American Academy of Actuaries-Health section

Al Bingham is the Academy's vice president for health issues. Cori Uccello is the senior health fellow.

Spotlight on health care reform

Critical Issues in Health Reform
The Academy is publishing a new series of papers entitled, Critical Issues in Health Reform. Each of the policy statements is designed to provide an actuarial perspective on various components of comprehensive health care reform proposals.

Risk Adjustment issue brief released
The Academy Health Practice Council released a new issue brief, Risk Assessment and Risk Adjustment. The brief provides an overview of risk adjustment and outlines general considerations for implementing a risk adjustment mechanism under PPACA.
Actuarial Equivalence
Administrative Expenses
Community Living Assistance Services and Supports (CLASS) Act
Gender Considerations in a Voluntary Individual Health Insurance Market and accompanying comments on the Women’s Health Insurance Fairness Act
Health Insurance Cooperatives
Individual Mandate
Market Reform Principles
Merging the Small Group and Individual Markets
Minimum Loss Ratios
Premium Setting in the Individual Market
Public Plan Option
Risk Pooling
State-Level Impact and State Characteristics
Transitioning Into New Markets
Value-Based Insurance Design

Shoring up Medicare

The Academy says the 2009 Medicare trustees’ report highlights the imperative to act immediately to address the challenges facing Medicare.

See the Academy issue brief on Medicare's financial condition
Read the Academy call to action for Medicare reform

Letter to the NAIC on draft rate-filing disclosure form

The Academy writes a comment letter on the NAIC's exposure draft of a rate-filing disclosure form that is intended to facilitate the reporting of unreasonable rate increases to HHS.

Letter to HHS on dependent coverage

The Academy writes a letter to HHS in response to an interim final rule on the PPACA provision that extends dependent coverage to age 26.

Letter to the NAIC on Covariance

On June 11, the Health Solvency work group sent a comment letter to the chair of the NAIC's Capital Adequacy Task Force regarding the evaluation of the current health risk-based capital covariance formula calculation for potential changes to the calculation or methodology.

DTA Bridge Group Report

The Academy's DTA Bridge Group submits a requested interim report to the NAIC Capital Adequacy Task Force showing the appropriate treatment of the Deferred Tax Asset (DTA) in the Risk-Based Capital formulas for Life, Property / Casualty (P&C), and Health.

Presentation on Health Reform Implementation

Academy Senior Health Fellow Cori Uccello presents during a June 15 American Enterprise Institute event, offering an actuarial perspective on health care reform implementation.

Letter to NAIC on Contract Reserves

The Academy writes a letter to the chair of the NAICs Accident and Health Working Group offering input on the potential inclusion of a change in contract reserves in the numerator of the MLR rebate calculation.

Letter to HHS on Early Retiree Reinsurance

The Academy writes a letter to the Department of Health and Human Services in response to an interim final rule on the PPACA provision that creates a temporary reinsurance program for early retirees.

Letter to NAIC regarding Health Annual Statement Instructions

The Health Practice Financial Reporting Committee sent a comment letter to the chair of the National Association of Insurance Commissioners' (NAIC) Blanks Working Group on the proposed changes to the NAICs Health Annual Statement Instructions.

Letter to the NAIC on Supplemental Health Care Exhibit exposure draft

The Academy writes a letter to the chair of the NAIC's Health Care Reform Solvency Impact Subgroup on an exposure draft of a new proposed financial reporting exhibit the Supplemental Health Care Exhibit.

Letter to HHS regarding MLR provisions

The Academy writes a letter to the Department of Health and Human Services in response to its request for comments on the PPACA provision that requires medical loss ratio reporting and rebates.

Letter to HHS regarding rate review

The Academy writes a letter to the Department of Health and Human Services in response to its request for comments on the PPACA provision that establishes a review process for unreasonable rate increases.

Letter to the NAIC regarding statistical credibility

The Academy writes a letter to the chair of the NAIC's Accident and Health Working Group responding to his request for input on defining an appropriate way to maintain statistical validity within the rebate process. The Academy sent a subsequent letter to respond to a request from the NAIC for more information on statistical credibility.

Letter to the NAIC regarding premium review

The Academy writes a letter to the chairs of the NAIC's Health Care Reform Solvency Impact Subgroup, the Accident and Health Working Group, and the Rate Review Subgroup regarding the Patient Protection and Affordability Act (PPACA) provision that establishes a review process for unreasonable rate increases.

Letter to the NAIC regarding MLR considerations and potential disruption in the individual market

The Academy writes a second letter to the chairs of the NAIC's Health Care Reform Solvency Impact Subgroup and the Accident and Health Working Group regarding the medical loss ratio provisions and the potential for individual market disruption under the Patient Protection and Affordability Act.

Letter to the North Carolina Department of Insurance

The Academy writes to the North Carolina Department of Insurance regarding the Department's proposal to change the definition of "qualified actuary."

Letter to the NAIC regarding medical loss ratio provisions in health reform law

The Academy writes a letter to the Chairs of the NAIC's Health Care Reform Solvency Impact Subgroup and the Accident and Health Working Group regarding considerations related to the Patient Protection and Affordability Act Medical Loss Ratio Provisions (2718).

Additional comments on the Medicare Supplement Compliance Manual

The Academy's Medicare Supplement Work Group provides additional comments to NAIC on the draft revisions to the Medicare Supplement Compliance Manual, clarifying the use of the pooling approach used in the manual and how it may interact with loss ratio standards. The Work Group first submitted comments Feb. 2.

Letter to Feb. 25 health summit invitees outlining key criteria for viable health reform

The Academy's Health Practice Council writes to the White House and all invitees of the Feb. 25 bipartisan health summit stressing critical actuarial aspects of health reform legislation that will need to be addressed to support the stated goals of reducing the number of uninsured, increasing the availability and affordability of coverage, and enhancing the focus on quality of care and health spending growth.

Letter to NAIC regarding morbidity tables

Letter to NAIC regarding the joint Academy State LTC Task Force and SOA Valuation Committee project to develop and recommend valuation morbidity tables for long-term care insurance.

Testimony to Massachusetts policymakers

The Academy's State Health Committee provides written testimony to the Massachusetts House and Senate Joint Committee on Financial Services regarding gender rating for disability insurance.

Updated: Actuaries urge comprehensive Medicare reform

Medicare faces serious financial challenges that require comprehensive reforms to the program now to avoid the need for even more drastic actions in the future. The Academy supports efforts by the President and Congress to address these challenges and urges action to restore the long-term solvency and financial sustainability of Medicare.

Letter to congressional leaders detailing health care reform concerns

The Academy writes to Speaker Nancy Pelosi and Senate Majority Leader Harry Reid highlighting some of the key differences on actuarial issues between the House’s Affordable Health Care for America Act (HR 3962) and the Senate’s Patient Protection and Affordable Care Act.

Actuaries recommend change to "Cadillac Plan" tax structure

The Academy and Society of Actuaries release a report to help policymakers and the public understand the potential implications of an excise tax on high-cost employer-provided health plans.

Updated: Practice note on small group certifications

In an updated practice note, the Academy provides guidance to actuaries that prepare small group actuarial certifications, incorporating the passage of ASOP 26 and relevant revisions to certification requirements in various states.

Comments on the "grandfather provisions" within the Patient Protection and Affordable Care Act

The Academy responds to a request for analysis on the "grandfathering provisions" contained in the Patient Protection and Affordable Care Act and whether they would mitigate “rate shock” for those individuals who keep the coverage they have.

Letter to the Senate

In a letter to Senators Harry Reid and Mitch McConnell, the Academy outlines key issues that need to be considered when evaluating whether the Senate’s health care reform bill will lead to a viable health insurance system and discusses whether the Patient Protection and Affordable Care Act addresses the outlined issues.

Letter to the House of Representatives

The Academy writes to Speaker Nancy Pelosi and Republican Leader John Boehner providing an actuarial perspective on health insurance market reforms, outlining three criteria to ensure that the current markets remain viable, and offering comments on how certain provisions of the House’s Affordable Health Care for America Act (HR 3962) conform with those criteria.

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