On Nov. 9, the Health Solvency Subcommittee provided the NAIC’s Capital Adequacy (E) Task Force an update on the evaluation of asset risk in the health risk-based capital formula.
The Medicare Supplemental Work Group sent answers Nov. 10 to the NAIC’s Medicare Supplement Refund Subgroup concerning questions regarding the work group’s recommendations on modifications to the Medicare supplement refund formula.
Academy work groups continued their dialog with insurance regulators at the NAIC’s Fall National Meeting in November. The Cancer Claims Cost Tables Work Group presented to the NAIC’s Health Actuarial Task Force (HATF) the produced graduated valuation tables and sample reserve calculations. The Long-Term Care Terminations Work Group sent its final report to the NAIC’s Long-Term Care Actuarial Working Group on terminations for long-term care insurance. The Individual Disability Tables Work Group presented an updated incidence modifiers report for use in active life reserve calculations for employer-sponsored disability income policies, along with a corresponding memo, to the HATF chairperson.
On Dec. 3, the Premium Review Work Group released a practice note on Actuarial Practices Relating to Preparing, Reviewing, and Commenting on Rate Filings Prepared in Accordance with the Affordable Care Act. The practice note addresses ACA-compliant plans only and provides information on issues related to 2014 market reforms, effective rate review, state requirements, the unified rate review template, and the actuarial memorandum.
Updates the benefit year 2017 risk adjustment factors using a data set that incorporates the 2014 MarketScan data when it becomes available in December.
Sets a separate, lower default risk adjustment charge for small issuers effective for the 2016 benefit year.
Sets a federally facilitated marketplace user fee rate of 3.5 percent for 2017 and a state-based marketplace rate (using the federal platform) of 3.0 percent.
Establishes the maximum annual limitation on cost sharing at $7,150 for individuals and $14,300 for family coverage.
Subjects issuers of student health insurance plans to the single risk pool index rating methodology.
Requires issuers to submit the unified rate review template (URRT) for all single risk pool products for rate increases, decreases, and no changes.
Sets the open enrollment period from Nov. 1, 2016, to Jan. 31, 2017.
Includes several provisions on network adequacy related to minimum standard, continuity of care, and cost sharing.
Adds a third employee choice option for the federally facilitated Small Business Health Options Program for plan years beginning Jan. 1, 2017.
Reduces the 2016 attachment point of $90,000 to pay any remaining contribution amounts for the 2016 benefit year.
Makes several adjustments to the risk corridor program for 2015 and 2016.
In the News/Media Activities
The Gallup organization used the Academy’s analysis of factors contributing to ACA premium rate changes to provide context to its release of an annual poll of Americans regarding whether health insurance premiums have gone up. Several news sites and blogs republished Gallup’s story.
The CMS’s requirement that capitation rates be certified by an Academy member was cited in an opinion pieceThe Hill on Medicaid rate-setting.
A Society for Human Resource Management article noted the Academy’s analysis of definitional changes of small employers in a story about California’s small group market expansion.
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