Description: Learn about key actuarial and analytic tools and methodologies used by commercial health insurance to identify and quantify drivers of healthcare cost and utilization (including wasteful and low-value ones) and risks. Use case scenarios in which these tools and methodologies apply, such as underwriting, reinsurance, medical management for population health and chronic diseases, managed care contracting, insurance market reform, provider payment reform, etc., will also be covered. Experience from the U.S., China and other parts of the world will be shared.

Description: The key tasks of credit risk capital project under CROSS II mainly focus onL(1 )Adjustment of measurement framework; (2) Calibration of risk factors, including both credit spread risk and credit default risk;3)Introduction of concentration risk measurement; (4) Higher requirement on look-through rule.

Description: After the bid process, desk review, rebate reallocation, an “enjoyable” audit, and open enrollment; the Medicare plan year starts. Throughout the year, organizations find it pertinent to get an accurate picture of their Part D liability as reinsurance, LICS (Low Income Cost-Sharing) subsidy, and risk corridors are accrued. Attendees will learn about the basics of Part D accruals, how future accrual amounts are estimated based on patterns in the data, and how bid assumptions versus actual results impact plan sponsor profitability. We will also discuss financial statement treatment of these items. Real-life examples from bids to outcomes will be provided to enhance the discussion. Ultimately, attendees will come away with a deeper understanding how their bid assumptions play out, and how they can use Part D accruals to plan for future bid development.

Description: More and more providers are desiring risk-based contracts instead of traditional FFS-based contracts. This session is intended to outline some of the actuarial best practices in risk-based contracting related to the many flavors of the CMS ACO programs, as well as Commercial risk-based contracts.

Description: Artificial intelligence (AI) and Machine Learning (ML) are accelerating us into the fourth industrial revolution. In the next few years technological change and innovation will be rapid. The implications of AI on the actuarial profession are real and game changing. This session will help health actuaries understand what to expect from AI, how to begin using AI, and how AI will dramatically enhance the actuarial profession in the near future.

Description: Investment risk management has become a core competency of insurance companies, and much has been discussed on this topic. This session examines the current investment risk management practices such as product line specific hedging and macro hedging, with a focus on what still remains to be addressed—whether the tradeoff of addition risk management is worthwhile.

Description: Insurance is a technically demanding, risk-based, capital intensive business. It is therefore not surprising that the industry is fertile ground for the development of technical models used to measure and price risk and manage capital. This session presents the forces which have significantly influenced the evolution of risk and capital management techniques and organization in the insurance industry, including regulatory changes, financial market instability, enlightened self-interest and ultimately a focus on shareholder value creation. Combining over 20 years in the industry in risk and finance roles with a rigorous academic approach, the presenter will provide insights into the most important business questions which insurers face today and the technical tools and frameworks used to answer them.

Description: Often actuarial practitioners are faced with working with data that is less than ideal. The data may be observed with gaps in it, a model may suggest variables that are observed at different frequencies, and sometimes predictive analytic results are very fragile to the inclusion or omission of just a few observations in the sample. Data, particularly big data, are often "messy" and something must be done about it. What is the actuary to do about these very practical matters? These types of questions are what this presentation is intended to address. Concerns on missing data, outliers, nonlinearity, mixed-frequency, cross-correlations are illustrated using real datasets in the Asia-Pacific countries. Some possible solutions to the messy data problems will be discussed.

Description: View the Living to 100 Symposium Sponsorship Package.

Description: This session will cover the latest developments of the Medicaid Final Rule proposed changes and their implications going forward.