The Medicaid Committee released a public policy issue brief providing an overview of Medicaid managed care state-directed payments. The brief discusses: how these payments have evolved from supplemental and pass-through payments; recent changes to federal guidance governing them; and recommendations from the Medicaid and CHIP Payment and Access Commission (MACPAC).
( )The Individual and Small Group Markets Committee and its Risk Sharing Subcommittee submitted a letter to the CCIIO on cost-sharing reduction (CSR) premium load factors. The letter was also submitted to state regulators and legislators. The letter first discusses using actual experience data/issuer pricing models to develop the load factor. It then discusses a method using federal actuarial value (AV) levels to develop the load and potential drawbacks of this approach.
( )The Health Equity Committee released a public policy issue brief on health care and health insurance system risk assessment and risk adjustment in the context of health equity. Risk assessment and risk adjustment are valuable tools that are used for a variety of purposes and are being reexamined to understand whether and how they should incorporate social risk factors.
( )The Health Equity Committee sent comments responding to the Centers for Medicare & Medicaid Services’ (CMS) request for information (RFI) that was seeking public comment on the Medicare Advantage program. The committee specifically focused on the health equity aspects of the questions posed within the RFI.
( )Academy Health Equity Committee Chairperson Annette James gave a presentation on equity considerations for barriers to care and health plan benefit design to the National Association of Insurance Commissioners (NAIC) Special (EX) Committee on Race & Insurance Workstream #5.
( )Academy Health Practice Council (HPC) Vice Chairperson, Barb Klever, provided an update on HPC activities to the National Association of Insurance Commissioners (NAIC) Health Actuarial (B) Task Force during their virtual meeting in lieu of the 2022 Summer National Meeting.
( )The Health Solvency Subcommittee submitted a letter response to its previous report to the NAIC’s Health Risk-Based Capital (E) Working Group to provide a timeline to analyze and comprehensively review the H2—Underwriting Risk component and the managed care credit calculation in the health risk-based capital (HRBC) formula.
( )The Group Life Waiver Premium Valuation Table Work Group submitted Proposed 2022 Group Life Waiver Tables and Adjustment Factors to the National Association of Insurance Commissioners’ (NAIC) Health Actuarial (B) Task Force (HATF). This Excel file is an addendum to the “Draft of the Revised AG 44” document, and the Graduation of Group Life Waiver of Premium Disability Experience Rates report by Jerry Holman (dated February 2022) submitted to HATF on June 13, 2022.
( )This infographic illustrates the factors underlying premium rate setting and highlighting the major components driving premium changes in the individual and small group markets for 2023, that are discussed in the recently released issue brief.
( )The Individual and Small Group Markets Committee released an issue brief laying out the factors underlying premium rate setting and highlighting the major components driving premium changes in the individual and small group markets for 2023.
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