Other Health documents

2011

Letter on Medicare to Joint Select Committee on Deficit Reduction

The Academy recently sent a comment [1] 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. (8/31/11)

Actuarial Value issue brief released

The Academy released a new issue brief [2], Actuarial Value under the Affordable Care Act. The brief offers an overview of the concept of actuarial value and provides insight into the calculation of actuarial value under ACA. (July 2011)

Letter to CMS on Rate Review and Disclosure Forms

The Academy submits comments [3] to CMS in response to the revised preliminary justification and consumer disclosure forms for purposes of rate review disclosure and reporting requirements (June 2011).

Fact sheet on Medicare Shared Savings Program and ACOs under the Affordable Care Act

The Academy released a new fact sheet [4] that provides an overview of the Medicare Shared Savings Program and how ACOs are addressed in the Affordable Care Act. (June 2011)

ACO issue brief released

The Academy released a new issue brief [5], An Actuarial Perspective on Accountable Care Organizations. The brief provides an actuarial overview of ACOs and outlines a number of issues that stakeholders should evaluate as ACOs are implemented. (June 2011)

Risk-Sharing under ACA issue brief released

The Academy released a new issue brief [6], Risk Adjustment and Other Risk-Sharing Provisions in the Affordable Care Act. The brief provides an overview of the various risk-sharing mechanisms in ACA and the risks each mechanism can mitigate. (June 2011)

Comments to CMS on ACO proposed regulation

The Academy submits comments [7] to CMS in response to proposed regulations on accountable care organizations and the Medicare Shared Savings Program under ACA. (June 2011)

2010

The Joint Committee on Retiree Health and the Pension Accounting Committee jointly submitted comments [8] to the NAIC regarding the exposure draft of SSAP 92 (OPEBs) and proposed revisions to SSAP 89 (pensions) (September 2010)

The Health Practice Financial Reporting Committee sent a commentletter [9] to the chair of the National Association of Insurance Commissioners' (NAIC) Blanks Working Group on the proposed changes to the NAIC's Health Annual Statement Instructions.

Letter [10] to congressional leaders on Health Reform Implementation (March 24, 2010)

Letter [11] to congressional leaders urging them to reconsider issues already approved in legislative form and to consider the implications of additional proposals to include in a reconciliation package as part of the health reform process (March 2010)

Letter [12] to the White House and all invitees of the Feb. 25 bipartisan health summit stressing critical actuarial aspects of health reform legislation that will need to be addressed to support the stated goals of reducing the number of uninsured, increasing the availability and affordability of coverage, and enhancing the focus on quality of care and health spending growth (February 2010)

Letter [13] to NAIC regarding the joint Academy State LTC Task Force and SOA Valuation Committee project to develop and recommend valuation morbidity tables for long-term care insurance (February 2010)

Comments [14] on the draft revisions to the Medicare Supplement Compliance Manual(February 2010)

Written testimony [15] to the Massachusetts House and Senate Joint Committee on Financial Services regarding gender rating for disability insurance (February 2010)

Call to Action [16]: Actuaries Urge Comprehensive Medicare Reform (February 2010)

Letter [17] to Speaker Nancy Pelosi and Senate Majority Leader Harry Reid highlighting some of the key differences on actuarial issues between the House’s Affordable Health Care for America Act (HR 3962) and the Senate’s Patient Protection and Affordable Care Act(January 2010)

Report [18] to help policymakers and the public understand the potential implications of an excise tax on high-cost employer-provided health plans (January 2010)

 

2009

Written testimony [19] to NAIC outlining several issues NAIC would need to address, in terms of implementation at the state level, if federal health care reform is enacted (December 2009)

Comments [20] on the "grandfathering provisions" contained in thePatient Protection and Affordable Care Act and whether they would mitigate “rate shock” for those individuals who keep the coverage they have (November 2009)

Letter [21] to Senators Harry Reid and Mitch McConnell, outlining key issues that need to be considered when evaluating whether the Senate’s health care reform bill will lead to a viable health insurance system and discussing whether the Patient Protection and Affordable Care Act addresses the outlined issues (November 2009)

Letter [22] to Speaker Nancy Pelosi and Republican Leader John Boehner providing an actuarial perspective on health insurance market reforms, outlining three criteria to ensure that the current markets remain viable, and offering comments on how certain provisions of the House’s Affordable Health Care for America Act (HR 3962) conform with those criteria (November 2009)

Issue brief [23] on Medicare Advantage payment reform (October 2009)

Analysis [24] by the Academy and Society of Actuaries of the proposed structure and funding approaches in the Community Living Assistance Services and Supports Act (CLASS Act). The analysis shows premiums may exceed affordable levels for those in the intended population of the CLASS Act and is unlikely to cover more than a very small proportion of the intended population (July 2009)

Testimony [25] to the U.S. House Committee on Ways and Means outlining three criteria to ensure that the current markets remain viable and offering comments on how certain provisions of the Tri-Committee bill conform with those criteria (June 2009)

Slides [26] and other information from an Academy Capitol Hill briefing on health care reform (June 2009)

Virtual Capitol Hill breifing on risk adjustment [27] (May 2009)

Comments [28] on the Women’s Health Insurance Fairness Act (May 2009)

Comments [29] to Senate Finance Committee on expanding health coverage options (May 2009)

Emerging Data on Consumer-Driven Health Plans (May 2009monograph [30])

Slides [27] and other information from an Academy Capitol Hill briefing (via webcast) on actuarial perspectives on health reform (May 2009)

Testimony [31] on individual health insurance market reform (April 2009)

Slides and other information from an Academy Capitol Hill briefing onrisk pooling [32] (March 2009)

2008

Comments on the Medical Hospital Quality Improvement Act [33](December 2008)

Slides and other information from an Academy Capitol Hill briefing onhealth spending growth [34] (September 2008)

Implications for Increased Comparative Effectiveness Research [35](September 2008)

Report from the Health RBC Trend Test Work Group to the NAIC on evaluating the effectiveness of three proposed trend tests [36] (August 2008)

Progress reports to the the NAIC from two Academy health RBC Work Groups [37] (August 2008)

Progress report to the the NAIC from a long-term care RBC [38] work group (August 2008)

Fundamentals of Insurance: Implications for Health Coverage [39] (July 2008 issue brief)

Slides and other information from an Academy Capitol Hill briefing onactuarial equivalence [40] (July 2008)

Testimony about dependent health benefits [41] at an NCOIL public hearing (July 2008)

Election 2008 [42] section (launched March 2008)

Letter to the editor [43], Los Angeles Times (June 2008)

Slides and other information from an Academy Capitol Hill briefing onrisk pooling [44] (May 2008)

Written testimony [45] for an NAIC hearing on increasing health costs, plus slides [46] used in oral testimony (May 20008)

A practice note on certifying to the actuarial equivalence of a prescription drug plan or Medicare Advantage prescription drug plan under Medicare Part D [47] (March 2008)

Comments on proposed changes in the actuarial opinion instructions [48] for NAIC health annual statements (February 2008)

 

2007

A practice note about evaluating the impact of a disease management program [49] on the cost and utilization of medical services (December 2007)

FAQs on HSAs [50]: Frequently Asked Questions on Health Savings Accounts (October 2007)

Mental Health Parity [51]: Often Separate, Usually Unequal (September 2007 issue brief)

Letter to Texas officials from the Joint Committee on Retiree Health about misinterpretations of the committee’s 2006 comments onaccounting standards for OPEBs [52] (June 2007)

Testimony for a House hearing on using private reinsurance [53] to expand the medical coverage offered by small businesses (May 24, 2007)

Comments to the NAIC Health Risk-Based Capital Working Group on a proposal to include a trend test in the health RBC [54] formula (May 2007)

Comments to the NAIC Health Risk-Based Capital Working Group onproposed RBC treatment [55] of medical insurance products for which active life reserves are held (May 2007)

Discussion paper on health premium deficiency reserves [56], with examples, common terms, and references to authoritative guidance (March 2007)

Progress report [57] from the Stop-Loss Work Group (March 2007)

Power point presentation [58] to the A&HWG by the LTC Principle-based Work Group, providing an update and requesting feedback on work to date (March 2007)

Comment letters to members of the House [59] and Senate [60] on the actuarial implications of restricting insurers' use of genetic information (February 2007)

Power point presentation [58] to the A&HWG by the LTC Principle-based Work Group, providing an update and requesting feedback on work to date (March 2007)

 

2006

Comments on problems with the one-role-per-user rule for aMedicare RDS [61] website (December 2006)

Progress report from the State Long-Term Care [62] Principle-based Work Group (December 2006)

Progress report from the Stop-Loss RBC [63] Work Group (December 2006)

Comments on ACLI's proposed long-term care experience form [64](December 2006)

Fact sheet on secondhand smoke exposure [65] (October 2006 analysis, accompanied by news release [66])

Primer on health insurance risk pools [67] (September 2006 issue brief, accompanied by news release [68])

Letter to Citizens’ Health Care Working Group on its interim recommendations for improving health care [69] (August 2006)

Final practice note on group long-term disability [70] insurance (August 2006)

Presentation to NAIC on principle-based long-term care valuation [71](June 2006)

Letters to FASB expressing concern over proposed changes in financial accounting standards for pensions [72] and OPEBs [73], accompanied by news release [74] (May 31, 2006)

Analysis of Senate small-business [75] health insurance legislation (May 2006)

 

2005

Health Coverage Issues: The Insured and the Uninsured [76] (December 2005)

Practice note on small-group medical [77] reserves and liabilities (updated October 2005)

Pay for Performance [78]: Rewarding Improvements in the Quality of Health Care (October 2005 issue brief)

Memo [79] to the NAIC from the Medicare Part D Subgroup, with proposed health RBC instruction [80] and health RBC formula [81] changes, proposed life RBC instruction [82] and life RBC formula [83] changes, andexplanatory slides [84] (September 2005)

Letter [85] to the NAIC from the Long-Term Care Experience Subgroup, with proposed revisions to the LTC experience reporting instructions [86]and forms [87], as well as pertinent examples [88] (September 2005)

Backgrounder on issues that should be considered in any effort to design a government-sponsored medical reinsurance [89] program (September 2005)

Actuarial Certification of Rates for Medicaid Managed Care [90] Programs (August 2005 practice note)

Letter to lawmakers opposing proposal to authorize non-actuarial statements of opininon for health reserves [91] (July 2005)

Proposed LTC loss experience exhibit forms [92], with instructions [93] andexamples [94] (May 2005)

Comments on an HHS draft report about about genetic testing [95]coverage (May 2005)

Disease Management Programs: What's the Cost? (April 2005 issue brief)

• Issue brief [96]
• News release [97]

Draft practice note [98] on statutory reserves for disability income insurance (April 2005)

Frequently Asked Questions on Association Health Plans. (March 2005 issue brief)

• Issue brief [99]
• News release [100]

Medical Reinsurance: [101] Considerations for Designing a Government-Sponsored Program (January 2005 issue brief)

2004

Mental Health Parity [102]: Often Separate, Usually Unequal (December 2004 issue brief)

Supplement [103] to a June LTC RBC report [104] to the NAIC (September 2004)

Tips on using the Rate Filing Task Force model [105] (September 2004)

Testimony for a House hearing on the use of genetic information [106](July 22, 2004)

Medicare Modernization Act: Financial Issues for State Medicaid Programs [107] (June 2004 issue brief)

The Academy's recommendation for a new long-term care RBC formula [104] (June 2004)

Slides from an Academy Capitol Hill briefing [108] on association health plan issues (May 14, 2004)

Rate Filing Task Force report [109] on potential regulatory solutions for the closed block problem (May 2004)

A letter to GASB on accounting by governmental employers for other postemployment benefits [110] (April 30, 2004)

Comments on an IRS notice concerning health savings accounts [111](March 30, 2004)

Statement for a House hearing on the uninsured [112] (March 9, 2004)

"The Questions Candidates Should Answer About ... Americans Without Health Insurance [113]" (An Election 2004 Guide to Analyzing the Issues; March 2004)

The Impact of Consumer-Driven Health Plans on Health Care Costs(January 2004 monograph [114] )

 

2003

Health Coverage Issues: The Uninsured [115] and the Insured (December 2003 issue brief)

Letter to the EEOC [116] about a proposed retiree health benefit rule (Sept. 12, 2003)

Letter [117] from the Long-Term Care Reserve Work Group on a proposed model valuation regulation (Sept. 10, 2003)

Letter [118] from the Long-Term Care RBC Work Group (Sept. 8, 2003)

Letter [119] from the Health Practice Financial Reporting Committee on reserves (Sept. 3, 2003)

Interim report [120] from the Long-Term Care RBC Work Group (June 22, 2003)

Progress report [121] from the LTC Reserving Work Group (June 2003)

A letter [122] to Congress on the use of genetic information (May 22, 2003)

Practice note [123] on pricing LTCI policies under the rate stability provisions of the NAIC's LTCI model regulation (May 2003)

Letter [124] outlining the objectives of the Long Term Care Reserve Work Group (March 7, 2003)

Status report [125] from the Health Liquidity Work Group (June 2003)

A letter [126] to GASB regarding the actuarial measurement of retiree health benefits (May 20, 2003)

Slide presentation [127], "Medical Malpractice Reform: Is Now the Time?" Washington Forum session (May 9, 2003)

Slide presentation [128],"For the Life, Health, and Annuity Actuary: International Accounting Issues" Washington Forum session (May 9, 2003)

Comment letter [129] to members of Congress on AHP legislation (April 28, 2003)

2002

Group and Health Coverage in the Wake of Sepember 11 [130] (December 2002 monograph)

Status report [131] of the Task Force on Health Insurance Rate Filing (December 2002)

Status report [132] from the Health Liquidity Work Group (December 2002)

Status report [133] of the LTC RBC Work Group (December 2002)

Status report [134] on draft LTC practice note (December 2002)

A letter [135] to GASB about a proposed standard for post-retirement benefit plans (Dec. 13, 2002)

A letter  [136]to the EEOC on the Erie County ruling (Oct. 16, 2002)

A statement [137] from the Life Products Committee to the National Conference of Insurance Legislators on life and disability insurance issues related to a proposed model law addressing genetic discrimination (July 13, 2002)

Understanding Defined Contribution [138] Health Plans (June 2002 issue brief)

• The Bottom Line [139] on Understanding Defined Contribution Health Plans (June 2002)

The Use of Genetic Information [140] in Disability Income and Long-Term Care Insurance (Spring 2002 issue brief)

• The Bottom Line [141] on the Use of Genetic Information in Disability Income and Long-Term Care Insurance (Spring 2002)

An outline [142] of possible methods of addressing the Erie County ruling (April 11, 2002)

Comments [143] to the speaker of the House on AHP provisions in patient protection legislation (April 9, 2002)

Progress report [144] from the Health Liquidity Work Group (March 2002)

Progress report [145] from the LTC Work Group to the NAIC Senior Issues Task Force (March 2002)

Progress report [146] from the LTC Work Group to the NAIC Accident and Health Working Group (March 2002)

Status report [147] from the Stop-Loss Health RBC Work Group (life) (March 2002)

Status report [148] from the Stop-Loss Health RBC Work Group (March 2002)

Statement [149] for House Ways and Means Committee hearing on health care tax credits (Feb. 13, 2002)

An updated comparison [150] of the NAIC's life, P/C, and health RBC formulas (Feb. 12, 2002)

Comments [151] on NAIC accounting guidelines (January 2002)

2001

Status report [152] of the LTC Work Group (December 2001)

HRBC Task Force report [153] (Dec. 8, 2001)

Risk Classification in Voluntary Individual Disability Income and Long-Term Care Insurance [154] (Winter 2001 issue brief)

Status report [155] of the LTC Work Group (September 2001)

A report [156] from the HRBC Work Group on asset codification (September 2001)

Comments [157] from the Health Financial Reporting Committee on SSAP 54 (Aug. 29, 2001)

Federal Tax Incentives for Long-Term Care Insurance: Actuarial Issues and Public Policy Implications (Summer 2001 issue brief [158] and Bottom Line [159])

The Effects of Proposed Patient Protection Legislation on Managed Care [160](Spring 2001 issue brief)

Comments [161] on proposed qualification requirements for life and health actuaries (March 29, 2001)

Risk Classification in Voluntary Individual Disability Income and Long-Term Care Insurance [154] (Winter 2001 issue brief)

Report on disability income RBC [162] (March 2001)

Report [163] from Asset Codification Work Group (March 2001)

Comment letter [164] on changing the health RBC formula (January 2001)

 

Before 2001

A report from the HORBC Task Force [165] (December 2000)

A progress report from the HORBC Asset Codification Work Group [166](December 2000)

A progress report from the HORBC Task Force [167] (September 2000)

Letter to ASB on LTC model regulation [168] (August 14, 2000)

Genetic Information and Medical Expense Insurance [169] (June 2000 monograph)

• The Bottom Line on Genetic Information and Medical Expense Insurance [170]

Progress report from the HORBC Task Force [171] (March 2000)

Comments to HHS on proposed privacy information standards [172] (Feb. 17, 2000)

Risk Classification [173] in Individually Purchased Voluntary Medical Expense Insurance (February 1999 issue paper)

Long-term Care: Actuarial Issues in Designing Voluntary Federal-Private LTC Insurance Programs [174] (January 1999)

Patient Protection [175] and Managed Care ( Winter 1999)

Managed Care Under Medicaid [176] : Savings, Access and Quality (April 1996)

DI/LTC/LB Working Group [177] progress report (June 1999)

RBC Form [178]

RBC Formula Treatment [179] for Stop-Loss Coverage to the HORBC and the RBC Working Groups (April 20, 1999)

RBC Formula Treatment [180] for Health Insurance Products (March 3,1999)

Preliminary Recommendations on the Development of a Health Liquidity Test [181] (Dec. 3, 1998)

Sponsored Organization (PSO) Solvency [182] (Feb. 18, 1998)

Health rate filing guidelines [183] letter to NAIC Accident and Health Working Group (Feb. 24, 2000)

Risk Classification [173] in Individually Purchased Voluntary Medical Expense Insurance (February 1999)

Loss Ratio Work Group [184] (November 1998)

Academy Comments on Title I of the Patient Protection Act [185] (Oct. 5, 1998)

Exposure of Health Related Statements of Statutory Accounting Principles [186] (May 5, 1998)

Mental Health Parity [187] Work Group, Federal Health Committee (March 23, 1998)

Exposure of Health Related Issue Papers/Statement of Statutory Accounting Principles [188] (SSAPs) (March 6, 1998)

The Academy's Health Organizations Risk-Based Capital Simplification Task Force issues a final report [189] regarding health risk based capital. (May 29, 1996)

Medical Malpractice Tort Reform: [190] Lessons from the States (Fall 1996)

Universal Access [191] in a Voluntary Private-Sector Market (February 1996)

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Note: The following three reports on medical savings accounts (MSAs) were published in 1995, before the emergence of two related concepts: health savings accounts (HSAs)and health reimbursement accounts (HRAs). The conclusions in the 1995 reports may not be appropriate for HSAs and HRAs. More recent reports on such consumer-driven health plans (also known as consumer-directed health plans and defined contribution health plans)as HSAs and HRAs are available online [192] or by contacting Academy staff (ask for Philip Hafler at 202-223-8196).

MSAs: Family Medical Savings and Investment Act of 1995 [193] Analysis (October 1995)

MSAs: Cost and Design Issues [194] (May 1995)

Medical Savings Accounts [195] (Summer 1995)

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The Academy's Health Organizations Risk Based Capital Task Force submits a report [196] to the National Association of Insurance Commissioners Health Organizations Risk Based Capital Working Group related to Risk Based Capital(RBC), including identifying risks that health organizations encounter and recommending an RBC formula reflecting the risks that would apply to all types of health organizations. (December 1994)

1994 Health Care Monograph Summary: What's Really at Stake inHealth Care Reform—1994 and After [197] (April 1995)

General Considerations [198] (doc. no. PN001/H95-01)

Small Group [199] Medical Business(doc. no. PN002/H95-02)

Large Group [200] Medical Business (doc. no. PN003/H95-03)

Individual Major Medical [201] Business (doc. no. PN004/H95-04)

Individual Disability [202] Income Insurance (doc. no. PN005/H95-05)

Group Long-Term Disability [203] Income Insurance (doc. no. PN006/H95-06)

Medicare Supplement [204] (doc. no. PN007/H95-07)

Small Group [205] Certification (doc. no. PN008/H95-08)

Long-Term Care [206] Insurance (doc. no. PN009/H95-09)