Academy Health Practice Council (HPC) Vice President, 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 Fall National Meeting.

Presentation at the National Association of Insurance Commissioners (NAIC) Affordable Care Act (ACA) State Rate Review Discussion Meeting on Considerations for Calculating Cost-Sharing Reduction (CSR) Premium Load Factors.

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.

The Long-Term Care Valuation Work Group gave a follow-up presentation to the National Association of Insurance Commissioners (NAIC) NAIC Long-Term Care Actuarial (B) Working Group to discuss the data set used in preparation of the of the Long-Term Care Insurance Mortality and Lapse Study. The NAIC will develop a list of areas that they would like commenters to focus on, and then will expose the report for a 60-day period.

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.

The Group Life Waiver Premium Valuation Table Work Group submitted recommendations for the revised 2022 Group Life Waiver of Premium Valuation Table and the revised Actuarial Guideline 44 (AG 44) to the National Association of Insurance Commissioners (NAIC) Health Actuarial (B) Task Force (HATF).

The Health Practice Council’s Individual and Small Group Markets Committee and Active Benefits Subcommittee submitted comments to the Internal Revenue Service (IRS) on the proposed rule for “Affordability of Employer Coverage for Family Members of Employees.” The comments relate to provisions addressing the so-called “family glitch,” revisions to the employer coverage affordability test, and the Minimum Value (MV) Calculator.