Academy Activities

The Academy’s Rate Review Practice Note Work Group has released an exposure draft of a new practice note, Actuarial Practices Relating to Preparing, Reviewing, and Commenting on Rate Filings Prepared in Accordance with the Affordable Care Act for 2015 and Beyond. This practice note does not replace the original October 2012 note, which is still useful for actuaries filing rate changes for transitional plans. However, it does replace the addendum (released for exposure in April 2013) to the original practice note and includes discussion of the instructions for the Unified Rate Review Template and the Actuarial Memorandum.

Comments on the practice note exposure draft are due by Oct. 27 and should be sent to healthanalyst@actuary.org.

Legislative/Regulatory Updates

On Sept. 30, the U.S. Departments of Health and Human Services, Labor, and the Treasury released final rules that amend “excepted benefits,” specifically addressing one category referred to as limited excepted benefits. The final regulations, which apply to group plans, are effective for plan years beginning Jan. 1, 2015. The final rules:

• Eliminate the requirement that participants must pay a separate premium in order for limited scope vision or dental plans to qualify as excepted benefits. This rule also applies to long-term care benefits.
• Define Employee Assistance Programs (EAPs) as excepted benefits if they:
• Do not offer significant medical coverage (including wellness programs);
• Do not include coordinated benefits;
• Do not require payment of premiums in order to participate; and
• Involve no cost sharing.

The administration published its Rate Review Annual Report in September. The report is based on 2013 calendar year data from 40 states in the individual market and 27 states in the small group market—all of which received rate review grants from the administration. According to the report, key findings for 2013 include:

• Rate review reduced total premiums by an estimated $290 million in the individual market and $703 million in the small group market.
• In the individual market, the average requested rate increase was reduced by 8 percent for the 40 states examined; the average rate increase was 10.3 percent in 2013, compared to 7.1 percent in 2012.
• In the small group market, the average requested rate increase was reduced by 11 percent for the 37 states examined; the average rate increase was 7.1 percent in 2013, compared to 4.7 percent in 2012.

Also in September, the U.S. Census Bureau published its annual report, Health Insurance Coverage in the United States: 2013. Some of the major findings include: In 2013, 86.6 percent of the population had health insurance coverage for all or part of the year; 64.2 percent of individuals had private health insurance; 53.9 percent of the population was covered by employer-based coverage; and 34.3 percent of the population was covered by government health insurance.

In the News/Media Activities

Kaiser Health News reached out to Senior Health Fellow Cori Uccello for comment in an article examining potential flaws in the federal insurance calculator used in determining whether health insurance plans meet the minimum coverage standards under the Affordable Care Act (ACA). The story ran in The Washington Post and was republished by other media outlets.

The Academy was mentioned in a Becker's Hospital Review story announcing the 2015 Medicaid managed care rate setting consultation guide for states released by the Centers for Medicare & Medicaid Services. Rate certification submissions must include a letter from a certifying actuary “who meets the qualification standards established by the American Academy of Actuaries and follows the practice standards established by the Actuarial Standards Board.”

Upcoming Events

3rd Annual Health Care Summit: Advancing Delivery System Reform
Summit: Oct. 22, 8:00 a.m.–6:00 p.m. EDT (no fee charged)
Sponsor: U.S. Chamber of Commerce

2014 Life and Health Qualifications Seminar
When: Nov. 10–13, 2014
Where: Key Bridge Marriot, Arlington, Va.

For a complete listing of upcoming and recent health care reform events, click here.