The Health Practice Council (HPC) provides objective technical expertise to policymakers and regulators on major health insurance and health care affordability issues, including Medicare.
Drivers of health care costs and slowing the growth in health care spending.
Financial reporting and solvency issues at the state level, such as NAIC-related projects on RBC, as well as emerging international solvency issues and federal regulation of insurance companies.
Federal and state long-term care issues, including the CLASS Act and LTC pricing/valuation.
Implementation of the Affordable Care Act, the health care reform law passed in 2010, and other health care reform issues.
Potential reform options addressing Medicare’s financial sustainability, and information on the Medicaid and CHIP programs.
The Life Practice Council, Health Practice Council, and Casualty Practice Council submitted a joint comment letter to the Colorado Division of Insurance on its recent exposure of a draft regulation on Governance and Risk Management Framework Requirements for Life Insurance Carriers’ Use of External Consumer Data and Information Sources, Algorithms, and Predictive Models: the first exposed implementation regulation for Colorado Revised Statute (C.R.S.) § 10-3-1104.9, signed into law on July 6, 2021.
( )The Health Practice Council’s Financial Reporting and Solvency Committee sent a comment letter to the National Association of Insurance Commissioners (NAIC) Long-Term Care Actuarial (B) Working Group inquiring if the Working Group might issue an accounting interpretation for the interaction between Actuarial Guideline LI (AG 51) and Appendix A-010.
( )The Health Solvency Subcommittee sent a comment letter responding to a request from the NAIC’s Health Risk-Based Capital (E) Working Group to provide additional investment return scenarios within the subcommittee’s summary of the Investment Income Adjusted Health H2 Experience Fluctuation Risk Factors.
( )The Health Practice Council’s Individual and Small Group Markets Committee and Risk Sharing Subcommittee submitted a comment letter to the Centers for Medicare & Medicaid Services’ (CMS) proposed rule for the 2024 Notice of Benefit and Payment Parameters (NBPP).
( )The Individual and Small Group Markets Committee submitted comments to the Centers for Medicare & Medicaid Services’ Center for Consumer Information & Insurance Oversight (CCIIO) on the Draft 2024 Actuarial Value (AV) Calculator Methodology.
( )Health Solvency Subcommittee Chairperson Derek Skoog provided an update to the NAIC’s Health Risk-Based Capital (E) Working Group at the NAIC’s Fall 2022 National Meeting in Tampa, FL, on the H2—underwriting risk component and the managed care credit calculation in the health risk-based capital formula.
( )Academy Health Practice Council (HPC) Vice President, Barb Klever, provided an update on HPC activities to the National Association of Insurance Commissioners (NAIC) Health Actuarial (B) Task Force during their virtual meeting in lieu of the 2022 Fall National Meeting.
( )Presentation at the National Association of Insurance Commissioners (NAIC) Affordable Care Act (ACA) State Rate Review Discussion Meeting on Considerations for Calculating Cost-Sharing Reduction (CSR) Premium Load Factors.
( )The Medicaid Committee released a public policy issue brief providing an overview of Medicaid managed care state-directed payments. The brief discusses: how these payments have evolved from supplemental and pass-through payments; recent changes to federal guidance governing them; and recommendations from the Medicaid and CHIP Payment and Access Commission (MACPAC).
( )The Individual and Small Group Markets Committee and its Risk Sharing Subcommittee submitted a letter to the CCIIO on cost-sharing reduction (CSR) premium load factors. The letter was also submitted to state regulators and legislators. The letter first discusses using actual experience data/issuer pricing models to develop the load factor. It then discusses a method using federal actuarial value (AV) levels to develop the load and potential drawbacks of this approach.
( )The Health Equity Committee released a public policy issue brief on health care and health insurance system risk assessment and risk adjustment in the context of health equity. Risk assessment and risk adjustment are valuable tools that are used for a variety of purposes and are being reexamined to understand whether and how they should incorporate social risk factors.
( )The Health Equity Committee sent comments responding to the Centers for Medicare & Medicaid Services’ (CMS) request for information (RFI) that was seeking public comment on the Medicare Advantage program. The committee specifically focused on the health equity aspects of the questions posed within the RFI.
( )Academy Health Equity Committee Chairperson Annette James gave a presentation on equity considerations for barriers to care and health plan benefit design to the National Association of Insurance Commissioners (NAIC) Special (EX) Committee on Race & Insurance Workstream #5.
( )Academy Health Practice Council (HPC) Vice Chairperson, Barb Klever, provided an update on HPC activities to the National Association of Insurance Commissioners (NAIC) Health Actuarial (B) Task Force during their virtual meeting in lieu of the 2022 Summer National Meeting.
( )The Health Solvency Subcommittee submitted a letter response to its previous report to the NAIC’s Health Risk-Based Capital (E) Working Group to provide a timeline to analyze and comprehensively review the H2—Underwriting Risk component and the managed care credit calculation in the health risk-based capital (HRBC) formula.
( )Comments, analysis, or explanatory material prepared for an external audience on behalf of an Academy group or the Academy as a whole; these include letters, memos, reports, and fact sheets.
Analyses of major actuarial or public policy issues written primarily for policy-makers, regulators, the news media, and the public.
Include white papers and monographs which are longer, more detailed analyses of major actuarial or public policy issues written primarily for policy-makers, regulators, the news media, and the public. Includes monographs and white papers.
Slides presented by the Academy at webinars, seminars, briefings, hearings, or other meetings and events.
The Academy works with the National Association of Insurance Commissioners (NAIC) on the creation and refinement of sensible, effective regulation. These reports and related documents highlight the NAIC-related work of the health practice councils.
Written and oral testimony provided to Congress or to other governmental and quasigovernmental bodies.
Practice notes offer examples of current and emerging approaches to selected actuarial tasks. They are intended to supplement the available actuarial literature, especially where the practices addressed are subject to evolving technology, recently adopted external requirements, or advances in actuarial science and other applicable disciplines.