Key Academy volunteers representing Health Practice Council groups addressed many issues before regulators at the NAIC 2015 Summer National Meeting, held in August in Chicago.
The Long-Term Care Terminations Work Group presented an update to the NAIC’s Long-Term Care Actuarial Working Group on progress made in developing a recommendation on LTC terminations and next steps.
The Long-Term Care Principle-Based Work Group offered an update on developing a principle-based approach model and a timeline for completion.
The Long-Term Care Credibility Monograph Work Group presented its progress in drafting its monograph.
The Cancer Claims Cost Tables Work Group presented to the NAIC’s Health Actuarial Task Force on the progress of the valuation table and expected next steps.
On Sept. 2, the Academy’s Health Practice Council hosted jointly with the International Actuarial Association’s (IAA) Health Section the third webinar in a series on health care cost drivers across the globe, titled “Exploring Global Health Care Cost Drivers: Australia and Singapore.” This webinar provided participants with a unique opportunity to learn about the successes and challenges that their global counterparts have experienced as they have worked to identify and address particular cost drivers.
Legislative/Regulatory Updates
On Aug. 31, the Center for Consumer Information and Insurance Oversight (CCIIO) published a list of proposed essential health benefit benchmark plans for 2017 and beyond. The list includes proposed plans for all 50 states and the District of Columbia. For each state, CCIIO provides a summary of the 2014-2016 benchmark plan benefits, limits, and prescription drug coverage; state required benefits; and the 2017 benchmark plan information.
Also on Aug. 31, the Centers for Medicare & Medicaid Services (CMS) issued a notice requesting additional information regarding issuers’ 2014 risk corridor and medical loss ratio (MLR) data submissions. On review of submitted data, CMS identified a number of discrepancies and common errors, and issuers are being asked to provide additional information in order to validate the data.
On Sept. 1, the Internal Revenue Service (IRS) proposed a modification to existing proposed regulations (published on May 3, 2013) that would update the definition of minimum value (MV) for eligible employer-sponsored health plans under the Affordable Care Act (ACA). Under the ACA, employer-sponsored health plans meet MV requirements if the plan covers 60 percent of the total allowed costs of benefits provided. In 2014, the IRS issued a notice that it intended to modify that definition so that in addition to the 60 percent threshold, plans also would have to cover substantial hospitalization and physician services. As a result, the IRS is now modifying the proposed rule to incorporate coverage of inpatient hospital and physician services in the definition of MV.
In the News/Media Activities
The Wall Street Journalmentioned the Academy in a story examining 2016 health care insurance premium increases in several states. The story cited analysis from the Individual and Small Group Markets Committee’s issue brief, Drivers of 2016 Health Insurance Premium Changes, which states that the phasing down of the ACA reinsurance program is one of several significant 2016 cost drivers. The issue brief was also cited in an Insurance & Financial Advisor story.
The issue brief, Potential Implications of the Small Group Definition Expanding to Employers with 51-100 Employees, also produced by the Academy’s Individual and Small Group Markets Committee, was cited in a Compass Benefit Solutions report on CMS’s announcement that composite rating will be an option for small group market plans in Oklahoma for 2016. The issue brief was also cited in a subscriber-only PoliticoPro story regarding proposed legislation being considered by a congressional panel that would give states the option to expand or not to expand their small group markets.
Life and Health Qualifications Seminar Set for November
The 2015 Life and Health Qualifications Seminar will be held Nov. 9-12 in Arlington, Va. (metropolitan Washington, D.C.), just prior to the Academy’s Annual Meeting and Public Policy Forum in Washington. See why so many of your peers find this seminar the most succinct and effective way to acquire the required basic education and continuing education to assist in being qualified to sign statements of actuarial opinion for NAIC life and health annual statements for those who may not have met the basic education requirements set forth in Section 3.1.1 of the U.S. Qualification Standards. Click here for registration information.
Upcoming Health Practice Events
International Webinar Series Explores Health Care Cost Drivers
The next webinar in the Health Practice Council/IAA Health Section series on health care cost drivers across the globe is scheduled for early November. This series provides a unique opportunity to learn about the successes and challenges that various countries have experienced as they have worked to identify and address particular cost drivers.
Exploring Global Health Care Cost Drivers: Canada and Chile. Wednesday, Nov. 4, at 10 a.m. EST (no fee charged for Academy members; registration will be available soon)
Sponsors: American Academy of Actuaries and the International Actuarial Association Health Section
For a complete listing of upcoming and recent health care reform events, click here.
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