates Consulting, Inc., 600 Phone: 217 544 5490
More informationChoosing Between Traditional Medicare and Medicare Advantage
Choosing Between Traditional Medicare and Medicare Advantage If you are eligible for Medicare you can chose between getting Medicare benefits through traditional Medicare (also known as original Medicare
More informationIt is intended to be a Qualified Long-Term Care Insurance contract under the Federal Internal Revenue Code.
John Hancock Life Insurance Company (U.S.A.) Product Name Form Number Issue Date Range Group Long Term Care GPB-SPR-0007.02 June 1998 - October 2012 1. Scope & Purpose This memorandum consists of materials
More informationA Guide to Medicare s s Financial Challenges and Options for Improvement. May 22, 2012 *updated*
A Guide to Medicare s s Financial Challenges and Options for Improvement May 22, 2012 *updated* May 2012 American Academy of Actuaries American Academy of Actuaries 17,000-member professional association
More information03 14 EXECUTIVE BRIEF Understanding the ACA
03 14 EXECUTIVE BRIEF Understanding the ACA By Stephen J. Adams, Acting Director of Research and Education; Jules Clark, Research Analyst; Luke Delorme, Research Fellow How the Affordable Care Act Affects
More information