Health Reform & ACA Implementation

Implementation of the Affordable Care Act, the health care reform law passed in 2010, and other health care reform issues.

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)
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)
Individual and Small Group Market Task Force and Premium Review Work Group comments to CMS on a proposed rule regarding health insurance market reforms, which included modifications to the final rule on rate review and disclosure requirements. (December 21, 2012)
Individual and Small Group Market Task Force comments to CMS on the EHB components of the proposed rule, Standards Related to Essential Health Benefits, Actuarial Value, and Accreditation. (December 21, 2012)
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)
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)
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)
Actuarial Value Subgroup comment letter on the proposed rule establishing standards for actuarial value determinations under the Affordable Care Act (December 18, 2012)
Guide to help voters understand what premium support is and the potential implications of shifting Medicare to a premium support program. (October 9, 2012)
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 9, 2012)
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)
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)
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)
Stop-Loss Work Group comments to the Employee Benefits Security Administration regarding stop-loss insurance and the Affordable Care Act (ACA).  (July 2, 2012)
Voter guide to help explain why broad participation is necessary in the health insurance system to avoid higher premiums. (June 28, 2012)
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)
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 4, 2012)
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)
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 2, 2012)
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)