Health Reform & ACA Implementation

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

Letter Regarding Appropriate Definition of Qualified Actuary Related to ACA's Rate Review Provision

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)

Comment Letter to CCIIO on Structure of the Actuarial Value Calculator

Health Practice Council 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). (April 2, 2012)

Comment Letter to House Leadership on HR 5 to Repeal IPAB

Health Practice Council comment letter to House leadership on legislation (HR 5) that would include a provision to repeal the Independent Payment Advisory Board, which was created under the ACA to provide recommendations to reduce growth in Medicare expenditures if spending exceeds a certain growth rate. (March 21, 2012)

Comments to CMS on MLR Reporting Form

Medical Loss Ratio (MLR) Work Group comments to CMS on the exposure draft of the MLR annual reporting form. (February 14, 2012)

Affordable Care Act--What Every Actuary Should Know

Health Practice Council webinar regarding Affordable Care Act (ACA) information every actuary should know. The webinar presentation provides background on the uninsured and pre-reform markets, key provisions of the ACA, and the current status of the ACA's implementation. (February 10, 2012)

Letter to HHS on Essential Health Benefits Bulletin

Individual and Small Group Market Task Force comments to the HHS on the essential health benefits bulletin. (January 31, 2012)

Letter to HHS on Research Brief Addressing Actuarial Value

Health Practice Council letter to the Assistant Secretary for Planning and Evaluation (ASPE) at HHS providing comments on a research brief, Actuarial Value and Employer-Sponsored Insurance. (January 31, 2012)

Amicus Curiae Supporting Respondents On The Severability Issue - Pending Challenge to the ACA

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. (January 27, 2012)

Committee Letter to Arizona Insurance Department

Health Practice Council and Committee on Qualifications letter to the Arizona insurance director pointing out that their regulatory definition of “qualified actuary” for health premium actuarial certifications was inappropriate and suggested corrective language. (November 18, 2011)

Comment Letter on Proposed Rule Related to Reinsurance, Risk Corridors, and Risk Adjustment

Risk Sharing Work Group comments to the Centers for Medicare and Medicaid Services (CMS) on the proposed rule implementing the risk-spreading mechanisms included in the Affordable Care Act (ACA) and related to reinsurance, risk corridors, and risk adjustment. (October 28, 2011)

Comments to CMS on Proposed Rule on Exchanges

Exchanges Work Group comments to CMS in response to proposed regulations establishing health insurance exchanges and qualified health plans under the ACA. (October 6, 2011)

Actuarial Value under the Affordable Care Act

Actuarial Value Subgroup issue brief offering an overview of the concept of actuarial value, and insight into the calculation of actuarial value under the Affordable Care Act. (July 22, 2011)

Presentation on the CLASS Act at 2011 NCOIL Summer Meeting

Co-chairperson of the Joint Academy/Society of Actuaries CLASS Act Task Force Steve Schoonveld presentation on the Community Living Assistance Supports and Services (CLASS) program before the National Conference of Insurance Legislators (NCOIL) Summer Meeting in Newport, RI. (July 16, 2011)

Letter to CMS on Rate Review and Disclosure Forms

Premium Review Work Group comments to CMS in response to the revised preliminary justification and consumer disclosure forms for purposes of rate review disclosure and reporting requirements. (June 28, 2011)

Fact Sheet: Medicare Shared Savings Program Under the Affordable Care Act

Health Practice Council fact sheet providing an overview of the Medicare Shared Savings Program and how accountable care organizations (ACOs) are addressed in the Affordable Care Act. (June 16, 2011)

An Actuarial Perspective on Accountable Care Organizations

Health Care Quality Work Group issue brief offering an actuarial perspective on accountable care organizations (ACOs) and outlining a number of issues that stakeholders should evaluate as ACOs are implemented. (June 16, 2011)

Comments to CMS on Proposed Regulations for Accountable Care Organizations

Health Care Quality Work Group comments to CMS in response to proposed regulations on accountable care organizations and the Medicare Shared Savings Program under the Affordable Care Act. (June 6, 2011)

Letter to CMS on Rate Review and Disclosure Forms

Premium Review Work Group comments to CMS in response to a notice on rate increase disclosure and review reporting requirements. (May 2, 2011)

Letter to NAIC on White Paper on Adverse Selection and Exchanges

Exchanges Work Group comments to the National Assocation of Insurance Commissioners (NAIC) Exchanges (B) Subgroup regarding its white paper on adverse selection and exchanges created through the Affordable Care Act. (April 5, 2011)

Congressional Testimony on the CLASS Program

Community Living Assistance Services and Supports (CLASS) Act Task Force testimony to the U.S. House Committee on Energy and Commerce Subcommittee on Health regarding the CLASS program. (March 17, 2011)

Health Reform &amp; ACA Implementation

Health Reform & ACA Implementation