Health News

The Academy’s Health Practice Council hosted a webinar on July 11 to provide actuaries from all practice areas with an analysis of the Supreme Court’s June 28 decision on the Affordable Care Act (ACA). Speakers outlined the decision, discussed the next steps in the federal and state implementation process, and highlighted future Academy activities aimed at the challenge of addressing long-term health costs. Download the presentation slides and audio recording. (July 11, 2012)
The Group Long-Term Disability Work Group submitted a report outline to the NAIC’s Health Actuarial Task Force (HATF) regarding a valuation proposal for a new group long-term disability table.
(July 6, 2012)
The Stop-Loss Work Group submitted comments to the Employee Benefits Security Administration on small employers' use of stop-loss insurance and how this affects the market for fully insured small health coverage under the Affordable Care Act (ACA). 
(July 2, 2012)
The Academy’s Health Practice Council Communications Task Force updated its recent Campaign 2012 voters’ guide, Making Health Care Reform Work: Why Broad Participation is Necessary. The guide is intended to assist voters to understand why broad participation is necessary in the health insurance system to avoid higher premiums. (June 28, 2012)
The Academy’s Medicaid Work Group submitted comments to CMS on a proposed rule regarding payments for Medicaid primary care services. The letter addresses issues relating to actuarial soundness as they pertain to changes in the Medicaid program. (June 12, 2012)
The Long-Term Care Practice Note work group has extended to July 8 the exposure period for the rate stability practice note, Long-Term Care Compliance with the National Association of Insurance Commissioners Long-Term Care Insurance Model Regulation Relating to Rate Stability. (June 12, 2012)
The Academy’s Actuarial Value Subgroup submitted comments to the IRS on Notice 2012-31, Minimum Value of an Employer-Sponsored Health Plan. The letter addresses 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)
The Academy's Health Practice Council and the SOA jointly released a research brief that summarizes the key findings and policy implications of a study, conducted by Milliman and sponsored by the SOA, of the risk mitigation programs under the Affordable Care Act (ACA)—risk adjustment, reinsurance, and risk corridors. (June 4, 2012)
The Joint Committee on Retiree Health submitted comments to the Actuarial Standards Board on the 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)
The Joint Committee on Retiree Health submitted comments to the Actuarial Standards Board on the exposure draft for ASOP 27, Selection of Economic Assumptions for Measuring Pension Obligations, regarding the implications for retiree group benefits. (May 31, 2012)
The Medicare Steering Committee updated its annual issue brief that offers an actuarial perspective on Medicare's financial condition and outlines the public policy options to address the program's long-term financial challenges. (May 22, 2012)
The Health Practice Financial Reporting Committee sent comments to the Actuarial Standards Board on revisions to ASOPs 22, Statements of Opinion Based on Asset Adequacy Analysis by Actuaries for Life and Health Insurers and 28, Statements of Actuarial Opinion Regarding Health Insurance Liabilities and Assets.
(May 17, 2012)
The Actuarial Value Subgroup sent a 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)
The Medical Loss Ratio Work Group sent a 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)
The Academy submitted 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)
The Federal Long-Term Care (LTC) Task Force sent a letter to the National Conference of Insurance Legislators in response to a request for information on strategies to reduce costs related to LTC coverage. The task force highlights a number of general approaches that would address both LTC costs and effectiveness. (April 27, 2012)
The Health Practice Council and the Committee on Qualifications sent a 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. Under the Affordable Care Act, the Centers for Medicare and Medicaid Services (CMS) is authorized to determine whether health insurance rate increases filed with states are “unreasonable.” As of September 1, 2011 rate increases equal to or greater than 10 percent may be reviewed by states that have been determined by CMS to have an effective rate review program; otherwise, increases in excess of 10 percent will be reviewed by CMS to determine whether such rate increases are “unreasonable.” As a result, many states are in the process of drafting regulatory language that would create their own rate review program. In the past few months, an inconsistency in the definition of “qualified actuary” in some state regulations has come to the attention of the American Academy of Actuaries. The letter provides recommended language regarding the appropriate definition of qualified actuary as states move to implement the Affordable Care Act’s rate review provision. (April 20, 2012)
The Academy has published two guides to help voters better understand the long-term financial challenges facing Medicare and Social Security. Read what to ask candidates—and how to evaluate their answers—about proposals for reforming these programs. The guides are part of the Academy’s Campaign 2012 Toolkits. For more information on the release of the guides, click here.  (April 20, 2012)
The Health Practice Council submitted a 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). The letter addresses cost-sharing inputs for the calculator, incorporation of induced demand, number of geographic pricing tiers, and incorporation of multiple network tiers. (April 2, 2012)
The Academy filed on Jan. 27 an amicus curiae brief with the U.S. Supreme Court in the pending challenge to the Affordable Care Act. The court will hear oral arguments in March. The brief addresses a very narrow aspect of the case before the court—the severability of the individual mandate from the other market reform provisions, namely guaranteed issue and modified community rating. The brief does not take a position on the constitutionality of the individual mandate or whether any other provisions in the law are severable from the mandate—nor does it support or oppose the law as a whole. Read the brief. Read the Academy’s member alert on the filing. Read the news release. (January 27, 2012)