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Health Practice Council

The Health Practice Council oversees the Academy’s public policy work on health issues, including Medicare. The Academy’s vice president for health issues heads the council and serves on the Academy Executive Committee and Board of Directors. The Council consists of committee and workgroup chairs and liaisons to other Academy groups working on issues of relevance to the Health Practice.

Staff liaison:
ASB Liaisons: Annette James, Rick Lassow
Professionalism Liaison: Karin Swenson-Moore

Chairperson: Barbara Klever
Vice Chairperson: Mitchell Momanyi
Andrew Dalton
Mick Diede
Steven Guzski
Marlene Howard
David Hutchins
Olga Jacobs
Annette James
Jason Karcher
Piotr Krekora
F Ronald Ogborne
Susan Pantely
Benjamin Rayburn
Rebecca Sheppard
Cori Uccello
Rina Vertes
Aaron Wright
Zerong Yu

Related Publications

Academy Updates HATF on HPC Activity at NAIC Fall Meeting

Senior Health Policy Analyst Matthew Williams provided an update on the Health Practice Council (HPC) activities of interest to the NAIC’s Health Actuarial (B) Task Force (HATF) at their recent meeting in Denver, including an update on recent and upcoming HPC publications, other Academy activity and key 2025 events.

(November 19, 2024 )

Committee Comments on 2026 NBPP

The Health Practice Council’s Individual and Small Group Markets Committee submitted comments to the Centers for Medicare & Medicaid Services regarding the proposed rule for the 2026 Notice of Benefit and Payment Parameters.

(November 12, 2024 )

Executive Summary - ERISA in the Context of Health Benefits

The Health Practice Council has released an issue brief, ERISA at 50: ERISA and Health Benefits. The issue brief covers the history of ERISA’s application to health benefits, subsequent amendments to the law, ERISA’s facilitation of coverage under employer-sponsored health plans, and its challenges. Released alongside the issue brief is an executive summary of the brief.

(October 17, 2024 )

Issue Brief Examines ERISA in the Context of Health Benefits

(October 17, 2024 )

Committee Comments on LTCI MSA Proposals

The Long-Term Care (LTC) Committee submitted comments to the NAIC’s Long-Term Care Actuarial (B) Working Group (LTCAWG) in response to LTCAWG's August 12, 2024, request for comments on Proposals A and B as candidates for a Single LTCI Multistate Rate Review Approach.

(September 27, 2024 )

Academy Updates NAIC on Health Equity Committee Activities

Annette James, co-chairperson of the Health Equity Committee (HEC), provided updates on recent HEC activities to the National Association of Insurance Commissioners (NAIC) Special (EX) Executive Committee on Race and Insurance. Topics included using cost-effectiveness as a metric for evaluating new benefits as opposed to using only cost. Behavioral health is also a major focus of the HEC this year to develop a framework that actuaries could use to incorporate other factors into the evaluation of health benefits.

(August 13, 2024 )

Academy Updates NAIC on the Drivers of Health Insurance Premium Changes

Academy Senior Health Fellow Cori Uccello presented on the “Drivers of 2025 federal Affordable Care Act (ACA) Health Insurance Premium Changes” to the National Association of Insurance Commissioners (NAIC) Health Actuarial (B) Task Force during its 2024 Summer National Meeting. The presentation also highlighted the recently released associated issue brief and infographic.

(August 12, 2024 )

Academy Updates NAIC on Key Health Initiatives

Academy Senior Health Policy Analyst Matthew Williams provided an update on the Health Practice Council (HPC) activities of interest to the National Association of Insurance Commissioners (NAIC) Health Actuarial (B) Task Force during its 2024 Summer National Meeting. Topics included key policy priorities and project updates for the HPC, annual Hill and agency visits, as well as current workstreams with the NAIC Health Risk-Based Capital (E) Working Group on tiered risk-based capital factor development.

(August 12, 2024 )

Premium Drivers Infographic Released

Released alongside the annual issue brief, The Individual and Small Group Markets Committee released an infographic, "Drivers of 2025 Health Insurance Premium Changes—Effects on Premiums". The infographic breaks down, in easy-to-understand language, the factors that may drive health insurance premium changes for the 2025 plan year.

(August 09, 2024 )

Premium Drivers Issue Brief Released

The Individual and Small Group Markets Committee released an issue brief, Drivers of 2025 Health Insurance Premium Changes. The brief provides more details on the factors that are likely to drive health insurance premium changes in 2025 for plans operating in the individual and small group markets subject to Affordable Care Act rules.

(August 09, 2024 )

Committee Comments on LTC MSA Minnesota Approach

The Long-Term Care (LTC) Committee submitted comments to the NAIC’s Long-Term Care Actuarial (B) Working Group (LTCAWG) in response to LTCAWG's July 2 request for comments on the Minnesota approach.

(July 23, 2024 )

Committee Presents on Health Equity at SOA Health Meeting

The Health Equity Committee presented at the 2024 SOA Health Meeting on “Improving Data Analysis Using a Health Equity Lens.” The session explored the intersection of health equity and data, including stakeholder perspectives and a Medicaid-focused case study.

(June 24, 2024 )

Committee Comments on Portable Health Benefits

The Health Practice Council’s Active Benefits Committee and Individual and Small Group Markets Committee responded to the U.S. Senate Committee on Health, Education, Labor and Pensions’ (HELP) request for information regarding portable benefits for self-employed workers and other individuals in nontraditional working arrangements.

(June 24, 2024 )

Medicare’s Financial Condition: Beyond Actuarial Balance

The Medicare Committee released an issue brief, Medicare’s Financial Condition: Beyond Actuarial Balance, that examines the findings of the 2024 Medicare Trustees Report with respect to program solvency and sustainability.

(May 08, 2024 )

Health Practice Council Comments on ASOP No. 12 Exposure Draft

The Health Practice Council submitted comments on the exposure draft of Actuarial Standard of Practice (ASOP) No. 12, Risk Classification (for All Practice Areas).

(May 01, 2024 )

Cross-Practice Letter on NY Proposed Circular on AIS and ECDIS in Insurance Underwriting and Pricing

The Academy’s Health, Life, and Casualty practice councils submitted comments on New York State Department of Financial Services’ proposed insurance circular letter on the use of Artificial Intelligence Systems (AIS) and External Consumer Data and Information Sources (ECDIS) in insurance underwriting and pricing. The councils support efforts to curb underwriting and pricing methods that “reflect systemic biases and can reinforce and exacerbate inequality.”

(March 14, 2024 )

Academy Updates NAIC on Key Health Initiatives

Academy Senior Health Policy Analyst Matthew Williams provided an update on the Health Practice Council (HPC) activities of interest to the National Association of Insurance Commissioners (NAIC) Health Actuarial (B) Task Force during its 2024 Spring National Meeting. Topics included key policy priorities and project updates for the HPC, as well as current workstreams with the NAIC Health Risk-Based Capital (E) Working Group (HRBC) on tiered risk-based capital factor development.

(March 15, 2024 )

Committees Comment on Definition of Employer—Association Health Plans

The Health Practice Council’s Individual and Small Group Markets Committee and Active Benefits Committee responded to the DOL’s Employee Benefits Security Administration’s proposed rule on Association Health Plan’s definition of employer.

(February 14, 2024 )

Committee Comments on Gene Therapy RFI

The Health Practice Council’s Health Care Delivery Committee, Individual and Small Group Markets Committee, and Active Benefits Committee responded to the Committee on Health, Education, Labor, and Pensions’ (HELP) request for information on access to gene therapies for patients with an ultra-rare disease.

(January 22, 2024 )

Academy Presents to AHIP on Health Equity and Benefit Design

Health Equity Committee co-chairpersons Annette James and Rebecca Sheppard, and member Yi-Ling Lin, gave an overview of the committee’s work on equity considerations related to benefit design to AHIP’s Health Equity Workgroup.

(January 09, 2024 )

Committee Comments on 2025 NBPP

(January 08, 2024 )

Committee Comments on Draft 2025 Actuarial Value (AV) Calculator Methodology

The Individual and Small Group Markets Committee submitted comments to the Centers for Medicare & Medicaid Services’ Center for Consumer Information & Insurance Oversight (CCIIO) on the Draft 2025 Actuarial Value (AV) Calculator Methodology.

(January 02, 2024 )

Academy Presents to AHIP on Health Equity for Managing Population Health and Risk Adjustment

Senior Health Fellow Cori Uccello and Health Equity Committee Co-Chairperson Rebecca Sheppard gave an overview of the committee’s work on equity considerations related managing population health and risk adjustment to AHIP’s Health Equity Workgroup.

(December 12, 2023 )

Academy Updates NAIC on Key Health Initiatives

Academy Senior Health Policy Analyst Matthew Williams provided an update on the Health Practice Council (HPC) activities of interest to the National Association of Insurance Commissioners (NAIC) Health Actuarial (B) Task Force during its 2023 Fall National Meeting. Topics included: updates on the Health Equity Committee’s workshops and symposium; long-term services and supports; tiered RBC factor development; and the key policy priorities for the HPC in 2024.

(November 30, 2023 )

Presentation to SEAC on Health Equity and Updates on the Health Equity Symposium/Workshops

On November 16, 2023, Academy Health Equity Committee chairperson Annette James and member Yi-Ling Lin presented to the Southeastern Actuaries Conference (SEAC) on the importance of health equity and cross-collaboration with various stakeholders. The presentation also highlighted the 2023 workshops and symposium focusing on the intersection of benefit design and health equity.

(November 16, 2023 )

Health Equity Issue Brief Summarizes Series on Benefit Design and Removing Barriers to Successful Implementation

The Health Equity Committee released an issue brief summarizing its "Health Benefit Design Innovations for Advancing Health Equity: Removing the Barriers to Successful Implementation" series.

(November 14, 2023 )

Health Equity Issue Brief Examines Overcoming Constraints to Implementation

The latest issue brief in its "Health Benefit Design Innovations for Advancing Health Equity: Removing the Barriers to Successful Implementation" series explores how to better understand unmet needs and incorporate input from employees and plan members into the benefit design decision-making process, and Overcoming Constraints to Implementation discusses some of the challenges of implementing equity-enhancing benefit plans—and possible solutions. (November 10, 2023 )

Health Equity Issue Brief Examines The Needs of Populations We are Trying to Serve

The latest issue brief in its “Health Benefit Design Innovations for Advancing Health Equity: Removing the Barriers to Successful Implementation” series explores how to better understand unmet needs and incorporate input from employees and plan members into the benefit design decision-making process, and Overcoming Constraints to Implementation discusses some of the challenges of implementing equity-enhancing benefit plans—and possible solutions.

(November 10, 2023 )

Update to the NAIC HRBC (E) Working Group on the Current and Proposed H3 Factors

Health Care Receivables Factors Work Group member David Quinn provided an update to the NAIC’s Health Risk-Based Capital (E) Working Group on the current and proposed H3 Factors.

(November 08, 2023 )

Letter to NAIC HRBC Working Group on H2 Updates

The Health Solvency Subcommittee’s Health Underwriting Risk Factors Analysis Work Group sent a letter updating the NAIC’s Health Risk-Based Capital (E) Working Group (HRBC) on progress on the NAIC’s request to comprehensively review the H2—Underwriting Risk Component and the Managed Care Credit Calculation included in the HRBC formula.

(October 31, 2023 )

Committee Comments on LTC Financing for WA Cares Fund Program

The Health Practice Council’s Long-Term Care (LTC) Reform Committee submitted comments to the Office of the State Actuary for the state of Washington on key issues related to LTC financing and risk management. The letter provides information on considerations necessary to achieve and maintain long-term services and supports (LTSS) trust solvency for the WA Cares Fund Program.

(October 23, 2023 )

Academy Presents to CBPP on Health Equity and Benefit Design

Senior Health Fellow Cori Uccello gave an overview of the Health Equity Committee’s work on equity considerations related to benefit design to the Center on Budget and Policy Priorities’ (CBPP) Marketplace Affordability Project.

(September 20, 2023 )

Academy Presents to AHIP on Health Equity and Provider Contracting and Network Development

Senior Health Fellow Cori Uccello and Health Equity Committee members Ugo Okpewho and Sara Teppema gave an overview of the committee’s work on equity considerations related to provider contracting and network development to AHIP’s Health Equity Workgroup.

(October 10, 2023 )

Health Equity Issue Brief Examines Evaluation of Benefit Changes

A new issue brief released by the Health Equity Committee provides an overview of how potential benefit changes are evaluated and how those evaluations could facilitate the incorporation of equity-enhancing benefit design features. These issues were discussed in the second of a series of workshops with stakeholders and decision-makers focusing on changing cost-sharing features, such as through value-based insurance design (VBID), as well as adding benefits to address health-related social needs.

(October 05, 2023 )

Committee Comments to CMS on Cost-Sharing Payments Program’s Maximum Monthly Cap

The Health Practice Council’s Medicare Committee submitted a comment letter to the Centers for Medicare & Medicaid Services on the draft part one guidance for the Maximum Monthly Cap on Cost-Sharing Payments Program.

(September 20, 2023 )

Academy Presents to AHIP on Health Equity and Plan Pricing

Senior Health Fellow Cori Uccello and Health Equity Committee member Rebecca Sheppard gave an overview of the committee’s work on equity considerations related to health plan pricing to AHIP’s Health Equity Workgroup.

(September 12, 2023 )

Committees Comment on Short-Term, Limited-Duration Insurance Proposed Rules

The Health Practice Council’s Individual and Small Group Markets Committee, Risk Sharing Subcommittee, and Active Benefits Committee submitted a comment letter to the Department of Health and Human Services (HHS), Department of Labor (DOL), and the Department of the Treasury on the Short-Term, Limited-Duration Insurance; Independent, Noncoordinated Excepted Benefits Coverage; Level-Funded Plan Arrangements; and Tax Treatment of Certain Accident and Health Insurance notice of proposed rulemaking (NPRM).

(September 11, 2023 )

Academy HPC Summer 2023 NAIC National Meeting Update to Health Actuarial (B) Task Force

Academy Senior Health Policy Analyst Matthew Williams provided an update on HPC activities to the National Association of Insurance Commissioners (NAIC) Health Actuarial (B) Task Force during its 2023 Summer National Meeting.

(August 17, 2023 )

Health Equity and Benefit Design

A new issue brief released by the Health Equity Committee provides an overview of issues related to designing health benefits to improve health equity. These issues were discussed in the first of a series of workshops with stakeholders and decision-makers focusing on changing cost-sharing features, such as through value-based insurance design (VBID), as well as adding benefits to address health-related social needs. In particular, the brief outlines some of the decision-making process with respect to adding benefits and the challenges of incorporating more equity-improving elements into health insurance plan designs.

(August 08, 2023 )

Drivers of 2024 Health Insurance Premium Changes

The Individual and Small Group Markets Committee released its annual 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 2024.

(July 19, 2023 )

Academy Presents at SOA Virtual Health Meeting

Academy Senior Health Fellow Cori Uccello presented on “Considerations for Calculating Cost-Sharing Reduction Load Factors” at the Society of Actuaries’ virtual health meeting.

(July 14, 2023 )

Letter to NAIC HRBC Working Group on H2 Updates

(July 13, 2023 )

Committee Comments to CMS on Medicaid Managed Care NPRM

The Health Practice Council’s Medicaid Committee submitted a comment letter to the Centers for Medicare & Medicaid Services’ (CMS) notice of proposed rulemaking (NPRM), Medicaid and Children’s Health Insurance Program (CHIP) Managed Care Access, Finance, and Quality (Managed Care NPRM).

(June 30, 2023 )

Academy Presents on Health Equity at SOA Meeting

Health Equity Committee (HEC) Chairperson Annette James presented at the 2023 Society of Actuaries Health Meeting in Seattle on “Health Equity: What it Means for Actuaries.” Her presentation gave an overview of health equity definitions, its intersection with actuarial work, and highlighted the HEC’s ongoing work, including the upcoming 2023 workshops and symposium focusing on the intersection of benefit design and health equity.

(June 26, 2023 )

Presentation to SEAC on Health Equity and the Upcoming Health Equity Symposium/Workshops

Academy Health Equity Committee Vice Chairperson Stacey Lampkin presented to the Southeastern Actuaries Conference (SEAC) on the committee’s ongoing work on health equity, including the upcoming 2023 workshops and symposium focusing on the intersection of benefit design and health equity.

(June 22, 2023 )

Comment Letter to NAIC Blanks (E) Working Group

The Committee on Property Liability and Financial Reporting (COPLFR) and the Health Practice Council’s Committee on Financial Reporting and Solvency submitted a comment letter to the National Association of Insurance Commissioners (NAIC) Blanks Working Group on proposed exposure to add instructions for the appointed actuary and qualified actuary contacts to the Jurat electronic only section in order to address any actuarial questions.

(April 26, 2023 )

Considering Employee Benefits for Health Policy Development

The Active Benefits Committee released an issue brief focusing on the role of actuaries in employee benefits for health policy development.

(April 17, 2023 )

Medicare’s Financial Condition: Beyond Actuarial Balance

The Medicare Committee released an issue brief focusing on the near and long-term financing challenges facing the Medicare program based on the 2023 Medicare Trustees Report.

(April 13, 2023 )

Comment Letter to the NAIC LTC Actuarial (B) Working Group on Long-Term Care (LTC) Past Losses

The Long-term Care Reform Subcommittee sent a comment letter to the National Association of Insurance Commissioners (NAIC) Long-Term Care Actuarial (B) Working Group featuring an Academy issue brief, Long-Term Care Insurance: Considerations for Treatment of Past Losses in Rate Increase Requests (October 2018), in response to a working group concern about the lack of a consistent definition of “past losses” in the context of recoupment.

(April 11, 2023 )

'Great Unwinding' Webinar Recap

Academy Medicaid Committee leadership and members joined with outside experts to break down the future of Medicaid as states plan to reinitiate Medicaid redeterminations for the first time since the start of the COVID-19 public health emergency.

(March 27, 2023 )

Life Practice Council, Health Practice Council, and Casualty Practice Council Submit a Joint Comment Letter to the Colorado Division of Insurance

The Life Practice Council, Health Practice Council, and Casualty Practice Council submitted a joint comment letter to the Colorado Division of Insurance on its recent exposure of a draft regulation on Governance and Risk Management Framework Requirements for Life Insurance Carriers’ Use of External Consumer Data and Information Sources, Algorithms, and Predictive Models: the first exposed implementation regulation for Colorado Revised Statute (C.R.S.) § 10-3-1104.9, signed into law on July 6, 2021.

(March 06, 2023 )

Financial Reporting and Solvency Committee Comments to NAIC on AG 51, Appendix A-010

The Health Practice Council’s Financial Reporting and Solvency Committee sent a comment letter to the National Association of Insurance Commissioners (NAIC) Long-Term Care Actuarial (B) Working Group inquiring if the Working Group might issue an accounting interpretation for the interaction between Actuarial Guideline LI (AG 51) and Appendix A-010.

(February 23, 2023 )

Comment Letter to the Health Risk-Based Capital (E) Working Group on Investment Income

The Health Solvency Subcommittee sent a comment letter responding to a request from the NAIC’s Health Risk-Based Capital (E) Working Group to provide additional investment return scenarios within the subcommittee’s summary of the Investment Income Adjusted Health H2 Experience Fluctuation Risk Factors.

(February 02, 2023 )

HPC Committees Comment on 2024 NBPP

The Health Practice Council’s Individual and Small Group Markets Committee and Risk Sharing Subcommittee submitted a comment letter to the Centers for Medicare & Medicaid Services’ (CMS) proposed rule for the 2024 Notice of Benefit and Payment Parameters (NBPP).

(January 30, 2023 )

Committee Comments on Draft 2024 Actuarial Value (AV) Calculator Methodology

(January 12, 2023 )

Academy Update to the NAIC HRBC (E) Working Group during the Fall 2022 NAIC National Meeting

Health Solvency Subcommittee Chairperson Derek Skoog provided an update to the NAIC’s Health Risk-Based Capital (E) Working Group at the NAIC’s Fall 2022 National Meeting in Tampa, FL, on the H2—underwriting risk component and the managed care credit calculation in the health risk-based capital formula.

(December 12, 2022 )

Academy HPC Fall 2022 NAIC National Meeting Update to Health Actuarial (B) Task Force

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.

(December 05, 2022 )

Academy Presentation to NAIC on Considerations for Calculating Cost-Sharing Premium Reduction Load Factors

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.

(November 16, 2022 )

Medicaid Managed Care State-Directed Payments

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).

(September 16, 2022 )

Health Practice Area Comment Letter Submitted to the Center for Consumer Information and Insurance Oversight (CCIIO) on Cost-Sharing Reduction Premium Load Factors

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.

(September 08, 2022 )

Health Care and Health Insurance System Risk Assessment and Risk Adjustment in the Context of Health Equity

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.

(August 30, 2022 )

Health Equity Committee Comments to CMS on Medicare Advantage

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.

(August 30, 2022 )

Health Equity Committee Presentation on Barriers to Care and Benefit Design to the NAIC Special (EX) Committee on Race and Insurance

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.

(August 23, 2022 )

Academy HPC Summer 2022 NAIC National Meeting Update to Health Actuarial (B) Task Force

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.

(August 01, 2022 )

Health Solvency Subcommittee Letter to the NAIC Health RBC Working Group on Timeline to Analyze and Review the H2 Underwriting Risk Component

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.

(July 13, 2022 )

Work Group Submits Proposed 2022 Group Life Waiver Tables and Adjustment Factors to the NAIC‘s HATF

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). (July 07, 2022 )

Work Group Follow-Up Presentation to the NAIC Long-Term Care Actuarial (B) Working Group on Long-Term Care Insurance Mortality and Lapse Study

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.

(June 24, 2022 )

Drivers of 2023 Health Insurance Premium Changes - Infographic

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.

(June 22, 2022 )

Drivers of 2023 Health Insurance Premium Changes

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.

(June 21, 2022 )

Group Life Waiver Premium Valuation Table Work Group Submits Recommendations to the NAIC Health Actuarial (B) Task Force

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).

(June 13, 2022 )

HPC Committees Comment on Proposed Rule on Affordability of Employer Coverage for Related Individuals

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.

(June 06, 2022 )

Medicare’s Financial Condition: Beyond Actuarial Balance

The Medicare Committee released an issue brief on the financing challenges facing the Medicare program based on the 2022 Medicare Trustees Report.

(June 03, 2022 )

Work Group Releases LTC Actuarial Equivalence Public Policy Issue Brief

The Long-Term Care (LTC) Reform Subcommittee’s LTC Actuarial Equivalence Work Group released the public policy issue brief, Value of Reduced Benefit Options in Long-Term Care Insurance Rate Increases. This issue brief examines the relationship of benefits to premiums for reduced benefit options (RBOs) in the context of ongoing long-term care insurance (LTCI) premium rate increases.

(May 25, 2022 )

Group Life Waiver Premium Valuation Table Work Group Updates Presentation to the NAIC Health Actuarial (B) Task Force

Group Life Waiver Premium Valuation Table Work Group chairperson, Sue Sames, presented an update on proposed recommendations to the National Association of Insurance Commissioners (NAIC) Health Actuarial (B) Task Force on the Group Life Waiver of Premium Valuation Table and Actuarial Guideline 44 (AG 44). The purpose of the presentation was to give an overview of the work group’s progress and present the initial set of recommendations.

(May 16, 2022 )

Academy DE&I Presentation at The Drake Symposium

On April 9, 2022, Academy Board member and Health Equity Work Group (HEWG) Chairperson Annette James presented to about 150 students at the Drake Symposium on Insurance on “Diversity, Equity & Inclusion in the Actuarial Profession.” Chairperson James highlighted the Academy’s strategic focus and ongoing efforts to address DE&I, including fostering a diverse, inclusive profession. She also presented on ongoing multifaceted HEWG initiatives to address health equity.

(April 14, 2022 )

Academy HPC Spring 2022 Update to NAIC Health Actuarial (B) Task Force

(March 29, 2022 )

Committee Releases Issue Brief on Hospital Price Variation

The Health Care Delivery Committee released an issue brief on the “Implications of Hospital Price Transparency on Hospital Prices and Price Variation.” The brief emphasizes that price transparency may be a necessary, but not sufficient mechanism, to lower hospital prices and health care spending.

(March 10, 2022 )

Subcommittee Comment Letter to CMS on the Proposed Rule for the 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs

The Long-Term Care Medicaid Subcommittee submitted a comment letter to the Centers for Medicare & Medicaid Services (CMS) on the proposed rule, “Medicare Program; Contract Year 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs.” The comments focused on dual-eligible special needs plans (D-SNP’s) and separate medical loss ratio (MLR) requirements.

(March 07, 2022 )

Statement for the Record on the Hospital Insurance Trust Fund and the Future of Medicare Financing

Medicare Committee Chairperson Rina Vertes and Academy Senior Health Fellow Cori Uccello submitted a statement for the record to the U.S. Senate Committee on Finance Subcommittee on Fiscal Responsibility and Economic Growth regarding the Feb. 2 hearing, “The Hospital Insurance Trust Fund and the Future of Medicare Financing.”

(February 11, 2022 )

Academy Submits Letter to Colorado Division of Insurance

Academy President Maryellen Coggins submitted a letter to the Colorado Division of Insurance in advance of the upcoming stakeholder engagement process for the recently passed state law aimed to protect consumers from unfair discrimination in insurance practices. The comments addressed potential concerns of the law’s impact on casualty, health, and life insurance.

(February 04, 2022 )

Committee Comments on Draft 2023 Actuarial Value (AV) Calculator Methodology

(January 31, 2022 )

HPC Committees Comment on 2023 NBPP

The Health Practice Council’s Individual and Small Group Markets Committee, Risk Sharing Subcommittee, and Health Equity Work Group submitted a comment letter to the Centers for Medicare & Medicaid Services (CMS) on CMS’ proposed rule for the 2023 Notice of Benefit and Payment Parameters (NBPP). The letter addresses network adequacy, standardized plan options, several provisions on health equity, updating quality improvement strategy standards and other topics.

(January 26, 2022 )

Health Solvency Subcommittee Report to the NAIC Health RBC Working Group on Review of the H2 Underwriting Risk Component

The Health Solvency Subcommittee submitted a report to the NAIC’s Health Risk-Based Capital (E) Working Group regarding the working group’s request of the subcommittee to conduct a comprehensive review of the H2—Underwriting Risk component and managed care credit calculation in the NAIC’s health risk-based capital formula.

(January 21, 2022 )

Health Equity Work Group Issues Request for Information – Deadline Extended to February 15, 2022

In October 2021 the American Academy of Actuaries Health Equity Work Group issued a request for information (RFI) to solicit input to its work assessing whether and how health actuarial practices and methods affect health disparities. The comment/submission period has now been extended to February 15, 2022.

The Academy created the Health Equity Work Group with a goal of contributing to efforts to reduce health disparities and improve health equity among racial and ethnic minority populations and underserved or under-resourced communities through actuarial practice and to facilitate providing actuarial input into the public policy process.

(January 11, 2022 )

Work Group Presentation to the NAIC Health Actuarial (B) Task Force on Long-Term Care Insurance Mortality and Lapse Study

The Long-Term Care Valuation Work Group presented results of the Long-Term Care Insurance Mortality and Lapse Study to the National Association of Insurance Commissioners (NAIC) Health Actuarial (B) Task Force.

(November 29, 2021 )

Academy HPC 2021 Updates to NAIC Health Actuarial (B) Task Force

Academy Health Practice Council (HPC) Vice Chairperson, Barb Klever, provided an update on the 2021 HPC activities to the National Association of Insurance Commissioners (NAIC) Health Actuarial (B) Task Force.

(November 29, 2021 )

Comment Letter to CMS/CCIIO on Exposure Draft of Risk Adjustment Technical Paper

The Risk Sharing Subcommittee submitted comments to the Centers for Medicare & Medicaid Services (CMS) Center for Consumer Information and Insurance Oversight (CCIIO) on the HHS-Operated Risk Adjustment Technical Paper on Possible Model Changes, exposed for comment on Oct. 26, 2021.

(November 24, 2021 )

Long-Term Care Valuation Work Group Releases the Long-Term Care Insurance Mortality and Lapse Study

The Long-Term Care Valuation Work Group released a major report, the Long-Term Care Insurance Mortality and Lapse Study, as a result of a 2016 request from the NAIC’s Health Actuarial (B) Task Force regarding replacing the mortality and lapse bases for statutory minimum reserves. The study was completed jointly by the Academy and the Society of Actuaries Research Institute.

(November 19, 2021 )

Comment Letter to RFI from the Treasury Department and FIO on Climate-Related Financial Risk and the Insurance Sector

Climate Change Joint Task Force comments to the U.S. Department of the Treasury and Federal Insurance Office (FIO) request for information (RFI) relating to regarding FIO's future work relating to the insurance sector and climate-related financial risks.

(November 15, 2021 )

Health Equity Work Group (HEWG) Sends Comment Letter to National Association of Insurance Commissioners (NAIC) committee on Revised Health Insurance Data Principles Exposure Draft

The HEWG sent a comment letter to the NAIC’s Special (EX) Committee on Race and Insurance – Workstream 5 (Health) on the exposure draft of the Principles for Data Collection document. The revised draft was exposed on October 15, 2021, with comments due November 15.

(November 15, 2021 )

Committee Releases Issue Paper on Medicaid Managed Care Plan Rate Setting as Impacted by COVID-19

The Medicaid Committee released an issue paper, Considerations for Reflecting the Impact of COVID-19 in Medicaid Managed Care Plan Rate Setting, which explores key components of rate setting during or shortly after the COVID-19 pandemic, including data, assumptions and adjustments, risk mitigation, and communication.

(November 12, 2021 )

HEWG Sends Comment Letter to NAIC Special Committee on Race and Insurance

The Health Equity Work Group sent a comment letter to the NAIC’s Special (EX) Committee on Race and Insurance – Workstream 5 (Health) on the exposure draft of the White Paper on Provider Network outline.

(November 05, 2021 )

Health Equity Work Group Issues Request for Information

The American Academy of Actuaries created a Health Equity Work Group (HEWG) with a goal of contributing to efforts to reduce health disparities and improve health equity among racial and ethnic minority populations and underserved or under-resourced communities. The HEWG is issuing a request for information (RFI) to solicit input to its work assessing whether and how health actuarial practices and methods affect health disparities. Health actuaries often partner with other professionals in many different aspects of the health care and health insurance systems, including those related to administration, financing, and care management. (October 29, 2021 )

Discussion Brief – Issue in Focus: Health Equity and Managing Population Health

Health Equity Work Group (HEWG) released a discussion brief, Health Equity from an Actuarial Perspective: Managing Population Health. This discussion brief is the final in the series developed by the HEWG to provide more context on issues raised in the initial discussion brief, Health Equity from an Actuarial Perspective: Questions to Explore. This series was undertaken by the HEWG to lay the groundwork for their future exploration and research into health disparities.

(October 15, 2021 )

Comment Letter to the NAIC Long-Term Care (EX) Task Force on the Long-Term Care Insurance Multistate Rate Review Framework

LTC Reform Subcommittee comment letter to the National Association of Insurance Commissioners (NAIC) Long-Term Care Insurance (EX) Task Force regarding the exposure drafts of the operational and actuarial sections of the Long-Term Care Insurance Multi-State Rate Review Framework released September 10 and September 15, 2021.

(October 08, 2021 )

Committee/Work Group Comments to CMS on Medicare Payment Policies Under the Physician Fee Schedule

Health Care Delivery Committee and its Telehealth Work Group comments to the Centers for Medicare & Medicaid Services (CMS) on CMS’ proposed rule on Medicare, payment policies, and enrollment regulation updates.

(September 13, 2021 )

Discussion Brief – Issue in Focus: Health Equity and Provider Contracting/Network Development

Health Equity Work Group (HEWG) discussion brief, Health Equity from an Actuarial Perspective: Provider Contracting and Network Development. This discussion brief is part of a series developed by the HEWG to provide more context on issues raised in the initial discussion brief, Health Equity from an Actuarial Perspective: Questions to Explore.

(September 16, 2021 )

Medicare’s Financial Condition: Beyond Actuarial Balance

Medicare Subcommittee issue brief on the financing challenges facing the Medicare program based on the 2021 annual review of the Medicare program’s trustees.

(September 03, 2021 )

Subcommittee Comment Letter to the NAIC Long-Term Care Insurance Reduced Benefit Options (EX) Subgroup on Issues Related to LTC Wellness Benefits

Long-term Care Reform Subcommittee comment letter to the National Association of Insurance Commissioners (NAIC) Long-Term Care Insurance Reduced Benefit Options (EX) Subgroup regarding the July 22, 2021 exposure draft, Issues Related to LTC Wellness Benefits.

(September 03, 2021 )

Drivers of 2022 Health Insurance Premium Changes

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 2022.

(September 02, 2021 )

Issue Brief on LTC Financing Reform Proposals Involving Public Programs

Long-term Care (LTC) Reform Subcommittee issue brief on LTC financing reform proposals involving public programs. This issue brief provides a side-by side assessment of various federal and state reform programs and proposals using essential criteria for LTC financing reform proposals developed by the Academy.

(July 28, 2021 )

Committee/Subcommittee Comments to CMS on Payment Parameters Proposed Rule

The Individual and Small Group Markets Committee and its Risk Sharing Subcommittee comments to the Centers for Medicare & Medicaid Services (CMS) on the proposed rule, Updating Payment Parameters, Section 1332 Waiver Implementing Regulations, and Improving Health Insurance Markets for 2022 and Beyond.

(July 28, 2021 )

Comment Letter to the NAIC Long-Term Care (EX) Task Force on the Long-Term Care Insurance Multistate Rate Review Framework

Long-term Care Reform Subcommittee comment letter to the National Association of Insurance Commissioners (NAIC) Long-Term Care (EX) Task Force regarding the June 10, 2021 exposure draft of the actuarial sections within the Long-Term Care Insurance Multi-State Rate Review Framework.

(July 26, 2021 )

Discussion Brief – Issue in Focus: Health Equity and Health Plan Benefit Design

Health Equity Work Group (HEWG) discussion brief, Health Equity from an Actuarial Perspective: Health Plan Benefit Design. This discussion brief is part of a series developed by the HEWG to provide more context on issues raised in the initial discussion brief, Health Equity from an Actuarial Perspective: Questions to Explore.

(July 23, 2021 )

Health Practice Council Public Policy Presentation on Long-Term Care Insurance

Academy Health Practice Council Vice President Al Schmitz, and Long-Term Care/Disability Committee Chairperson Bruce Stahl, April 28, 2021, presentation to the Columbus Actuarial Club on “Long-Term Care Insurance: Public Policy Update.”

(April 28, 2021 )

Letter to the NAIC Health RBC Working Group on Review of the H2 Underwriting Risk Component

Health Solvency Subcommittee letter to the National Association of Insurance Commissioners (NAIC) Health Risk-Based Capital (E) Working Group regarding its request of the Academy to conduct a comprehensive review of the H2—Underwriting Risk component and managed care credit calculation in the health risk-based capital formula.

(July 08, 2021 )

Committee/Subcommittee Comments to HHS, DOL, and the Treasury on the No Surprises Act

The Health Practice Council’s Individual and Small Group Markets Committee and the Active Benefits Subcommittee comments to the Departments of Health & Human Services, Labor, and the Treasury as the agencies develop proposed rules related to the recently enacted No Surprises Act pertaining to surprise medical billing.

(June 25, 2021 )

Discussion Brief – Issue in Focus: Health Equity and Premium Pricing

Health Equity Work Group (HEWG) Discussion Brief – Issue in Focus, Health Equity From An Actuarial Perspective: A Deeper Dive Into Health Plan Pricing. This discussion brief, which focuses on questions related to pricing health insurance products, is part of a series to identify areas that may affect health equity. An introductory discussion brief provided an overview of the HEWG’s work.

(May 25, 2021 )

Comment Letter to the NAIC Long-Term Care (EX) Task Force on the Long-Term Care Insurance Multistate Rate Review Framework

Long-term Care Reform Subcommittee comment letter to the National Association of Insurance Commissioners (NAIC) Long-Term Care (EX) Task Force regarding the April 9, 2021 exposure draft of the Long-Term Care Insurance Multi-State Rate Review Framework.

(May 24, 2021 )

Long-Term Care Insurance Practice Note

Long-Term Care (LTC) Practice Note Work Group’s Long-Term Care Insurance public policy practice note to provide a source of information to practicing long-term care (LTC) actuaries seeking to better understand the considerations in evaluating experience, setting assumptions, valuation, and financial reporting.

(May 14, 2021 )

Financial Reporting and Solvency Committee Comment Letter to the NAIC Health Actuarial (B) Task Force on the Revised Instructions for the Health Statement of Actuarial Opinion

The Financial Reporting and Solvency Committee sent a comment letter to the National Association of Insurance Commissioners (NAIC) Health Actuarial (B) Task Force regarding the definition of “actuarial assets” in the revised proposed instructions for the Health Statement of Actuarial Opinion.

(May 07, 2021 )

Health Practice Council Comment Letter on Colorado Insurance Unfair Discrimination Legislation

Health Practice Council comment letter on a revised draft of Colorado Senate Bill 21-169, dated April 21, 2021, aimed to protect consumers from unfair discrimination in insurance practices. This letter follows up on previous Health Practice Council comments on the introduced version of the bill, submitted on March 29, 2021, and again focuses on the potential impact to health insurance.

(April 30, 2021 )

Comment Letter to the NAIC Health RBC Working Group on Impact of Investment Income

Health Solvency Subcommittee comment letter in response to a request from the NAIC’s Health Risk-Based Capital (E) Working Group to provide an additional digit within the subcommittee’s summary of the Investment Income Adjusted Health H2 Experience Fluctuation Risk Factors.

(April 27, 2021 )

Financial Reporting and Solvency Committee Comment Letter to the NAIC Health Actuarial (B) Task Force on the Proposed Definition Changes to “Actuarial Assets”

Financial Reporting and Solvency Committee comment letter to the National Association of Insurance Commissioners (NAIC) Health Actuarial (B) Task Force regarding the proposal to modify the definition of “actuarial assets” as used in the instructions for the Health Statement of Actuarial Opinion.

(April 19, 2021 )

Issue Brief on Telehealth After COVID-19

Telehealth Work Group issue brief on telehealth coverage and payment considerations for policymakers now and after the COVID-19 public health emergency.

(April 14, 2021 )

Discussion Brief on Health Equity From an Actuarial Perspective

Health Equity Work Group (HEWG) discussion brief on health equity from an actuarial perspective. This brief serves as an introduction to the HEWG’s work in examining the following areas: health insurance benefit design, provider contracting and network development, premium pricing, and managing population health.

(March 31, 2021 )

Health Practice Council Comment Letter on Colorado Senate Bill 21-169

Health Practice Council comment letter on Colorado Senate Bill 21-169 which is aimed to protect consumers from unfair discrimination in insurance practices. The comments focus on potential impacts to health insurance.

(March 29, 2021 )

ASOP No. 6 Practice Note on Valuing Retiree Health Benefit Plans

The ASOP No. 6 Practice Note Work Group's ASOP No. 6—Development of Age-Specific Retiree Health Cost Assumptions, Including Applications to Pooled and Non-Pooled Health Plans practice note, which provides information on valuing retiree health benefit plans.

(March 15, 2021 )

Issue Brief on Regulatory Options for Long-Term Care Insurance Innovation

The Long-Term Care (LTC) Reform Subcommittee's issue brief on regulatory options for LTC insurance innovation. This issue brief examines some National Association of Insurance Commissioners (NAIC) proposed options specific to regulatory changes, and discusses recommended changes with actuarial implications.

(March 10, 2021 )

Senior Health Fellow Presentation on Medicare at Health Policy Webinar

Academy Senior Health Fellow Cori Uccello presentation from “Medicare Solvency Projections and Potential Policy Solutions” webinar sponsored by the Alliance for Health Policy. Presentation provides basic program information, covering Hospital Insurance (HI) and Supplementary Medical Insurance (SMI), the projected depletion of the HI trust fund, and also notes that Medicare’s sustainability challenges go beyond solvency.

(February 25, 2021 )

Comment Letter to the NAIC Health RBC Working Group on Impact of Investment Income

The Health Solvency Subcommittee sent a comment letter in response to a request from the NAIC’s Health Risk-Based Capital (E) Working Group to further analyze the impact of incorporating investment income into the existing underwriting risk factors within the health risk-based capital formula.

(February 22, 2021 )

HPC Comments on Review of Agency Actions Related to the Affordable Care Act and Medicaid

The Health Practice Council submitted a comment letter to the Department of the Treasury, the Department of Labor (DOL), and the Department of Health & Human Services (HHS), on review of agency actions related to the Affordable Care Act and Medicaid, as put forward in a recent presidential executive order. The letter provides references to previous Academy comment letters to agencies regarding relevant proposed rules.

(February 12, 2021 )

Committee/Subcommittee Comments to Treasury, DOL, and HHS, on Insurance and Health Plan Coverage of COVID-19 Testing

The Individual and Small Group Markets Committee and the Active Benefits Subcommittee submitted comments to the Department of the Treasury, the Department of Labor (DOL), and the Department of Health & Human Services (HHS), on insurance and health plan coverage of COVID-19 testing, as put forward in a presidential executive order, Establishing the COVID-19 Pandemic Testing Board and Ensuring a Sustainable Public Health Workforce for COVID-19 and Other Biological Threats.

(February 11, 2021 )

Academy Recommendation Letter to HHS on COVID-19 Health Equity Task Force

Academy President Thomas A. Campbell’s letter of recommendation for Annette V. James as a candidate for appointment to the COVID-19 Health Equity Task Force as put forward in a presidential executive order, Ensuring an Equitable Pandemic Response and Recovery.

(February 01, 2021 )

Issue Brief on COVID-19’s Impacts on Long-Term Care Insurance

The Long-Term Care Reform Subcommittee's COVID-19 Work Group issue brief on COVID-19’s potential short-term and long-term impacts on long-term care insurance (LTCI), with a focus on key actuarial and economic assumptions impacting standalone LTCI policies.

(January 25, 2021 )

Comment Letter to the NAIC Health RBC Working Group on Investment Income

The Health Solvency Subcommittee sent a comment letter in response to a request from the NAIC’s Health Risk-Based Capital (E) Working Group providing additional detail regarding the potential investment income adjustment factor for Health H2 Experience Fluctuation Risk.

(January 11, 2021 )

Committee/Subcommittee Comment to CMS on Payment Parameters Proposed Rule

The Individual and Small Group Markets Committee and its Risk Sharing Subcommittee comments to the Centers for Medicare & Medicaid Services (CMS) on the Proposed Notice of Benefit and Payment Parameters for 2022.

(December 30, 2020 )

Health Solvency Subcommittee Comment Letter to NAIC Health Risk-Based Capital Working Group on Investment Income and Underwriting Risk Factors

The Health Solvency Subcommittee comment letter to the National Association of Insurance Commissioners (NAIC) Health Risk-Based Capital (E) Working Group to provide analysis to incorporate investment income into the existing underwriting risk factors within the health risk-based capital formula.

(December 17, 2020 )

Academy Senior Health Fellow Presentation on Health Equity at NAIC Special (EX) Committee on Race and Insurance

On December 2, 2020, Cori Uccello, the Academy’s Senior Health Fellow, presented on behalf of the Academy’s Health Equity Work Group (HEWG) at the National Association of Insurance Commissioners’ (NAIC’s) Special (EX) Committee on Race and Insurance, Workstream #5 meeting. Written comments by HEWG chairperson Annette James were also submitted to the special committee highlighting the HEWG’s efforts to facilitate solutions to address health disparities.

(December 04, 2020 )

Health Equity Work Group Comments to the NAIC Special (EX) Committee on Race and Insurance

The Health Practice Council’s Health Equity Work Group comments to the National Association of Insurance Commissioners (NAIC) highlighting their efforts to facilitate solutions to address health disparities.

(December 04, 2020 )

HPC Comments to ASB on ASOP No. 22 Proposed Revision

The Health Practice Council’s Long-Term Care (LTC) Reform Subcommittee Task Force to Review ASOP No. 22 comments on the proposed revision of Actuarial Standard of Practice (ASOP) No. 22, Statements of Actuarial Opinion Based on Asset Adequacy Analysis for Life Insurance, Annuity, or Health Insurance Reserves and Other Liabilities (the "Second Exposure Draft").

(December 01, 2020 )

Committee Comments on 2021 Actuarial Value (AV) Calculator

Comments from the Individual and Small Group Markets Committee to the Center for Consumer Information & Insurance Oversight (CCIIO) expressing concerns on the claims data updates finalized in the 2021 Actuarial Value (AV) Calculator. These comments are for consideration in preparing the draft 2022 AV Calculator.

(November 12, 2020 )

Actuarial Memorandum Practice Note

The purpose of this practice note is to provide information that can be useful for appointed actuaries dealing with the challenges of producing an Actuarial Memorandum in support of the Actuarial Opinion filed as part of the Health Annual Statement Blank (often referred to as the Health Blank or the Orange Blank). However, the concepts covered in this practice note could be useful for other situations requiring documentation for health business.

(October 29, 2020 )

HPIC Releases Report on International Health Care Funding

The Health Practice International Committee (HPIC) released the International Health Care Funding Report. This report is the first iteration of a project is intended to be an illustration of international models of health care funding, and reflects the state of 36 health funding systems from around the world as of December 31, 2019. This report is a joint effort of volunteers of the American Academy of Actuaries Health Practice International Committee (HPIC), the International Actuarial Association Health Section (IAAHS), and the Society of Actuaries (SOA) International Section.

(October 23, 2020 )

Comments on ASOP 11, Reinsurance Involving Life Insurance, Annuities, or Health Benefit Plans in Financial Reports

The Health Practice Council and its Task Force to Review Actuarial Standard of Practice (ASOP) 11 filed a comment on the Actuarial Standards Board exposure draft, Reinsurance Involving Life Insurance, Annuities, or Health Benefit Plans in Financial Reports.

(July 02, 2020 )

Risk Sharing Subcommittee Comments on HHS-Operated RADV Under the Patient PPACA’s HHS-Operated RADV Program

The Risk Sharing Subcommittee filed comments with the Department of Health and Human Services and the Centers for Medicare and Medicaid Services on exposed Amendments to the HHS-Operated Risk Adjustment Data Validation Under the Patient Protection and Affordable Care Act’s HHS-Operated Risk Adjustment Program.

(July 02, 2020 )

Drivers of 2021 Health Insurance Premium Changes: The Effects of COVID-19

Individual and Small Group Markets Committee issue brief outlining the major factors driving premium changes for the next plan year. This year’s issue brief focuses primarily on the impact of COVID-19 on the 2021 premium rate filings.

(June 09, 2020 )

Issue Brief on Health Risk Mitigation

The Health Practice Council has released an issue brief that examines the different types of risks that insurers can face and the various risk mitigation mechanisms that can be used to address them, Health Insurance Risk Mitigation Mechanisms and COVID-19.

(May 15, 2020 )

FAQs on COVID-19 and Its Effects on Health Spending and Health Insurance

Health Practice Council answers to frequently asked questions (FAQs) on COVID-19’s potential effects on health care spending and the health insurance system.

(March 24, 2020 )

Health Solvency Subcommittee Response Letter on Health Bond Factors to HRBC Working Group

The Health Solvency Subcommittee submitted a response letter to the NAIC Health Risk-Based Capital (HRBC) Working Group for their request to provide the health bond factors over a range of additional time horizons - spanning one to five years.

(March 18, 2020 )

Individual and Small Group Markets Committee and Risk Sharing Subcommittee Comments on the Proposed Rule for the 2020 NBPP

Comments of the Individual and Small Group Markets Committee and Risk Sharing Subcommittee on the proposed rule for the 2020 Notice of Benefit and Payment Parameters (NBPP).

(March 02, 2020 )

Long-Term Care Insurance Products and Addressing the ‘Use It or Lose It’ Concern Issue Brief

Issue brief on the evolving marketplace and regulatory environment of long-term care insurance (LTCI).

(February 26, 2020 )

Actuarial Memorandum Practice Note

Actuarial Memorandum Practice Note Work Group exposure draft to provide information that can be useful for appointed actuaries dealing with the challenges of producing an Actuarial Memorandum in support of the Actuarial Opinion filed as part of the Health Annual Statement Blank (often referred to as the Health Blank or the Orange Blank). Comments due March 16, 2020 to health@actuary.org (January 14, 2020 )

Wellness Program Demonstration Project in the Individual Market

Individual and Small Group Markets Committee comments on the September 30, 2019 bulletin, Opportunity for States to Participate in a Wellness Program Demonstration Project to Implement Health-Contingent Wellness Programs in the Individual Market.

(January 14, 2020 )

Subcommittee Comments on HHS-RADV White Paper

Risk Sharing Subcommittee comments on the HHS Risk Adjustment Validation (RADV) White Paper, released on December 6, 2019.

(January 02, 2020 )

Work Group Presents Update to LTCAWG

The Long-Term Care Valuation Work Group presented updates on the mortality and lapse tables development.

(December 06, 2019 )

Committee Comments on Changes to RADV timing in the final 2020 NBPP and related documents

Individual and Small Group Markets Committee sent comments to Centers for Medicare & Medicaid Services on rules finalized in the 2020 Notice of Benefit and Payment Parameters (NBPP) concerning risk adjustment data validation (RADV)-related transfers.

(October 03, 2019 )

Briefing on Telehealth—A Digital Communication Approach to Improving Health

Members of the Telehealth Work Group presented on the topic of telehealth along with the debut of their new issue brief with moderator Cori Uccello, senior health fellow, to a policy audience of Capitol hill staff.

(September 25, 2019 )

Telehealth—A Digital Communication Approach to Improving Health

Telehealth Work Group has released a new issue brief exploring the perspectives of the patients and providers, while also analyzing the financial, legal and regulatory aspects associated with telehealth.

(September 25, 2019 )

Surprise Medical Bills: An Overview of the Problem and Approaches to Address It

Health Practice Council issue brief providing an overview of the surprise-billing problem and provides insights on approaches to address it.

(September 10, 2019 )

Subcommittee Comments to NAIC Health Risk-Based Capital Working Group

The Health Solvency Subcommittee sent comments to the NAIC Health Risk-Based Capital (HRBC) Working Group on the comment letters received on the exposure of the Draft Bond Structure and Instructions.

(September 04, 2019 )

Subcommittee Members Comment to Federal Interagency Task Force on LTCI

Members of the LTC Reform Subcommittee submitted comments following their discussion with the Federal Interagency Task Force on Long-Term Care Insurance (LTCI) earlier this year. These comments reiterate and expand on their original discussion including addressing regulatory hurdles to innovation.

(August 30, 2019 )

Work Group Presents Update to LTCAWG

The Long-Term Care Valuation Work Group presented updates on the mortality and lapse tables development.

(August 28, 2019 )

Work Group Presents Update to HATF

The Group Life Waiver Valuation Table Work Group updated the Health Actuarial Task Force of the National Association of Insurance Commissioners on group life waiver of premium mortality and recovery tables development.

(August 27, 2019 )

Presentation on LTC Valuation Work Group Update to NAIC

This presentation was given to the Long-Term Care (LTC) Actuarial Working Group of the National Association of Insurance Commissioners as an update on the LTC Valuation Work Group's recent activity.

(August 02, 2019 )

Presentation on LTC Combo Practice Note to NAIC

This presentation was given to the Long-Term Care (LTC) Actuarial Working Group of the National Association of Insurance Commissioners on the LTC Combination Product Valuation Practice Note currently exposed for comment.

(August 02, 2019 )

Council Comments to Actuarial Standards Board on Setting Assumptions

Health Practice Council comments in response to the Actuarial Standards Board’s (ASB) second exposure draft of a proposed actuarial standard of practice (ASOP) titled Setting Assumptions.

(July 31, 2019 )

Long-Term Care (LTC) Combination Product Valuation Practice Note

Work Group Long-Term Care Combination Product Valuation Practice Note to provide information to actuaries on current and emerging practices in which their peers are engaged with respect to the considerations in the statutory, Generally Accepted Accounting Principles (GAAP) and tax valuation of long-term care combination products.

(December 02, 2019 )

Subcommittee Comments to Center for Medicaid and CHIP Services on May 15, 2019 Informational Bulletin

Medicaid Subcommittee comments on May 15, 2019 CMCS Informational Bulletin (CIB) titled Medical Loss Ratio (MLR) Requirements Related to Third-Party Vendors seeking additional clarification.

(July 17, 2019 )

Drivers of 2020 Health Insurance Premium Changes

Individual and Small Group Markets Committee issue brief outlines the major drivers behind why 2020 premiums could differ from those in 2019. The brief focuses primarily on the individual market, yet many of the factors discussed are also relevant to the small group market.

(June 27, 2019 )

Nearly a Decade Later the ACA is...

This presentation was a session at the SOA Health Meeting which reviewed the challenges the Affordable Care Act (ACA) has faced since its enactment in 2010 and will looked forward to where it’s headed in the future. Panelists discussed current ACA legislative and regulatory activities as well as ongoing ACA litigation.

(June 24, 2019 )

Council Comments to Congressional Committee Regarding Hearing on Pathways to Universal Health Coverage

Health Practice Council comments to the U.S. House Committee on Ways and Means regarding its June 12 hearing, "Pathways to Universal Health Coverage."

(June 07, 2019 )

Council Letter to Congressional Committee Regarding Hearing on Single-Payer Health Care

Health Practice Council letter to the U.S. House Committee on the Budget regarding its May 22 hearing, "Key Design Components and Considerations for Establishing a Single-Payer Health Care System."

(May 22, 2019 )

Council Comment Letter on Proposed Modeling ASOP

Health Practice Council letter to the Actuarial Standards Board on the fourth exposure draft of a proposed new actuarial standard of practice for modeling.

(May 15, 2019 )

Committee Comments on Selling Insurance Across State Lines

Individual and Small Group Markets Committee comments in response to the Department of Health and Human Services’ request for information on selling insurance across state lines through Health Care Choice Compacts.

(May 06, 2019 )

Medicare’s Financial Condition: Beyond Actuarial Balance

Medicare Subcommittee issue brief on the three fundamental long-range financing challenges facing the Medicare program.

(April 24, 2019 )

Subcommittee Comment Letter on Prescription Drug Rebate Proposed Rule

Medicare Subcommittee comments on the proposed rule regarding the removal of safe harbor protection for rebates involving prescription pharmaceuticals and the creation of new safe harbor protections.

(April 03, 2019 )

Unified Rate Review Template (URRT) and Instructions

Premium Review Work Group comments on the recently released final Unified Rate Review Template (URRT) and Instructions. (March 12, 2019 )

Expanding Access to Public Insurance Plans

Proposals to expand access to public health insurance plans are being put forward as a way to supplement efforts to strengthen insurance markets under the Affordable Care Act (ACA) or to replace the ACA marketplaces and/or other health insurance programs altogether. Goals of these proposals vary and include increasing access to affordable coverage, exerting downward pressure on provider prices, increasing plan availability, and reducing the number of uninsured. (March 03, 2019 )

Medicaid and Long-Term Care Insurance

Medicaid and Long-Term Care Insurance Work Group issue brief exploring the potential for catastrophic long-term care costs as a major financial risk especially facing older Americans and to help clarify the options currently available for dealing with it.

(February 25, 2019 )

2020 Benefit and Payment Parameters Proposed Rule

Individual and Small Group Markets Committee and Risk Sharing Subcommittee comments on the proposed rule for the 2020 notice of benefit and payment parameters (NBPP). (February 18, 2019 )

Long-Term Care Insurance Practice Note

Exposure draft of practice note to provide a source of information to practicing long-term care (LTC) actuaries seeking to better understand the considerations in evaluating experience, setting assumptions, valuation, and financial reporting.

(January 30, 2019 )

Subcommittee Comment Letter on Medicaid and CHIP Proposed Rule

Medicaid Subcommittee letter to CMS providing comments on Nov. 14, 2018 proposed rule regarding Medicaid and CHIP managed care programs. (January 13, 2019 )

Comments on (1332) State Relief and Empowerment Waivers Guidance

Committee comments on the Oct. 22, 2018 guidance from the Department of the Treasury and the Department of Health and Human Services on State Relief and Empowerment Waivers under Section 1332 of the Affordable Care Act (ACA), focusing on three areas: evaluation of coverage comprehensiveness and affordability, evaluation of coverage, and waiver funding. (December 17, 2018 )

Comments on Risk Adjustment Data Validation (RADV)

Council letter to the Centers for Medicare and Medicaid Services (CMS) in response to its request for comments on proposed rules pertaining to the Medicare Advantage (MA) program, including provisions to revise the risk adjustment data validation (RADV) payment error calculation methodology and process. (December 16, 2018 )

Comments on Health Reimbursement Arrangements and Other Account-Based Group Health Plans

Committees comment on the proposed rule regarding Health Reimbursement Arrangements (HRAs), that would create two new types of HRAs—Integrated HRAs and Excepted Benefit HRAs—which would allow employers to provide HRAs that could be used to pay for individual plan premiums and out-of-pocket health costs. (December 12, 2018 )

Update to NAIC LTC Actuarial Working Group

Long-Term Care Valuations Work Group update to NAIC's Long-Term Care Actuarial Working Group on the progress of the groups activities. (November 13, 2018 )

Academy Study on Potential Health Care Savings of Reference Pricing

Academy research study, Estimating the Potential Health Care Savings of Reference Pricing, exploring the possibility of using reference pricing to address health care costs, and building upon existing research by estimating the impact of expanding reference pricing to a broader set of health care services. (October 31, 2018 )

Considerations for Treatment of Past Losses in Long-Term Care Insurance Rate Increase Requests

Identifying issues commonly raised in favor of and against recoupment of past losses in various situations. (October 30, 2018 )

Comments on the impact of corporate tax rate change on HRBC

Subcommittee comments on the impact on Health Risk-Based Capital (HRBC) from the Tax Cuts and Jobs Act of 2017 (TCJA). (October 17, 2018 )

Comments on Adoption of Methodology for HHS-Operated Permanent Risk Adjustment Program for 2018 Benefit Year

Committee and Subcommittee comments on the Centers for Medicare and Medicaid Services’ (CMS) and Department of Health and Human Services’ (HHS) Aug. 10 proposed rule regarding the adoption of methodology for the HHS-operated permanent risk adjustment program. (September 04, 2018 )

Auto-Enrollment Into Individual Market Health Insurance Coverage

Individual and Small Group Markets Committee issue brief providing insights on the potential and challenges of using auto-enrollment in the individual health insurance market. (September 03, 2018 )

An Update to the Property & Casualty and Health Risk-Based Capital Bond Factors

Report to the NAIC Investment Risk-Based Capital (E) Working Group, Health Risk-Based Capital (E) Working Group, and Property and Casualty Risk- Based Capital (E) Working Group on indicated bond risk factors for the Property Casualty Risk Based Capital Formula (P&C RBC Formula) and the Health Risk Based Capital Formula (Health RBC Formula).

(July 29, 2018 )

Discussion Draft of Joint P/C Health Report on Health-Specific Considerations

Joint P&C/Health Bond Factors Analysis Work Group discussion draft of a report to the NAIC’s Health RBC Working Group on Risk-based Capital (RBC) factors related to risk charges for fixed income securities Health-Specific Considerations. (July 09, 2018 )

The AHP, Short-Term Duration and HRA Rules: What’s the Latest?

Presentation at the 2018 SOA Health Meeting examining rules surrounding association health plans, short-term limited duration insurance plans, and health reimbursement arrangements from the Trump Administration. (June 26, 2018 )

Comments on the Medicare Long-Term Care Services and Supports Act of 2018

Committee comments on proposed legislation to add a long-term care benefit to the Medicare program, evaluating in terms of financing, benefits, and coordination with other programs. (June 14, 2018 )

Medicare’s Financial Condition: Beyond Actuarial Balance

Medicare Subcommittee issue brief on the three fundamental long-range financing challenges facing the Medicare program. (June 12, 2018 )

Drivers of 2019 Health Insurance Premium Changes

Individual and Small Group Markets Committee issue brief providing an overview of the general factors underlying premium rate setting and highlighting the major components driving premium changes in 2019. (June 12, 2018 )

Updated Discussion Draft of Joint P/C Health Report on Bond Factors

Joint P&C/Health Bond Factors Analysis Work Group discussion draft of a report to the NAIC’s Joint Health RBC and P/C RBC Drafting Group on bond factors on risk charges for speculative grade (SG) bonds. (May 28, 2018 )

Comments on Short-term, Limited Duration Insurance

Committee comments on a proposed rule that would lengthen the maximum period of short-term, limited-duration (STLD) insurance through amending the definition of STLD. (April 05, 2018 )

Statutory Reserving for Group Long-Term Disability Income Insurance

Group Long-Term Disability Practice Note Work Group on some of the current practices used by health actuaries in the United States for determining actuarial reserves and liabilities for Group Long-Term Disability Income business. (March 12, 2018 )

Prescription Drug Spending in the U.S. Health Care System

Health Practice Council Capitol Hill briefing that examines the issues underlying prescription drug spending in the United States. (March 09, 2018 )

Prescription Drug Spending in the U.S. Health Care System

Prescription Drug Work Group issue brief highlighting prescription drug issues present in our health care system, including cost drivers, the effect on various stakeholders, and possible approaches that might help address the health care cost growth associated with prescription drugs.

(March 07, 2018 )

Comments on Association Health Plans

Committee comments on the definition of ‘‘Employer’’ under section 3(5) of ERISA—Association Health Plans. (March 05, 2018 )

Letter to Idaho Department of Insurance

Health Practice Council comments to the Idaho Department of Insurance on allowing health insurers to offer state-based plans that are not compliant with the Affordable Care Act in Idaho. (March 02, 2018 )

High-Performance Networks

High-Performance Network Work Group issue paper on addressing the growth in health care spending through high-performance networks, which generally focus on delivering high-quality care that also is efficient care. These networks generally result in lower total costs for health programs.

(February 26, 2018 )

Comments on Considerations Related to Modeling the Potential Impact of Association Health Plans

Committee comments to Office of Regulations and Interpretations within the Employee Benefits Security Administration in response to the Department of Labor's proposed rule on the definition of employer—small business health plans. (February 09, 2018 )

Discussion Draft of Joint P/C Health Report on Bond Factors

Joint P&C/Health Bond Factors Analysis Work Group discussion draft of a report to the NAIC’s Joint Health RBC and P/C RBC Drafting Group on bond factors.
(January 31, 2018 )

Comments on Promoting Healthcare Choice and Competition

Committee comments to Office of the Assistant Secretary for Planning and Evaluation in response to the Department of Health and Human Services’ request for information on promoting healthcare choice and competition. (January 25, 2018 )

Letter to U.S. House and Senate on Proposal to Eliminate Individual Mandate

Health Practice Council comments to the U.S. House and Senate on the potential inclusion of individual mandate repeal in The Tax Cuts and Jobs Act. (December 12, 2017 )

End-of-Life Care in an Aging World: A Global Perspective

Health Practice International Committee issue brief on global aging demographics, quality of life during the end-of-life period, palliative versus curative care, and strategies for address health care challenges at the end of life using case studies from a variety of countries.
(December 06, 2017 )

Comments on 2019 Benefit and Payment Parameters Proposed Rule

Risk Sharing Subcommittee and Premium Review Work Group letter to the U.S. Department of Health and Human Services (HHS) regarding the proposed rule for the 2019 benefit and payment parameters. The comments address proposed changes to the risk sharing mechanisms, special enrollment periods, essential health benefits, minimum essential coverage, and medical loss ratios.
(November 27, 2017 )

Letter to Senate on Proposal to Eliminate Individual Mandate

Health Practice Council comments to the U.S. Senate on a proposal in the Tax Cuts and Jobs Act to eliminate the ACA's individual mandate. (November 21, 2017 )

Comparative Effectiveness Research

Health Care Delivery Committee issue brief providing an actuarial overview of comparative effectiveness research, including measuring its impact and its potential to reduce health care costs. (November 17, 2017 )

Presentation on LTC to NCOIL

Presentation to the National Conference of Insurance Legislators about long-term care and sales and premium increase data; understanding premium rate increases; and essential criteria in LTC reform. (November 17, 2017 )

Comments on Presidential Executive Order to Departments of Treasury, Labor, and HHS

Health Practice Council comments on the October 12 executive order. (November 07, 2017 )

Comments on the Graham-Cassidy-Heller-Johnson Proposal

Health Practice Council comments on the Graham-Cassidy-Heller-Johnson Proposal (GCHJ), legislation that would make revisions to the individual health insurance market and approaches to federal Medicaid funding. (September 22, 2017 )

Letter to Senate HELP Committee on Stabilization

Health Practice Council letter to the U.S. Senate HELP Committee on stabilizing the individual health insurance market. (September 12, 2017 )

Letter to Senate on ACA Individual Mandate

Health Practice Council letter to the U.S. Senate on potential adverse consequences of legislation to eliminate the Affordable Care Act’s (ACA) individual mandate. (July 25, 2017 )

Comments on Investment RBC Bond Factors

Comment letter submitted jointly by the P/C RBC Committee and the Health Solvency Subcommittee regarding changes to corporate bond factors being considered by the NAIC’s Investment Risk-Based Capital Working Group. (July 25, 2017 )

Cost-Sharing Reductions: What Are They and Why Do They Need to Be Funded?

Health Practice Council paper on what cost-sharing reductions are and why they need to be funded. (July 24, 2017 )

Medicare’s Financial Condition: Beyond Actuarial Balance

Medicare Subcommittee issue brief on significant concerns about Medicare’s long-term financial health. (July 19, 2017 )

Risk Pooling: How Health Insurance in the Individual Market Works

Health Practice Council FAQ on how risk pooling in the individual health insurance market works. (July 14, 2017 )

Presentation on Drivers of 2018 Health Insurance Premium Changes

Presentation to the National Conference of Insurance Legislators about the Akey drivers of 2018 premiums and what goes into developing a premium. (July 14, 2017 )

Drivers of 2018 Health Insurance Premium Changes

Committee comments on High-Cost Risk Pooling in ACA Risk Adjustment

Health Financial Reporting and Solvency Committee comments to NAIC Statutory Accounting Principles Working Group in Form A Maintence Maintenance Agenda Submission Form. (July 07, 2017 )

Comments on the Better Care Reconciliation Act of 2017 (BCRA)

Indivdiual and Small Group Markets Committee and Medicaid Subcommittee comments on the Better Care Reconciliation Act (BCRA) of 2017, the proposed legislation to repeal and replace provisions in the Affordable Care Act. (June 30, 2017 )

Presentation on the Academy and Health Care Reform

Presentation at the SOA Health Meeting explaining the role of the Academy and the current legislative and regulatory environment for health care reform. (June 13, 2017 )

Presentation on LTC Essential Criteria

Presentation at the SOA Health Meeting examining essential criteria for LTC reform proposals. (June 15, 2017 )

Presentation on Telehealth From An International Perspective

Presentation at the SOA Health Meeting examining telehealth from an international perspective and discussing its theory, practice, and potential. (June 13, 2017 )

Comments to House Ways and Means Health Subcommittee on Medicare

Medicare Subcommittee comments to House Ways and Means Health Subcommittee on preserving and strengthening the Medicare program.
(June 01, 2017 )

Comments to Senate Finance Committee on Individual Market and Medicaid

Health Practice Council comments to Senate Finance Committee on improving the individual health insurance market and changing the approach to Medicaid funding.
(May 23, 2017 )

How Changes to Health Insurance Market Rules Would Affect Risk Adjustment

Risk Sharing Subcommittee issue brief examining the risk adjustment program implemented under the Affordable Care Act (ACA) and the implications for the program under different potential changes to current insurance market rules. (May 10, 2017 )

Comments to NAIC on Stop-Loss Calibration of Risk Factors

Stop-Loss Work Group comments to the NAIC’s Capital Adequacy (E) Task Force concerning calibration of risk factors in the Stop-Loss Factors Report. (May 09, 2017 )

Subgroup Comments on 2018 URRT Instructions

Premium Review Subgroup comments to the Center for Consumer Information and Insurance Oversight on the final 2018 unified rate review template (URRT) instructions. (April 27, 2017 )

Steps Toward a More Sustainable Individual Health Insurance Market

Health Practice Council issue brief examining ways in which the individual health insurance market can be strengthened and made more viable.
(April 24, 2017 )

Presentation on an Evaluation of the Individual Health Insurance Market

Health Practice Council presentation to NAIC’s Health Insurance and Managed Care Committee on potential changes to the Affordable Care Act through possible legislation and administrative actions. (April 09, 2017 )

Presentation on Potential Legislative and Administrative Actions to the Affordable Care Act

Health Practice Council presentation to NAIC’s Health Actuarial Task Force on potential changes to the Affordable Care Act through possible legislation and administrative actions and actuarial considerations. (April 07, 2017 )

Comments on American Health Care Act (AHCA)

Indivdiual and Small Group Markets Committee and Medicaid Subcommittee comments on H.R. 1628, the American Health Care Act, the proposed legislation to repeal and replace provisions in the Affordable Care Act. (March 22, 2017 )

Proposed Approaches to Medicaid Funding

Medicaid Funding Work Group issue brief addresses key design elements of block grants and per capita caps in relation to program sustainability.
(March 17, 2017 )

Comments on Association Health Plans in U.S. House Bill

Individual and Small Group Markets Committee comments to the U.S. House Committee on Education and the Workforce on H.R. 1101, the Small Business Health Fairness Act, related to association health plans.
(March 08, 2017 )

Committee Comments on Market Stabilization Proposed Rule

Individual and Small Group Markets Committee letter to the Centers for Medicare & Medicaid Services regarding the proposed rule for market stabilization. (March 07, 2017 )

Association Health Plans

Individual and Small Group Markets Committee issue brief highlighting the various policy consideration and potential implications of establishing association health plans (AHPs). (February 13, 2017 )

Selling Insurance Across State Lines

Individual and Small Group Markets Committee issue brief highlighting the various policy considerations and the potential implications of allowing the sale of insurance across state lines. (February 13, 2017 )

Using High-Risk Pools to Cover High-Risk Enrollees

Individual and Small Group Markets Committee issue brief providing an overview of three potential high-risk pool approaches to covering the costs of high-risk enrollees and examining the implications of various design features, including eligibility criteria, benefit coverage, funding sources, and regulatory responsibility. (February 10, 2017 )

Academy Congressional Testimony on Effectiveness of Individual Mandate in ACA

Written testimony on the effectiveness of the individual mandate under the Affordable Care Act (ACA) to a U.S. House Ways and Means Oversight. (February 06, 2017 )

Comments on Asset Treatment for Stand-Alone LTC Asset Adequacy Analysis

Health Financial Reporting and Solvency Committee comments to the Long-Term Care Valuation (B) Subgroup on asset treatment for stand-alone LTC asset adequacy analysis. (January 26, 2017 )

Committee Issue Paper Evaluating the Individual Health Insurance Market

Individual and Small Group Markets Committee issue paper examining the experience in the Affordable Care Act (ACA) individual market, outlining the conditions necessary for a sustainable market, examining whether these conditions are currently being met, and discussing the implications of potential changes to improve the ACA market rules or replace ACA with an alternative approach. (January 18, 2017 )

Subcommittee Comments to Maryland Insurance Commissioner on LTC Public Hearing

LTC Reform Subcommittee comment letter to the Maryland Insurance Administration Public Hearing on Long-Term Care Insurance. (January 06, 2017 )

P/C and Health Group Comments on Operational Risk Factor

Joint Property and Casualty Risk-Based Capital Committee and Health Solvency Subcommittee letter to the NAIC's Operational Risk Subgroup on proposed changes to the operational risk factor in risk-based capital (RBC) formulas for property/casualty and health. (December 19, 2016 )

Work Group Comments on GASB 74 Implementation Guide

GASB 74 Implementation Work Group comments on the GASB 74 implementation guide exposure draft that addresses financial reporting for postemployment benefit plans other than pension plans. (December 19, 2016 )

Letters to Congress on ACA Repeal without Replace

Health Practice Council letters to both the U.S. House and Senate on potential adverse consequences of repealing provisions of the Affordable Care Act (ACA) without having a replacement approach in place, and the challenges faced by eliminating the reimbursements to insurers for cost-sharing reduction subsidies.
(December 07, 2016 )

Academy Testimony at Congressional Hearing on Long-Term Care

Laurel Kastrup, chairperson of the Academy’s Health Financial Reporting and Solvency Committee, testimony at a U.S. House Subcommittee on Government Operations hearing on the federal long-term care insurance program. (November 30, 2016 )

Essential Criteria for Long-Term Care Financing Reform Proposals

LTC Criteria Work Group issue brief examining the essential criteria that should be used to analyze long-term care (LTC) financing reform proposals. (November 29, 2016 )

Report to NAIC on Stop Loss Factors

Stop Loss Factors Work Group report to the NAIC Health Risk-Based Capital (RBC) Work Group (E) reviewing the RBC formulas currently used for medical excess of loss business.
(November 14, 2016 )

Comments on 2018 Benefit and Payment Parameters Proposed Rule

Risk Sharing Subcommittee and Premium Review Work Group letter to the U.S. Department of Health and Human Services (HHS) regarding the proposed rule for the 2018 benefit and payment parameters. The comments address proposed changes to the risk sharing mechanisms, market reforms, and rate review provisions. (October 06, 2016 )

Letters to Congress on ACA Individual Mandate

Health Practice Council letters to both the U.S. House and Senate on potential adverse consequences of legislation to weaken the Affordable Care Act’s (ACA) individual mandate. (September 22, 2016 )

Report on RBC Risk Factors for Medicare Part D Coverage

Medicare Part D RBC Subgroup report recommending RBC risk factors for Medicare Part D coverage based on analysis of detailed carrier experience, which follows up on an initial report released in 2014.
(August 24, 2016 )

Long-Term Care Credibility Monograph

Long-Term Care (LTC) Credibility Monograph Work Group presentation on increasing the awareness of the applicability of credibility procedures to LTC insurance-related work, providing information on current practices, and outlining considerations and suggestions for advancing actuarial practice in LTC insurance. (August 25, 2016 )

Report on Proposed 2016 Cancer Claim Cost Valuation Tables

Cancer Claims Cost Tables Work Group report on developing a new set of valuation tables for use with cancer insurance policies in order to aid actuaries with their pricing and reviewing product filings by providing analysis on the initial data provided by the industry. (August 25, 2016 )

Long-Term Care Credibility Monograph

Long-Term Care (LTC) Credibility Monograph Work Group monograph on increasing the awareness of the applicability of credibility procedures to LTC insurance-related work, providing information on current practices, and outlining considerations and suggestions for advancing actuarial practice in LTC insurance.
(August 17, 2016 )

Academy Congressional Testimony on Drivers of 2017 Health Insurance Premium Changes

Written testimony on the general factors underlying premium rate setting and the major components driving premium changes for 2017 under the Affordable Care Act to a U.S. House Ways and Means Committee hearing on rising health care premiums. (July 22, 2016 )

Medicare’s Financial Condition: Beyond Actuarial Balance

Medicare Subcommittee issue brief on significant concerns about Medicare’s long-term financial health. (June 24, 2016 )

Understanding Premium Rate Increases on Private Long-Term Care Insurance Policyholders

LTC Reform Subcommittee issue brief providing an overview of premium rate increases on private long-term care insurance policyholders. (June 02, 2016 )

Drivers of 2017 Health Insurance Premium Changes

Subcommittee Comments to Maryland Insurance Commissioner on LTC

LTC Reform Subcommittee comment letter to the Maryland Insurance Administration Public Hearing on Long-Term Care Insurance. (April 28, 2016 )

Subcommittee Comments on CMS Risk Adjustment Methodology Discussion Paper

Risk Sharing Subcommittee letter to the Centers for Medicare & Medicaid Services (CMS) with comments on its recent discussion paper, HHS-Operated Risk Adjustment Methodology. The letter includes comments on partial year enrollment, use of pharmacy data, use of concurrent versus prospective model, high-risk enrollee pooling, recalibration of the model, and the transfer formula. (April 22, 2016 )

Work Group report to NAIC’s Health Risk Based Capital (E) Work Group

Health Care Receivables Factors Work Group recommendation on credit risk factors for health care receivables to the NAIC’s Health Risk Based Capital (E) Work Group. (April 15, 2016 )

Subcommittee Issue Paper on ACA Risk Adjustment Program

Risk Sharing Subcommittee issue paper that reviews the first year of experience under the Affordable Care Act’s (ACA) risk adjustment program with focus on experience in the individual market.

(April 12, 2016 )

Subcommittee Presentation to HATF on Risk Adjustment Program

Risk Sharing Subcommittee presentation to the Health Actuarial Task Force (B) on its report on the risk adjustment program. (April 05, 2016 )

LTC PBR Work Group Presentation to NAIC’s Long-Term Care Actuarial Working Group

Long-Term Care (LTC) Principle Based Reserve (PBR) Work Group presentation of its final report to the NAIC’s Long-Term Care Actuarial Working Group (B). (April 05, 2016 )

Work Group Presentation to NAIC’s Long-Term Care Actuarial Working Group

Long-Term Care (LTC) Credibility Monograph Work Group update presentation to the NAIC’s Long-Term Care Actuarial Working Group (B). (April 05, 2016 )

Work Group Presentation to NAIC’s Health Actuarial Task Force

Cancer Claim Cost Table Work Group presentation to the NAIC’s Health Actuarial Task Force (B) updating the 1985 cancer claim cost tables. (April 05, 2016 )

Work Group Comments on 2017 URRT and Instructions

Premium Review Work Group letter to CCIIO with comments on the 2017 unified rate review template (URRT). (March 30, 2016 )

Subcommittee Comments to NAIC’s Health Risk-Based Capital (E) Working Group

Health Solvency Subcommittee letter to the NAIC’s Health Risk-Based Capital (E) Working Group with comments on Proposal 2016-01-H’s individual premiums and claims footnote. (March 28, 2016 )

Subcommittee Letter to U.S. Senate Finance Committee on Chronic Care

Medicare Subcommittee letter to the Senate Finance Committee with comments on the Bipartisan Chronic Care Working Group’s Policy Options Document. (January 26, 2016 )

Work Group Final Report to HATF on Individual Disability Valuation Standard

Individual Disability Tables Work Group final report and documentation on a recommended new statutory valuation standard basis for morbidity to the NAIC's Health Actuarial Task Force.

(January 21, 2016 )

Work Group Final Report to NAIC on LTC Principle-Based Model

LTC Principle-Based Reserves Work Group final report on a principle-based approach model to the NAIC's Long-Term Care Actuarial Working Group. (January 21, 2016 )

Subcommittee Comments on Benefit and Payment Parameters Proposed Rule

Risk Sharing Subcommittee letter to the U.S. Department of Health and Human Services (HHS) regarding the proposed rule on benefit and payment parameters for 2017. (December 20, 2015 )

Presentation to FSOC on Regulatory Capital Requirements for U.S. Insurers

Academy Senior Life Fellow Nancy Bennett and Senior Casualty Fellow Jim MacGinnitie presentation to the Financial Stability Oversight Council (FSOC) on regulatory capital requirements for U.S. insurers. (December 11, 2015 )

Rate Filings under the Affordable Care Act

Premium Review Work Group practice note on Actuarial Practices Relating to Preparing, Reviewing, and Commenting on Rate Filings Prepared in Accordance with the Affordable Care Act, providing information on general rate filing requirements and considerations related to the URRT adn actuarial memorandum. (December 03, 2015 )

Work Group Update on Cancer Claims Cost Tables Project

Cancer Claims Cost Tables Work Group presentation to the NAIC's Health Actuarial Task Force the produced graduated valuation tables, and sample reserve calculations.
(November 18, 2015 )

LTCTWG Report on Terminations for LTC Insurance

Long-Term Care Terminations Work Group final report to the NAIC's Long-Term Care Actuarial Working Group on terminations for long-term care (LTC) insurance.
(November 18, 2015 )

Subcommittee Update on Evaluation of Asset Risk in HRBC Formula

Health Solvency Subcommittee updated on the evaluation of asset risk in the health risk-based capital (HRBC) formula.
(November 09, 2015 )

Work Group Responses on Recommendations for Medicare Modifications

Medicare Supplemental Work Group responses to questions regarding the work group’s recommendations on modifications to the Medicare supplement refund formula.

(November 10, 2015 )

IDTWG Updates Incidence Modifies for Life Reserve Calculations

Individual Disability Tables Work Group (IDTWG) presented updated incidence modifiers report for use in active life reserve calculations for employer-sponsored disability income policies along with a corresponding (November 18, 2015 )

Committee Comments to NAIC on ACA Risk Corridors Exposure Draft

Financial Reporting and Solvency Committee comment letter to the NAIC's Emerging Accounting Issues (E) Working Group on the “ACA Risk Corridors Collectability” exposure draft. (October 30, 2015 )

International Perspective on Long-Term Care

Health Practice International Committee issue brief exploring the similarities and differences with respect to long-term care reform in Austria, Germany, Israel, Japan, Korea, the Netherlands, and the U.S. (October 29, 2015 )

Long-Term Care Insurance: Pricing Flexibility

Long-Term Care (LTC) Reform Subcommittee issue brief exploring observations and concerns about pricing in LTC insurance, which is part of its new LTC series.

(October 23, 2015 )

Long-Term Care Insurance: Product Design Flexibility

Long-Term Care (LTC) Reform Subcommittee issue brief that examines the limited role played by private insurance in financing long-term care services and supports, which is part of its new LTC series.

(October 23, 2015 )

Long-Term Care Insurance: Portability

Long-Term Care (LTC) Reform Subcommittee issue brief exploring observations and challenges in LTC insurance portability, which is part of its new LTC series.

(October 23, 2015 )

Medicare at 50: Medicare Advantage Plans

Medicare Subcommittee issue brief that examines the potential for Medicare Advantage plans to improve quality of care at lower prices as part the Medicare@50 series.

(October 23, 2015 )

Subcommittee Comments on Excise Tax on High-Cost Employer-Sponsored Health Coverage

Active Benefits Subcommittee letter to the IRS regarding Notice 2015-52 on the excise tax for high-cost employer-sponsored health coverage under the Affordable Care Act (ACA). (October 01, 2015 )

Work Group Comments on URRT and Rating Methodology

Premium Review Work Group letter to CCIIO with suggested changes to the unified rate review template (URRT) and rating methodology. (September 22, 2015 )

Congressional Testimony on Small Group Definition

Academy Senior Health Fellow Cori Uccello written testimony on potential implications of expanding small-group definition to companies with 51-100 employees to a U.S. House Energy & Commerce Subcommittee on Health hearing on affordable health care. (September 09, 2015 )

Drivers of 2016 Health Insurance Premium Changes

Individual and Small Group Markets Committee issue brief providing an overview of the factors underlying the general premium rate setting and highlighting the major drivers behind why 2016 premiums could differ from those in 2015 under the Affordable Care Act (ACA). (August 05, 2015 )

Academy Committees Comment on PCAOB Auditor and Specialist Paper

The Financial Reporting Committee, Pension Accounting Committee, Casualty Committee on Property and Liability Financial Reporting, Health Financial Reporting and Solvency Committee, and Life Financial Reporting Committee comments on the Public Company Accounting Oversight Board’s (PCAOB) “The Auditor's Use of the Work of Specialists” consultation paper. (July 15, 2015 )

Medicare at 50: Who Are the Beneficiaries?

Medicare Subcommittee issue brief in the Medicare at 50 series examining the diverse needs and characteristics of Medicare beneficiaries. (July 29, 2015 )

Medicare at 50: Is It Sustainable for 50 More Years?

Medicare Subcommittee issue brief in the Medicare at 50 series exploring the financial challenges facing the Medicare program and highlighting the need for policy options to ensure the program's long-term sustainability. (July 29, 2015 )

Medicare at 50: Does It Meet the Needs of the Beneficiaries

Medicare Subcommittee issue brief in the Medicare at 50 series exploring the benefits available under the traditional fee-for-service Medicare program, as well as Medicare Advantage and supplemental policies. (July 29, 2015 )

Medicaid Subcommittee Comments to CMS

Medicaid Subcommittee comment letter to Centers for Medicare and Medicaid Services (CMS) on proposed rules about Medicaid and Children’s Health Insurance Program (CHIP) Programs; Medicaid managed care, CHIP delivered in managed care, Medicaid and CHIP comprehensive quality strategies, and revisions related to third party liability. (July 27, 2015 )

Academy Councils Comments on NAIC E Committee Questionnaire

The Casualty Practice Council, Health Practice Council, Life Practice Council, and Risk Management and Financial Reporting Council comments to the National Association of Insurance Commissioners (NAIC) on its Financial Condition (E) Committee questionnaire that examines the reasons for single-state solutions to help regulators develop a process for creating a uniform framework for state-based regulation. (July 27, 2015 )

Medicare Subcommittee Issue Brief on Trustees' Report

Medicare Subcommittee issue brief, “Medicare’s Financial Condition: Beyond Actuarial Balance,” on significant concerns about Medicare’s long-term financial health. (July 24, 2015 )

Task Force Comments on Individual Disability Valuation Standard Report

Individual Disability Tables Work Group comments on the “The Individual Disability Valuation Standard Report” of the Joint American Academy of Actuaries/Society of Actuaries Individual Disability Tables Work Group. (July 22, 2015 )

International Wellness Initiatives

Health Practice International Committee issue brief exploring current wellness initiatives with four international case studies as examples. (July 06, 2015 )

Implications of Proposed Changes to the ACA in Response to King v. Burwell

Health Practice Council issue brief examining the approaches included in various proposals policymakers are considering in case the Supreme Court rules in King v. Burwell that federal premium subsidies are not available for individual market plans in states participating in the federally facilitated marketplace. (May 28, 2015 )

Work Group Comments to NAIC on Evaluation of Asset Risk Factors

Health Solvency Work Group comment letter to the NAIC's Investment Risk-Based Capital Working Group on the evaluation of asset risk factors for the health risk-based capital formula. (May 20, 2015 )

Work Group Comments on EDGE Data Submissions

Risk Sharing Work Group letter to CCIIO on the methodology proposed to evaluate the sufficiency of EDGE server data. (May 08, 2015 )

Congressional Testimony on ACA Mandates

Senior Health Fellow Cori Uccello written testimony to the U.S. House Ways and Means Subcommittee on Health hearing on alternatives to the individual and employer mandates under the Affordable Care Act (ACA). (April 27, 2015 )

Work Group Comments on 2014 MLR Annual Reporting Form

Risk Sharing Work Group letter to CMS with comments on the 2014 medical loss ratio (MLR) annual reporting form. (March 31, 2015 )

Work Group Update to NAIC on LTC Credibility Monograph

Long-Term Care Credibility Monograph Work Group’s progress update in drafting a monograph that addresses long-term care credibility and a timeline for completion to the NAIC’s Long-Term Care Actuarial Working Group. (March 27, 2015 )

Presentation on LTC Principle-based Model Update to NAIC

Presentation to NAIC’s Long-Term Care Actuarial Working Group on the Long-Term Care Principle-Based Work Group’s progress on developing a principle-based approach model and a timeline for completion. (March 27, 2015 )

Update to NAIC on LTC Terminations

Long-Term Care Terminations Work Group presented an update to NAIC’s Long-Term Care Actuarial Working Group on the progress in gathering data on terminations for long-term care insurance. (March 27, 2015 )

Council Comments on Premium Rate Filing Implications of King v. Burwell

Health Practice Council comments urging HHS to consider implementing measures to counter the potential adverse consequences on health insurance premium rate filings in the event the Supreme Court rules for the petitioners in King v. Burwell. (February 24, 2015 )

Work Group Recommendations for Changes to Rate Review Instructions

Rate Review Practice Note Work Group letter to CCIIO with suggested recommendations for modifications to the unified rate review template (URRT) and actuarial memorandum instructions to provide further clarification on a number of issues. (January 16, 2015 )

Academy Comments to NAIC on Operational Risk

Life Capital Adequacy Committee, Property and Casualty Risk-Based Capital Committee, and Health Solvency Work Group comments to the National Association of Insurance Commissioners (NAIC) on operational risk issues. (January 07, 2015 )

Work Group Comments on Payment Parameters Proposed Rule

Risk Sharing Work Group letter to the U.S. Department of Health and Human Services (HHS) in response to the proposed rule on benefit and payment parameters for 2016. (December 22, 2014 )

Comments to ASB on Public Pension Plan Funding

Joint Committee on Retiree Health letter to the Actuarial Standards Board on actuarial valuations and other analyses used for determining public pension and other post-employment plan funding and accounting. (November 15, 2014 )

Work Group Presentation on Medicare Supplement Refund Formula Recommendation

Medicare Supplement Work Group presentation to the NAIC on recommendations for potential modifications to the Medicare Supplement refund formula.

(November 18, 2014 )

Work Group Presentation on Updated Individual Disability Tables and Actuarial Guideline

Individual Disability Tables Work Group presentation to Health Actuarial Task Force at NAIC Fall National Meeting on the newly revised individual disability table and actuarial guideline. (November 18, 2014 )

Report on Medicare Supplement Refund Formula Recommendation

Medicare Supplement Work Group report to the NAIC on recommendations for potential modifications to the Medicare Supplement refund formula.

(November 12, 2014 )

Comment on Breakthrough Therapy Designation Medications

Medicaid Work Group letter to the Centers for Medicare & Medicaid Services on the introduction of new Breakthrough Therapy Designation medications and their potential impact on Medicaid costs. (November 11, 2014 )

Work Group Presentation on Revised Individual Disability Tables and Actuarial Guideline

Individual Disability Tables Work Group presentation to NAIC’s Health Actuarial Task Force on a newly revised individual disability table and actuarial guideline. (October 31, 2014 )

Revised Individual Disability Table Report and Actuarial Guideline Released

Individual Disability Table Work Group revised individual disability table report and actuarial guideline to the NAIC’s Health Actuarial Task Force. (October 31, 2014 )

Exposure Draft: Rate Filings and Review for 2015 and Beyond

Exposure draft of a new practice note related to rate filings, review, and disclosure under the Affordable Care Act for calendar year 2015 and beyond. Comments on the exposure draft should be submitted by Oct. 27. (October 26, 2014 )

Joint Committee on Retiree Health Sends Comment Letter to GASB Regarding Exposure Draft

The Joint Committee on Retiree Health letter to the Governmental Accounting Standards Board commenting on proposed statements of accounting and financial reporting by governmental employers for other postemployment benefits (OPEBs). (August 29, 2014 )

Joint Committee on Retiree Health Sends Comment Letter to GASB Regarding Exposure Draft

Update to NAIC on LTC Credibility Monograph

Update to the NAIC’s Long-Term Care Actuarial Working Group on the Long-Term Care Credibility Monograph Work Group’s progress in drafting a monograph that addresses long-term care credibility. (August 15, 2014 )

Update to NAIC on LTC Principle-based Model

Update to NAIC’s Long-Term Care Actuarial Working Group on the Long-Term Care Principle-based Work Group’s progress on developing a principle-based approach model and a timeline for completion. (August 15, 2014 )

Update to NAIC on LTC Terminations

Update to NAIC’s Long-Term Care Actuarial Working Group on the progress in gathering data on terminations for long-term care insurance. (August 15, 2014 )

Curbing the High Cost of Diabetes

Health Practice International Task Force issue brief providing an overview of the prevalence and costs associated with diabetes internationally and exploring current diabetes mitigation efforts in seven specific countries. (August 13, 2014 )

Medicare's Financial Condition: Beyond Actuarial Balance (2014)

Medicare Steering Committee issue brief offering an actuarial perspective on Medicare's financial condition and outlining the public policy options to address the program's long-term financial challenges. (July 31, 2014 )

Comment Letter on Health Insurance Providers Fee For Medicaid

Medicaid Work Group request to the Centers for Medicare and Medicaid Services for specific guidance on the Affordable Care Act's Health Insurance Providers fee and how it affects the Medicaid program. (July 07, 2014 )

Comment Letter on New Accounting Proposal for ACA Risk-Sharing Programs

Health Practice Financial Reporting Committee comments to the NAIC on new accounting proposals for the risk-sharing programs of the Affordable Care Act. (June 20, 2014 )

Comment Letter on New Accounting Proposal for ACA Risk-Sharing Programs

Health Practice Financial Reporting Committee comments to the NAIC on new accounting proposals for the risk-sharing programs of the Affordable Care Act. (June 20, 2014 )

Academy Congressional Testimony on the ACA 3Rs

Senior Health Fellow testimony to the U.S. House Oversight and Government Reform Subcommittee on Economic Growth, Job Creation, and Regulatory Affairs hearing on the Affordable Care Act's risk-sharing mechanisms, also known as the 3Rs. (June 18, 2014 )

Report to NAIC on Medicare Part D RBC Factors

Medicare Part D RBC Subgroup report to NAIC’s Health Risk-Based Capital Working Group recommending no change be made to the risk factors for Medicare Part D coverage. (June 12, 2014 )

Drivers of 2015 Health Insurance Premium Changes (Updated)

Health Practice Council issue brief providing an overview of the factors underlying general premium rate setting and highlighting the major drivers behind why 2015 premiums could differ from those in 2014 under the Affordable Care Act (ACA). (June 04, 2014 )

Minimum Value and Actuarial Value Determinations Under Affordable Care Act

Practice note by the Minimum Value Practice Note Work Group on the calculation of minimum value and actuarial value under the Affordable Care Act (ACA), which includes a discussion of plan designs not accommodated by the calculators. (April 24, 2014 )

Work Group Comments on ACA Risk-Sharing Mechanisms

Risk Sharing Work Group letter to CCIIO with comments on a proposed rule related to exchanges and market reforms for 2015, specifically addressing ACA risk-sharing mechanisms. (April 21, 2014 )

Update to NAIC on Medicare Supplement Refund Formula Review

Medicare Supplement Work Group update to NAIC's Health Actuarial Task Force on the progress of a review of the Medicare supplement review and a list of next steps. (March 28, 2014 )

Actuary Serving Congress: A Conversation with GAO’s Chief Actuary

Presentation by Frank Todisco, chief actuary of the Government Accountability Office, at an Academy Capitol Forum webinar on the GAO’s mission, the role of the actuary at the agency, and some of its selected work areas. (March 20, 2014 )

Letter to NAIC on Impact of 3Rs on Health RBC

Letter from Health Solvency Work Group to NAIC Health Risk-Based Capital Working Group regarding the effect of the 3Rs on risk-based capital. (March 11, 2014 )

Putting A Premium on Health: The Affordable Care Act & Underwriting

Presentation to the National Conference of Insurance Legislators about the Affordable Care Act’s effect on rating. (March 10, 2014 )

Joint Academy/SOA Work Group Report on LTC Valuation Table

Joint Academy/SOA LTC Valuation Work Group report that highlights the work group's process in considering the development of an LTC valuation table. (February 12, 2014 )

Academy Congressional Testimony on ACA Risk Corridors

Senior Health Fellow written testimony to the U.S. House Oversight and Government Reform hearing on the Affordable Care Act's risk corridor program and whether it constitutes a "bailout" for insurance companies. (February 05, 2014 )

Comments to NAIC on Definition of Qualified Actuary

Academy comments to NAIC’s Joint Qualified Actuary (A/B/C) Subgroup on definitions of “qualified actuary” as prescribed by the NAIC. (February 03, 2014 )

Joint Committee on Retiree Health Comments on ASOP No. 35

Joint Committee on Retiree Health comments to the Actuarial Standards Board on revisions to ASOP No. 35, Selection of Demographic and Other Noneconomic Assumptions for Measuring Pension Obligations. (February 02, 2014 )

Academy Letter to NAIC on Operational Risk Proposal

Letter from Academy RBC work groups to the NAIC SMI RBC Subgroup regarding the NAIC’s Dec. 9 Operational Risk Proposal. (January 30, 2014 )

Work Group Technical Comments on ACA Rate Review Template

The Rate Review Practice Note Work Group submitted comments to the Center for Consumer Information and Insurance Oversight (CCIIO) on a second draft of revisions to the Unified Rate Review Template (URRT) and actuarial memorandum instructions. (January 24, 2014 )

NAIC Exposure of Individual Disability Tables Instructions

NAIC's Health Actuarial Task Force exposure of the Individual Disability Tables Work Group's instructions for utilizing the individual disability tables with comments due by June 30. (January 24, 2014 )

NAIC Exposure of Individual Disability Tables

NAIC's Health Actuarial Task Force exposure of the Individual Disability Table Work Group's proposed individual disability tables with comments due by June 30.

(January 24, 2014 )

NAIC Exposure of Individual Disability Tables Final Report and Proposed Actuarial Guideline

NAIC's Health Actuarial Task Force exposure of Individual Disability Tables Work Group's proposed individual disability tables final report and actuarial guideline with comments due by June 30. (January 24, 2014 )

Revised Individual Disability Valuation Table Instructions

Individual Disability Table Work Group instructions for use of the newly revised individual disability valuation table. (January 17, 2014 )

Work Group Technical Comments on ACA Rate Review Template

Rate Review Practice Note Work Group letter to the Center for Consumer Information and Insurance Oversight (CCIIO) with comments on a new proposed list of changes to the Unified Rate Review Template (URRT) for quarterly 2014 and annual 2015 filings. The letter also reiterates several other technical comments on the URRT and the actuarial memorandum instructions. (January 03, 2014 )

Council Comments on Benefit and Payment Parameters for 2015 Proposed Rule

Health Practice Council letter to HHS in response to the proposed rule on benefit and payment parameters for 2015, specifically addressing composite rating, proposed changes to the actuarial value calculator and methodology, and the three risk-sharing mechanisms. (December 20, 2013 )

Actuarial Guideline to Group Long-Term Disability Valuation Table Adopted

Actuarial guideline for the revised Group Long-Term Disability Valuation Table adopted at NAIC fall national meeting. (December 18, 2013 )

Revised Group Long-Term Disability Valuation Table Adopted

Revised Group Long-Term Disability Valuation Table adopted by Health Insurance and Managed Care (B) Committee at NAIC fall national meeting. (December 18, 2013 )

Work Group Gives Presentation on Updated Individual Disability Table

Individual Disability Table Work Group presentation to NAIC's Health Actuarial Task Force on an updated individual disability table. (December 17, 2013 )

Work Group Final Report and Actuarial Guideline on New Individual Disability Table

Individual Disability Table Work Group final report and actuarial guideline to the NAIC's Health Actuarial Task Force on a new individual disability table, which will be exposed until June 30. (December 16, 2013 )

Update to NAIC on LTC Principle-Based Model

Update to NAIC's Health Actuarial Task Force on the progress of the Long-Term Care principle-based approach model and a timeline for completion. (December 16, 2013 )

Technical Comments to CCIIO on ACA Rate Review Template

Rate Review Practice Note Work Group letter to the Center for Consumer Information and Insurance Oversight (CCIIO) highlighting several technical comments on the current versions of the Unified Rate Review Template and the actuarial memorandum instructions. (December 04, 2013 )

ACA Risk-Sharing Mechanisms - The 3Rs (Risk Adjustment, Risk Corridors, and Reinsurance) Explained

Health Practice Council fact sheet providing and overview of the three risk-sharing mechanisms included in the Affordable Care Act (ACA) - the permanent risk-adjustment program, temporary risk corridors, and the transitional reinsurance program. (December 04, 2013 )

Presentation on New Models of Care Delivery to NCOIL

Presentation to the National Conference of Insurance Legislators about new models of care delivery. (November 24, 2013 )

Presentation on Premiums to NCOIL

Presentation to the National Conference of Insurance Legislators about the Affordable Care Act's effect on premiums. (November 21, 2013 )

Re-Exposure of Group Long-Term Disability Actuarial Guideline

Group Long-Term Disability Valuation Table Implementation (B) Subgroup re-exposure of Academy group long-term disability Actuarial Guideline with comments due by Dec. 3. (November 15, 2013 )

Implications of Changing ACA Rules Regarding Insurance Cancellations In The Individual And Small Group Health Insurance Markets

Health Practice Council letter to members of Congress on potential consequences of proposals that would modify ACA provisions regarding plan cancellations in the individual and small group health insurance markets.
(November 14, 2013 )

State LTC Task Force Comment Letter to NAIC on Proposed Changes to Model Reg

State Long-Term Care Task Force comment letter to the NAIC's Long-Term Care Valuation Subgroup regarding proposed changes to the NAIC's Health Insurance Reserves Model Regulation. (November 06, 2013 )

Letter to Congress on Implications of Delaying Individual Mandate or Extending Open Enrollment under ACA

Health Practice Council letter to members of Congress on potential adverse consequences of delaying the Affordable Care Act's (ACA) individual mandate and/or extending its open enrollment period. (November 05, 2013 )

Financial Reporting Implications Under the Affordable Care Act

Health Practice Financial Reporting Committee issue brief providing an overview of Affordable Care Act provisions - the premium-stabilization programs, new taxes and fees, advanced payments, and existing actuarial liabilities - that may create a certain amount of volatility on future financial statements. (November 01, 2013 )

Response Letter to NAIC on Health Solvency Concentration Risk Model

Health Solvency Work Group response letter to questions raised by the NAIC's Health RBC Working Group regarding the HSWG's model that examines administrative expenses within the context of business concentration risk. (October 18, 2013 )

Exposure of Group Long-Term Disability Final Report

Group Long-Term Disability Work Group exposure of proposed group long-term disability final report to the NAIC's Health Actuarial Task Force. Comments are due by Oct. 30. (October 11, 2013 )

Exposure of Group Long-Term Disability Actuarial Guideline

Group Long-Term Disability Work Group exposure of proposed group long-term disability actuarial guideline to the NAIC's Health Actuarial Task Force. Comments are due by Oct. 30. (October 11, 2013 )

LTC Presentation to SERA Conference

Presentation to the Southeastern Regulators Association Conference on actuarial implications for long-term care insurance. (October 04, 2013 )

Work Group Presents New Guidelines for Health Care Receivables

Health Care Receivables Factors Work Group presentation on the NAIC Health Annual Statement's new Exhibit 3A, which provides guidelines for health care receivables. (September 24, 2013 )

Work Group Presentation on Individual Disability Tables

Individual Disability Tables Work Group update to Disability Insurance & Long-Term Care Insurer's Forum on the history of developing the valuation table, progress made to date, and what remains to be done. (September 20, 2013 )

Work Group Comments on Requirements for Medicare Advantage, Part D Programs

MLR Work Group comments to CMS that reiterate previous comments on the proposed rule implementing medical loss ratio (MLR) requirements for Medicare Advantage (MA) and Medicare prescription drug (Part D) programs. (September 06, 2013 )

Joint Practice Council Letter on Coordinating ASOPs on Retiree Benefits

Health and Pension Practice Council letter to the Actuarial Standards Board on coordinating Actuarial Standards of Practice (ASOP) affecting pension and retiree group benefits. (August 30, 2013 )

Joint Committee on Retiree Health Comments on ASOP No. 6 Exposure Draft

Joint Committee on Retiree Health comments to the Actuarial Standards Board on revisions to a second exposure draft of ASOP No. 6, Measuring Retiree Group Benefits Obligations and Determining Retiree Group Benefits Program Periodic Costs or Prefunding Contributions. (August 30, 2013 )

Financial Reporting Implications Under the Affordable Care Act

Aug. 22, 2013 Webinar Presentation: Financial Reporting Implications Under the Affordable Care Act (August 22, 2013 )

Large Group Medical Insurance Reserves, Liabilities, and Actuarial Assets

Update of the Large Group Medical Business Practice Note by the Large Group Medical Business Practice Note Work Group. (August 07, 2013 )

Financial Reporting Implications Under the ACA

Health Practice Financial Reporting Committee white paper providing an overview of provisions in the Affordable Care Act - the premium-stabilization programs, new taxes and fees, advanced payments, and existing actuarial liabilities - that may create a certain amount of volatility on future financial statements. (June 25, 2013 )

Congressional Testimony on the 2013 Medicare Trustees Report

Medicare Steering Committee testimony to the House Ways and Means Subcommittee on Health regarding the 2013 Medicare Trustees Report. (June 20, 2013 )

Medicare's Financial Condition: Beyond Actuarial Balance (2013)

Medicare Steering Committee issue brief offering an annual perspective on Medicare's financial condition and outlining the public policy options to address the program's long-term financial challenges. (June 12, 2013 )

Comment Letter to NAIC on ACA Health Insurer Fee

Health Practice Financial Reporting Committee comments to the NAIC on proposed modifications to the Maintenance Agenda Submission Form that addresses and Accounting Standards Update surrounding fees paid to the federal government by health issuers. (May 17, 2013 )

Issue Brief - How Will Premiums Change Under the ACA?

Issue brief by Senior Health Fellow Cori Uccello provides an overview of the basic concepts underlying premium calculations, and highlights and examines several Affordable Care Act-related provisions that could affect premiums. (May 09, 2013 )

Work Group Comments on Amendment to Benefit and Payment Parameters Rule

Risk Sharing Work Group comments to HHS on the interim final rule implementing amendments to the Notice of Benefit and Payment Parameters final rule. (April 30, 2013 )

Actuarial Practices Relating to Preparing, Reviewing, and Commenting on Rate Filings Prepared in Accordance with the Affordable Care Act

Exposure draft of an addendum to the October 2012 practice note, Actuarial Practices Relating to Preparing, Reviewing, and Commenting on Rate Filings Prepared in Accordance with the Affordable Care Act. Comments on the addendum, which highlights changes to the rate review and disclosure requirements since the initial practice note was finalized, are due by June 3. (April 26, 2013 )

MLR Work Group Comments on Proposed Rule on Requirements for Medicare Advantage, Part D Programs

Comments to CMS on the proposed rule implementing MLR requirements for Medicare Advantage (MA) and Medicare prescription drug (Part D) programs. (April 25, 2013 )

Academy/SOA Individual Disability Table Work Group Update at NAIC Spring Meeting

Individual Disability Table Work Group update to the NAIC's Health Actaurial Task Force on the progress of the valuation table and requesting volunteers from the task force to join the work group. (April 05, 2013 )

Joint Academy/SOA LTC Valuation Work Group Final Recommendation to NAIC on LTC Valuation Table

Final recommendation to the NAIC's Long-Term Care Actuarial Working Group that a long-term care valuation table is not feasible at this time due to lack of quality data. (April 05, 2013 )

MLR Work Group Comments on Proposed Rule for Preventive Services

Medical Loss Ratio Work Group's comments to HHS on a proposed rule that requires issuers to offer a new type of individual health insurance policy covering contraceptive benefits. The comments focus only on the effect of the proposed rule on the MLR calculation. (March 28, 2013 )

Letter to NAIC on New Long-Term Care Terminations Work Group

Long-Term Care Terminations Work Group letter to the NAIC regarding the formation of the work group that is charged with gathering data on terminations in long-term care insurance, and outlines its proposed tasks and timelines. (March 15, 2013 )

Group Long-Term Disability Table at NAIC

Three Academy-related documents before the NAIC Health Actuarial (B) Task Force for comment include 2012 Group Long-Term Disability Valuation Table, proposed related Actuarial Guideline, and the proposed modification to the Health Insurance Reserves Model Regulation. (March 15, 2013 )

Senior Health Fellow Written Testimony on Medicare's Benefit Design

Academy Senior Health Fellow Cori Uccello's written testimony to the House Ways and Means Subcommittee on Health in response to its recent hearing that examined Medicare's traditional fee-for-service benefit design. (March 08, 2013 )

Work Group Comments on ACA Rate Review Template

Rate Review Practice Note Work Group letter to CCIIO recommending several modifications to the unified rate review template and instructions associated with the final rules implementing the rate review and disclosure provisions in the ACA. (March 07, 2013 )

Practice Councils' Comments to NAIC Joint Qualified Actuary (A/B/C) Subgroup

Councils' letter to NAIC's Joint Qualified Actuary (A/B/C) Subgroup on the subgroup's two new charges related to defining a "qualified actuary" and recommending a process to address "unprofessional" actuarial work. (February 11, 2013 )

Analysis on ACA-Related Potential Risks to Health RBC

Health Solvency Work Group letter to the NAIC's Health Risk-Based Capital Working Group on the work group's analysis of Affordable Care Act-related possible risks to the health risk-based capital formula. (February 08, 2013 )

Update on Academy/SOA Cancer Claims Cost Tables Work Group Project

Cancer Claims Cost Tables Work Group letter to the NAIC's Health Actuarial Task Force on it's valuation table progress. (February 01, 2013 )

Large Group Medical Business

Exposure draft update of the Large Group Medical Business Practice Note by the Large Group Medical Business Practice Note Work Group. (January 24, 2013 )

HPC Letter on Need to Appoint Actuary to LTC Commission

HPC letter to President Obama and congressional leaders urging them to appoint an actuary to the new Commission on Long-Term Care that was enacted as part of the American Taxpayer Relief Act of 2012. (January 10, 2013 )

Updated Proposal to NAIC on Health Care Receivables

Health Care Receivables Factors Work Group letter to the NAIC's Health Risk-Based Capital Working Group providing recommendations for receivables factors for the current RBC formula. (January 08, 2013 )

Letter to NAIC on Health Receivables

Health Care Receivables Factors Work Group letter to the NAIC on a revised proposal providing recommendations for receivables factors for the current RBC formula. (January 07, 2013 )

Comment Letter on MLR Provisions in Benefit and Payment Parameters Proposed Rule

MLR Work Group comments to CMS on the proposed rule, Benefit and Payment Parameters for 2014, addressing proposed changes to the final rule on MLR. (December 31, 2012 )

Comment Letter on Benefit and Payment Parameters Proposed Rule

Risk Sharing Work Group comments to CMS on proposed rule, Benefit and Payment Parameters for 2014, addressing payment methodologies and data collection for risk adjustment, reinsurance, and risk corridor mechanisms in the ACA. (December 31, 2012 )

Comment Letter on Plan Data Collection Requirements

Actuarial Value Subgroup comment letter on plan data collection requirements, specificially asking for clarification on whether any AV-related data collection elements will be consistent with those data elements in the AV calculator. (December 20, 2012 )

An Actuarial Perspective on Accountable Care Organizations (update)

Update of a June 2011 issue brief by the Health Care Quality Work Group highlighting a number of actuarial issues that should be considered when designing and implementing accountable care organizations (December 19, 2012 )

Fact Sheet: Medicare Shared Savings Program and the Pioneer ACO Program

Update of a June 2011 fact sheet by the Health Care Quality Work Group providing an overview of the Medicare Shared Savings Program and the Pioneer ACO program. (December 19, 2012 )

Comment Letter on Actuarial Value Proposed Rule

Actuarial Value Subgroup comment letter on the proposed rule establishing standards for actuarial value determinations under the Affordable Care Act (December 18, 2012 )

Long-Term Care Actuarial Implications

Presentation at the NAIC Senior Issues Task Force Long-Term Care hearing at the 2012 Fall National Meeting on actuarial implications for long-term care insurance.

(December 06, 2012 )

Implications for State Medicaid Expansion Decisions

Presentation to the 2012 NCOIL Annual Meeting on implications for states regarding their Affordable Care Act-related Medicaid expansion decisions. (November 26, 2012 )

Letter to NAIC on Health Care Receivables Factors

Letter from the Health Care Receivables Factors Work Group's Health RBC Working Group providing recommendations to receivables factors for the current RBC formula. (November 16, 2012 )

Actuarial Guideline for New Long-Term Disability Table

Proposed Actuarial Guideline to the NAIC's Health Actuarial Task Force (HATF) regarding the proposed new long-term disability table. (November 14, 2012 )

Understanding LTC Rate Stability

Long Term Care Practice Note Work Group slides from webinar discussing LTC rate stability.

(October 31, 2012 )

Understanding the ACA – Rate Filing Review and Disclosure

Slides providing an overview of the review and disclosure requirements of "unreasonable" rate increases under the Affordable Care Act (ACA) for the webinar, Understanding the ACA—Rate Filing Review and Disclosure. (October 12, 2012 )

Actuarial Practices Relating to Preparing, Reviewing, and Commenting on Rate Filings Prepared in Accordance with the Affordable Care Act

Practice note by the Rate Review Practice Note Work Group on the preparation, review, and disclosure of rate filings under the Affordable Care Act. (October 09, 2012 )

Voter Guide – A Guide to Analyzing the Issues: Medicare Premium Support

Guide to help voters understand what premium support is and the potential implications of shifting Medicare to a premium support program. (October 09, 2012 )

Decision Brief: Implications of Medicaid Expansion Decisions on Private Coverage

Decision brief highlighting some of the issues that federal and state policymakers and regulators should consider as they are making their Medicaid expansion decisions. (September 10, 2012 )

Letter to Sen. Thune and Rep. Boustany on Long-Term Care

Health Practice Council letter to Sen. Thune and Rep. Boustany clarifying the nature and intent of recent Academy-hosted roundtables focused on addressing the accessibility and affordability of long-term care services. (August 15, 2012 )

Final Report on New Long-Term Disability Table

Final report to the NAIC’s Health Actuarial Task Force regarding a valuation proposal for a new group long-term disability table. (August 10, 2012 )

Request for Approval From NAIC on New Group Long-Term Disability Table

Presentation to the NAIC's Health Actuarial Task Force on a new group long-term disability valuation table. (August 10, 2012 )

Update to NAIC on LTC Valuation Morbidity Tables

Update to the NAIC's Health Actuarial Task Force on the progress of long-term care valuation morbidity tables, including what has been accomplished as well as next steps. (August 10, 2012 )

Exposure Draft: Rate Review

Exposure draft of a practice note related to the preparation and review of rate filings under the Affordable Care Act. Comments on Actuarial Practices Relating to Preparing, Reviewing, and Commenting on Rate Filings Prepared in Accordance with the Affordable Care Act should be submitted by September 4. (July 23, 2012 )

Comments to ASB on ASOP 6 Exposure Draft

Joint Committee on Retiree Health comments on the ASB's exposure draft of ASOP 6, Measuring Retiree Group Benefits Obligations and Determining Retiree Group Benefits Plan Costs or Contributions. (July 14, 2012 )

Long-Term Care Reform Options

Federal Long-Term Care Task Force presentation to the 2012 NCOIL Summer Meeting on options to reform the long-term care system in the United States. (July 18, 2012 )

Health Care Reform After the Supreme Court - An Actuarial Perspective

Health Practice Council webinar slides addressing the Supreme Court decision on the individual mandate and next steps in state and federal implementation of the Affordable Care Act (ACA). (July 11, 2012 )

Report Outline on New Long-Term Disability Table

Report outline to NAIC’s Health Actuarial Task Force (HATF) regarding a valuation proposal for a new group long-term disability table. (July 06, 2012 )

Comments on Impact of Stop-Loss Insurance Under ACA

Stop-Loss Work Group comments to the Employee Benefits Security Administration regarding stop-loss insurance and the Affordable Care Act (ACA). (July 02, 2012 )

Risk Adjustment and Other Risk-Sharing Provisions in the Affordable Care Act

Risk Sharing Work Group issue brief providing an overview of the various risk-sharing mechanisms in the ACA and the risks each mechanism can mitigate. (June 01, 2011 )

Comment Letter to CMS on Medicaid Payment Rate Change

Medicaid Work Group comments to CMS on a proposed rule regarding payments for Medicaid primary care services. (June 12, 2012 )

Comment Letter to IRS on Minimum Value

Actuarial Value Subgroup comments to the IRS on Notice 2012-31, Minimum Value of an Employer Sponsored Health Plan, addressing how to account for non-core benefits and non-standard plan features as well as other considerations related to the treatment of health savings account (HSA) contributions. (June 11, 2012 )

Long-Term Care Insurance Compliance With the NAIC LTCI Model Regulation Relating to Rate Stability

Exposure draft of the long-term care rate stability practice note.

(June 08, 2012 )

Voter Guide - Making Health Care Reform Work: Why Broad Participation is Necessary (Updated)

Voter guide to help explain why broad participation is necessary in the health insurance system to avoid higher premiums. (June 28, 2012 )

Sample slide deck without speaker notes (updated 5/12): A Guide to Medicare’s Financial Challenges and Options for Improvement

Medicare Steering Committee sample slide deck without speaker notes (updated 5/12) regarding a guide to Medicare's financial challenges and options for improvement. (May 22, 2012 )

Research Brief: Design and Implementation Considerations of ACA Risk-Mitigation Programs

Joint Academy/SOA research brief on risk-mitigation programs under the Affordable Care Act appear to reduce financial risks to health plans but overly restrictive limitations on premium rate increases can lead to high federal risk-corridor payments. (June 04, 2012 )

Comments to ASB on ASOP 27 Exposure Draft

Joint Committee on Retiree Health comments on the ASB's exposure draft for ASOP 27, Selection of Economic Assumptions for Measuring Pension Obligations, regarding the implications for retiree group benefits. (May 31, 2012 )

Comments to ASB on ASOP 4 Exposure Draft

Joint Committee on Retiree Health comments on the ASB's exposure draft for ASOP 4, Measuring Pension Obligations and Determining Pension Plan Costs or Contributions, requesting clarification on the implications for retiree group benefits. (May 31, 2012 )

Medicare’s Financial Condition: Beyond Actuarial Balance

Letter to CCIIO on Actuarial Value and Cost-Sharing Reduction Bulletin

Actuarial Value Subgroup letter to CCIIO offering comments on the Actuarial Value and Cost-Sharing Reduction bulletin, specifically addressing the proposed actuarial value calculator. This letter supplements comments submitted April 2 on the cost-sharing inputs for the calculator.

(May 16, 2012 )

Comments on Revisions to ASOPs 22 and 28

Health Practice Financial Reporting Committee comments to the ASB on revisions to ASOPs 22 and 28. (May 15, 2012 )

Letter to CMS on Revised MLR Annual Reporting Form

Medical Loss Ratio Subgroup letter to CMS offering comments on the revised annual reporting form, specifically on the definition of premiums, contract reserves, and the definition of pre-tax underwriting gain/(loss). (May 02, 2012 )

Comments on White Paper, 'The U.S. National State-Based System of Insurance Financial Regulation and the Solvency Modernization Initiative'

Public policy practice groups comments to the NAIC on its draft white paper on the Solvency Modernization Initiative and insurance regulation offering suggestions encompassing RBC, ORSA, and NAIC model laws. (April 30, 2012 )

Letter to NCOIL on LTC Reform Options

Federal Long-Term Care (LTC) Task Force letter to NCOIL in response to a request for information on strategies to reduce costs related to LTC coverage. (April 27, 2012 )

Letter Regarding Appropriate Definition of Qualified Actuary Related to ACA's Rate Review Provision

Health Practice Council and the Committee on Qualifications letter to all state insurance commissioners and chairs of each state house and senate insurance committee regarding the appropriate definition of "Qualified Actuary" as it relates to the Affordable Care Act's rate review provision. (April 20, 2012 )

Comments on Life, Health Insurance Principles Proposed by NAIC PBRWG

Comments from Life, Health, and Casualty Practice Councils on life and health insurance principles proposed by the NAIC's Principle-based Reserving (EX) Working Group. (August 17, 2007 )

Comment Letter to CCIIO on Structure of the Actuarial Value Calculator

Health Practice Council comment letter to the Center for Consumer Information and Insurance Oversight (CCIIO) providing responses to questions raised during a meeting with representatives of CCIIO on the structure of a proposed actuarial value calculator (for purposes of the ACA). (April 02, 2012 )

Loss Ratios and Health Coverages

Loss Ratio Work Group white paper on the various ways in which loss ratios are currently used by different audiences, and identifies some of the issues inherent in methods of valuation employed.
(November 30, 1998 )

Providing Universal Access in a Voluntary Private-Sector Market

Guaranteed Issue/Universal Access Work Group monograph provides an understanding of the forces with which reformers are confronted in trying to implement guaranteed issue successfully in a voluntary private insurance system - a system that does not mandate universal coverage. (February 29, 1996 )

Outline of Possible Methods for Addressing the Erie County1 Ruling

Retiree Health Work Group outline of six possible approaches that could be used as “safe harbor” methods for meeting nondiscrimination-testing requirements under EEOC guidelines for retiree health care plans. (April 11, 2002 )

Comment Letter to House Leadership on HR 5 to Repeal IPAB

Health Practice Council comment letter to House leadership on legislation (HR 5) that would include a provision to repeal the Independent Payment Advisory Board, which was created under the ACA to provide recommendations to reduce growth in Medicare expenditures if spending exceeds a certain growth rate. (March 21, 2012 )

Call to Action: Actuaries Urge Comprehensive Medicare Reform

Health Policy Council call to action urging the President and Congress to restore the long-term solvency and financial sustainability of Medicare. (February 01, 2010 )

Letter to NAIC on Medicare Part D Survey Request

Medicare Part D RBC Subgroup letter to the NAIC's Health RBC Working Group asking it to sponsor and administer a survey of carriers that write Medicare Part D business. The survey is designed to gather additional data that may support any needed changes to the formula. (February 09, 2011 )

Affordable Care Act--What Every Actuary Should Know

Health Practice Council webinar regarding Affordable Care Act (ACA) information every actuary should know. The webinar presentation provides background on the uninsured and pre-reform markets, key provisions of the ACA, and the current status of the ACA's implementation. (February 10, 2012 )

Letter to HHS on Research Brief Addressing Actuarial Value

Health Practice Council letter to the Assistant Secretary for Planning and Evaluation (ASPE) at HHS providing comments on a research brief, Actuarial Value and Employer-Sponsored Insurance. (January 31, 2012 )

Revising Medicare’s Fee-For- Service Benefit Structure

Medicare Steering Committee issue brief discussing proposals to update Medicare's traditional fee-for-service benefit design. (March 01, 2012 )

Health Reform Implementation: Understanding the Terminology

Health Practice Council brief providing definitions for commonly used terms associated with health care reform implemenation. (August 01, 2010 )

Medicaid Managed Care: Savings, Access and Quality

Medicaid Work Group monograph on how cost and utilization savings can occur in managed care programs and provides an overview of components that should be considered when developing and implementing a Medicaid managed care program. (April 01, 1996 )

Long-term Care: Actuarial Issues in Designing Voluntary Federal-Private LTC Insurance Programs

Long Term Care Committee monograph issues that need to be considered when determining whether a voluntary federal-private LTC insurance program could be considered a viable option within a more comprehensive framework involving multiple programs. (January 01, 1999 )

Comments to CMS on MLR Reporting Form

Medical Loss Ratio (MLR) Work Group comments to CMS on the exposure draft of the MLR annual reporting form. (February 14, 2012 )

Second Health Practice Council Letter to Arizona Insurance Department

Health Practice Council and Committee on Qualifications letter to the Arizona insurance director stressing its concern that their regulatory definition of “qualified actuary” for health premium rate actuarial certifications was inappropriate and suggested corrective language. (February 10, 2012 )

Committee Letter to Arizona Insurance Department

Health Practice Council and Committee on Qualifications letter to the Arizona insurance director pointing out that their regulatory definition of “qualified actuary” for health premium actuarial certifications was inappropriate and suggested corrective language. (November 18, 2011 )

Presentation on the CLASS Act at 2011 NCOIL Summer Meeting

Co-chairperson of the Joint Academy/Society of Actuaries CLASS Act Task Force Steve Schoonveld presentation on the Community Living Assistance Supports and Services (CLASS) program before the National Conference of Insurance Legislators (NCOIL) Summer Meeting in Newport, RI. (July 16, 2011 )

Medicaid Rate Setting 101: Capitation Rate Development Process and Considerations

Medicaid Work Group presentation regarding the Medicaid rate-setting process for Medicaid Managed Care programs. The presentation includes a discussion about base data sources, base data adjustments, risk adjustment, risk-sharing arrangements, and performance incentives. (July 21, 2011 )

MSWG Letter to NAIC on Medicare Supplement Refund Formula

Medicare Supplement Work Group letter to the NAIC's Medicare Supplement Refund Formula Subgroup with a proposed charge to have the work group review the Medicare Supplement Refund Formula for potential changes that may need to be addressed.

(August 24, 2011 )

Group Long-Term Disability Work Group Update

Academy/SOA Long-Term Disability Work Group update to the NAIC's Health Actuarial Task Force on the work group's progress regarding the creation of a valuation table for group long-term disability. (August 23, 2011 )

Letter to NAIC on MedSupp White Paper

Medicare Supplement Work Group letter to the NAIC Medigap PPACA Subgroup offering comments on the subgroup’s new discussion paper, Medicare Supplement Insurance First Dollar Coverage and Cost-Shares.

(October 04, 2011 )

Comments to CMS on Proposed Rule on Exchanges

Exchanges Work Group comments to CMS in response to proposed regulations establishing health insurance exchanges and qualified health plans under the ACA. (October 06, 2011 )

Medicare's Financial Condition: Beyond Actuarial Balance (May 2011)

(May 01, 2011 )

Academy/SOA Group Long-Term Disability Work Group Provides Update at NAIC Fall Meeting

Group Long-Term Disability Work Group update to the NAIC's Health Actuarial Task Force at its fall meeting highlighting the progress on the long-term disability valuation table and work that still needs to be completed. (November 02, 2011 )

Letter to NAIC on Progress of Academy/SOA Cancer Claims Cost Tables Work Group

Cancer Claims Cost Tables Work Group letter to the NAIC’s Health Actuarial Task Force discussing the progress it has made over the past year and outlining its objectives for the coming year. (October 31, 2011 )

Letter to HHS on GINA Application to Long-Term Care

Joint work group of the SOA Long-Term Section Council and the Academy’s Federal Long-Term Care Task Force letter to HHS Secretary Sebelius regarding the department’s extension of the Genetic Information Nondiscrimination Act (GINA) to long-term care insurance in proposed regulations. (October 13, 2011 )

Letter to Massachusetts Senate on Amendment to H.3535

Premium Review Work Group letter to the Massachusetts Senate regarding an amendment to the state budget that would require the disapproval of any health insurance rates to be supported by "sound actuarial assumptions and methods." (November 30, 2011 )

Comments on 'Statement of Statutory Accounting Principles No. 101 - Income Taxes, A Replacement of SSAP No. 10R and SSAP No. 10'

DTA Bridge Group letter to the NAIC relating to the SSAP No. 101 - Income Taxes, A Replacement of SSAP No. 10R and SSAP No. 10 recently adopted by the NAIC’s Statutory Accounting Principles Working Group. (October 25, 2011 )

Comment Letter on Proposed Rule Related to Reinsurance, Risk Corridors, and Risk Adjustment

Risk Sharing Work Group comments to the Centers for Medicare and Medicaid Services (CMS) on the proposed rule implementing the risk-spreading mechanisms included in the Affordable Care Act (ACA) and related to reinsurance, risk corridors, and risk adjustment. (October 28, 2011 )

Comment Letter on NAIC Discussion Paper on Medicare Supplement Insurance First Dollar Coverage and Cost- Shares

(October 04, 2011 )

Proposed Rule—Establishment of Exchanges and Qualified Health Plans

(October 06, 2011 )

Revised Actuarial Statement of Opinion Instructions of NAIC Health Annual Statement Effective December 31, 2010

Health Practice Financial Reporting Committee practice note on the Revised Actuarial Statement of Opinion Instructions of the NAIC Health Annual Statement that went into effect Dec. 31, 2010. This practice note is intended to help actuaries both understand and comply with new requirements issued by the NAIC regarding health annual statement filings. (January 01, 2011 )

Comments to HHS Regarding MLR Interim Final Rule

Medical Loss Ratio Regulation Work Group letter to HHS in response to an interim final rule on the medical loss ratio (MLR) provisions in the Affordable Care Act. (January 31, 2011 )

Comments to HHS on Rate Review Proposed Regulations

Premium Review Work Group comments to HHS in response to proposed regulations on rate increase disclosure and review. (February 22, 2011 )

Letter to CMS on Rate Review and Disclosure Forms

Premium Review Work Group comments to CMS in response to a notice on rate increase disclosure and review reporting requirements. (May 02, 2011 )

Comments to CMS on Proposed Regulations for Accountable Care Organizations

Health Care Quality Work Group comments to CMS in response to proposed regulations on accountable care organizations and the Medicare Shared Savings Program under the Affordable Care Act. (June 06, 2011 )

An Actuarial Perspective on Accountable Care Organizations

Health Care Quality Work Group issue brief offering an actuarial perspective on accountable care organizations (ACOs) and outlining a number of issues that stakeholders should evaluate as ACOs are implemented. (June 16, 2011 )

Actuarial Value under the Affordable Care Act

Actuarial Value Subgroup issue brief offering an overview of the concept of actuarial value, and insight into the calculation of actuarial value under the Affordable Care Act. (July 22, 2011 )

Letter on Medicare to Joint Select Committee on Deficit Reduction

Medicare Steering Committee comment letter to the members of the new Joint Select Committee on Deficit Reduction urging action to improve the long-term solvency and sustainability of the Medicare program. (August 31, 2011 )

An Actuarial Perspective on Proposals to Improve Medicare’s Financial Condition

Medicare Steering Committee issue brief that summarizes the key cost, access, and quality issues associated with some of the Medicare-related provisions in the various debt and deficit reduction proposals. (May 12, 2011 )

“Bottom Line” on Medicare+Choice

Executive summary of the monograph on Actuarial Issues in the Expansion of Beneficiary Options Under Medicare+Choice. (January 01, 1999 )

Actuarial Issues in the Expansion of Beneficiary Options Under Medicare+Choice

Expanding Choice for Medicare Beneficiaries Task Force monograph on the actuarial issues concerning the changes to Medicare under the Balanced Budget Act of 1997 that will have major impact on the health care market. (January 01, 1999 )

Medicare Reform: Evaluating the Fiscal Soundness of Medicare

Medicare Reform Task Force monograph on how Medicare solvency is measured and several proposals to strengthen the financial basis of the program. (July 01, 2000 )

Medicare Reform: Providing Prescription Drug Coverage for Medicare Beneficiaries

Medicare Reform Task Force monograph on one option available to provide prescription drug coverage to seniors – adding prescription drug coverage to Medicare. (July 03, 2000 )

Bottom Line on Genetic Information and Medical Expense Insurance

Executive summary of the monograph on Genetic Information and Medical Expense Insurance.
(June 30, 2000 )

Genetic Information and Medical Expense Insurance

Task Force on Genetic Testing in Health Insurance monongraph on key concerns raised with respect to genetic testing, including access to health care, the cost of health care and health insurance, and the privacy of genetic information. (June 30, 2000 )

The Impact of Consumer Driven Health Plans on Health Care Costs: A Closer Look at Plans with Health Reimbursement Accounts

Defined Contribution Health Plan Work Group monograph providing an actuarial model to illustrate the impact of CDHPs on health costs. The monograph examines the theoretical impact of a shift to CDHPs on the various health care system participants. (January 31, 2004 )

Actuarial Review of Health Status Risk Adjustor Methodology

Risk Adjustor Work Group report on the health status risk adjustment methodology proposed for implementation by the Health Care Financing Administration (HCFA). (January 14, 1999 )

Medicare Prescription Drug Plans: The Devil is in the Details

Health Practice Council white paper addressing issues for consideration in the debate over a prescription drug program under Medicare. (April 30, 2003 )

Medical Reinsurance: Considerations and Design Options for a Government-Sponsored Reinsurance Program

Health Practice Council backgrounder on issues that should be considered in efforts to design a government-sponsored medical reinsurance program. (September 30, 2005 )

Costs Associated with Secondhand Smoke

Health Practice Council fact sheet highlighting findings from a study released by the Society of Actuaries that provides insights into the costs among nonsmokers exposed to secondhand smoke. (October 03, 2006 )

Letter to CMS on Medicaid Rate Setting Checklist

Medicaid Work Group letter to CMS in response to CMS' request for assistance in revising the Medicaid rate setting checklist. (January 14, 2011 )

Comments to CMS on RADV

Health Practice Council letter to CMS in response to its request for comments on the Medicare Advantage risk adjustment data validation (RADV) payment error calculation methodology. (January 21, 2011 )

Letter to NAIC Regarding New Long-Term Care Work Group

Long-Term Care Practice Note Work Group letter to the NAIC regarding the formation of a new work group in charge of updating the Academy's 2003 practice note, Long-Term Care Insurance Compliance with the NAIC LTCI Model Regulation Relating to Rate Stability. The letter also outlines the proposed tasks and timeline for completion.

(February 17, 2011 )

Letter to NAIC on White Paper on Adverse Selection and Exchanges

Exchanges Work Group comments to the National Assocation of Insurance Commissioners (NAIC) Exchanges (B) Subgroup regarding its white paper on adverse selection and exchanges created through the Affordable Care Act. (April 05, 2011 )