Academy Activities

A webinar on the Academy’s Large Group Medical Insurance Reserves, Liabilities, and Actuarial Assets practice note will take place Sept. 27. Presenters will focus on updates to the practice note, which provides information for valuation actuaries on their responsibilities related to determining reserve levels and other actuarial assets and liabilities for large group medical insurance coverage.

On Sept. 20 (noon to 1 p.m. EST), the Academy’s Minimum Value Practice Note Work Group will host a webinar for health actuaries. The webinar will walk them through the exposure draft of the new practice note Minimum Value and Actuarial Value Determinations Under the Affordable Care Act, including a discussion of plan designs not accommodated by the calculators.

The Academy’s Medical Loss Ratio Work Group submitted a comment letter on Sept. 6 to the Centers for Medicare and Medicaid Services reiterating earlier comments the work group made regarding a proposed rule implementing MLR requirements for Medicare Advantage and prescription drug (Part D) programs.

The Joint Committee on Retiree Health submitted comments on Aug. 30 to the Actuarial Standards Board (ASB) on revisions to a second exposure draft of ASOP No. 6, Measuring Retiree Group Benefit Obligations and Determining Retiree Group Benefits Program Periodic Costs or Prefunding Contributions. In addition, the Health Practice Council and Pension Practice Council sent a joint letter to the ASB regarding ASOP No. 6 indicating an intent to send further comments by the end of the month specifically addressing coordination of standards.

Legislative and Regulatory Updates

The Centers for Medicare and Medicaid Services (CMS) released a final rule on Aug. 30 outlining Affordable Insurance Exchanges standards. The rule establishes standards for eligibility appeals, verification of eligibility for minimum essential coverage, and treatment of incomplete applications. The rule also establishes additional consumer protections for privacy and security, clarifies the role of those helping consumers apply for exchange coverage, establishes non-discrimination standards for methods of premium payment, and sets forth provisions for a state’s operation of the Small Business Health Option Program (SHOP). The final rule is effective Sept. 29.

The Department of the Treasury released a proposed rule on Aug. 26 implementing a provision in the Affordable Care Act (ACA) that makes a tax credit available to certain small employers that provide insured health coverage to their employees. To qualify for the credit, the proposed rule states that an employer must have in effect a contribution arrangement that qualifies and have no more than 25 full-time employees (FTEs). The rule also states that the average annual wages of its FTEs must not exceed $50,000 (as adjusted for inflation for taxable years beginning after Dec. 31). Comments on the proposed rules are due by Nov. 25.

On Aug. 27, the Department of the Treasury released the final rule providing guidance on the payment requirements for not maintaining minimum essential coverage as mandated by the ACA. The final rule will be effective on Aug. 30.

In the News

Senior Health Fellow Cori Uccello was quoted in a Reuters article about ACA health care costs that was featured in The Denver Post, The Morning Call (Allentown, Pa.), and Yahoo!

In an article on pending health insurance exchange coverage prices, the Academy told LifeHealthPro that health premium oversight should include strong actuarial representation.

The Academy’s public policy practice note, Large Group Medical Insurance Reserves, Liabilities, and Actuarial Assets, was mentioned as a resource for reserve setting for health insurance in the Vita Advisors’ blog posting.

Upcoming Events

What Kinds of Data and Analyses Are Needed to Support Successful Payment and Delivery Reform?
Webinar: Sept. 13
Sponsor: Academy Health (no fee charged)

The 3rd Annual Dual Eligibles Best Practices 
Conference: Sept. 16–17, Lake Buena Vista, Fla.
Sponsor: Healthcare Education Associates (fee charged)

For a complete listing of upcoming and recent health care reform events click here.