Description: This article contains a condensed summary and excerpt from the fourth white paper in the Commercial Health Care: What’s Next? series.

Description: This article discusses future benchmarks of Medicare and Medicare's rising costs and its relativity to the actuarial profession.

Description: Discussion of the impact of the ACA on RBS and required surplus for a health plan

Description: This article provides an overview of the Own Risk and Solvency Assessment (ORSA) model act, and of enterprise risk management (ERM). Compared to other actuarial disciplines, health actuaries have not historically focused as much on ERM. But health coverages do have risks that can threaten an insurer's solvency, and ORSA (now in force in most states) will force health insurers to beef up their ERM capabilities.

Description: Remain a competitor in health insurance with value, knowing the competition, and using external experts Issue No. 37.

Description: Analysis of the projected impact of the Affordable Care Act on Medicare Part C revenue over 2014 through 2017, with background on recent historical revenue trends. The analysis is largely based on CMS published data, with trend analysis based on the Medicare Trustees report and author's assumptions.

Description: Current Status of managing costs & increasing costs, Future Direction of Consumerism, technology and defined contribution health plans. Issue No. 39.

Description: A summary of the driving forces behind, and effects of, the historical increases and future expectations of Generic Dispensing Rates.

Description: This article will consider several issues arising from ACO budgeting and pricing of stoploss coverage, including: 1) attribution of members; 2) claim carve outs; 3) ambiguous stoploss terms; 4) providers gaming the system and 5) credibility of data.

Description: In this article, the author discusses the considerations and advantages of implementing an integrated enterprise risk management program for a health insurance company, and presents a summary of Aetna's experience with ERM as a case study.