Health Insurance Regulation: Pricing Presentation for the Alliance for Health Care Reform By Thomas F. Wildsmith, FSA, MAAA, CLU, ChFC Hay Group, Inc.

Slides:

Advertisements

Similar presentations

Jack Jedwab Association for Canadian Studies September 27 th, 2008 Canadian Post Olympic Survey.

Advertisements

Stewardship Benefit Plan a Report from the Field Survey & Claim Data presented by David G. Wegge, Ph.D.

Analysis of Financial Statements

AP STUDY SESSION 2.

Multiplication X 1 1 x 1 = 1 2 x 1 = 2 3 x 1 = 3 4 x 1 = 4 5 x 1 = 5 6 x 1 = 6 7 x 1 = 7 8 x 1 = 8 9 x 1 = 9 10 x 1 = x 1 = x 1 = 12 X 2 1.

Division ÷ 1 1 ÷ 1 = 1 2 ÷ 1 = 2 3 ÷ 1 = 3 4 ÷ 1 = 4 5 ÷ 1 = 5 6 ÷ 1 = 6 7 ÷ 1 = 7 8 ÷ 1 = 8 9 ÷ 1 = 9 10 ÷ 1 = ÷ 1 = ÷ 1 = 12 ÷ 2 2 ÷ 2 =

Objectives: Generate and describe sequences. Vocabulary:

Insure Montana Small Business Health Insurance Program The Small Business Health Care Affordability Act, was requested by State Auditor John Morrison and.

The Role of Health Coverage in Eliminating Disparities in Care Marsha Lillie-Blanton, DrPH Associate Research Professor GWU School of Public Health and.

1 Private Insurance: What State Advocates Need to Know Cheryl Fish-Parcham Families USA January 25, 2007.

Medicare Reform Exhibit 12 New benefit administered exclusively by private insurers New benefit administered exclusively by private insurers New income-related.

Managing Health Insurance Risk

K A I S E R C O M M I S S I O N O N Medicaid and the Uninsured Figure 0 Health Reform Primer: Who are the Uninsured? Diane Rowland, Sc.D. Executive Vice.

The Tax Expenditure for Health: Update for 2007 John Sheils April 29, 2008.

AFL-CIO. Costs Have Been Eating Up More and More of Our PAYCHECKS.

Private Health Insurance: Challenges for Reform Karen Pollitz Research Professor Georgetown University Health Policy Institute Alliance for Health Reform.

1 September North Lee Street, Suite 400 · Alexandria, Virginia · · FAX Public Opinion on Coverage for the Uninsured.

Health Insurance Coverage of Young Adults John Holahan The Urban Institute February 4, 2008 THE URBAN INSTITUTE.

TABLE OF CONTENTS CHAPTER 1.0: Trends in the Overall Health Care Market Chart 1.1: Total National Health Expenditures, 1980 – 2007 Chart 1.2: Percent.

TABLE OF CONTENTS CHAPTER 1.0: Trends in the Overall Health Care Market Chart 1.1: Total National Health Expenditures, 1980 – 2005 Chart 1.2: Percent.

TABLE OF CONTENTS CHAPTER 1.0: Trends in the Overall Health Care Market Chart 1.1: Total National Health Expenditures, 1980 – 2006 Chart 1.2: Percent.

David Burdett May 11, 2004 Package Binding for WS CDL.

Wisconsin: A PCIP Case Study October 7, The Health Insurance Risk-Sharing Plan (HIRSP) is Wisconsins state high-risk pool. HIRSP has been operational.

Figure 1. There Are 13.3 Million Uninsured Young Adults Ages 19–29, 30 Percent of the Nonelderly Uninsured, 2005 Source: Analysis of the March 2006 Current.

Majorities of Americans Across Income Groups Say that Candidates Views on Health Care Reform Will Be Important Factor in Election Decisions Percent Source:

Chart 1 Cost Shifts to Workers: Increased Premiums and Cost-Sharing * Premiums increased more than a little. Increased cost-sharing includes cuts in benefits.

SECURITY MATTERS: HOW INSTABILITY IN HEALTH INSURANCE PUTS U.S. WORKERS AT RISK FINDINGS FROM THE COMMONWEALTH FUND 2001 HEALTH INSURANCE SURVEY CHARTS.

Figure 1. Majority of U.S. Workers Get Health Insurance Through Employers, 2007 Own employer coverage 56% Other employer coverage 16% Public programs 5%

THE COMMONWEALTH FUND The Future of Employer-Sponsored Health Insurance The Commonwealth Fund and The Century Foundation Business and National Health Care.

THE COMMONWEALTH FUND Insured But Poorly Protected: How Many Are Underinsured? U.S. Adults Trends, 2003 to 2007 Release Briefing Charts Commonwealth Fund.

THE COMMONWEALTH FUND 1 An Estimated 116 Million Adults Were Uninsured, Underinsured, Reported a Medical Bill Problem, and/or Did Not Access Needed Health.

Figure ES-1. Major Features of Health Insurance Expansion Bills and Impact on Uninsured, National Expenditures President Bushs Tax Reform Plan Healthy.

Figure 1. COBRA Eligibility of Working Adults, Ages 19–64 ESI from small firm 5.9 million 5% Uninsured 17.3 million 15% Note: Numbers may not add to total.

THE COMMONWEALTH FUND 1 Shifting Health Care Financial Risk to Families Is Not a Sound Strategy: The Changes Needed to Ensure Americans Health Security.

1 Screening & Eligibility Jeopardy Title V/PHC.

Regulation of the Small Group and Individual Health Insurance Markets: Why, Why Not, and What Could Be Better? Len M. Nichols, Ph.D. Director, Health Policy.

Proposals for Universal Health Care or Back to the Health Care Future Leonard Rodberg New York Metro Chapter Physicians for a National Health Program February.

Media-Monitoring Final Report April - May 2010 News.

Break Time Remaining 10:00.

PP Test Review Sections 6-1 to 6-6

A Presentation of the Colorado Health Institute 1576 Sherman Street, Suite 300 Denver, Colorado Hot Issues in.

Comparison of Free and Reduced Price Lunch Eligibility: Tulsa County and Oklahoma County School Years Ending 2008 through 2012 Prepared by the Community.

NEW JERSEY DEPARTMENT OF LABOR PROJECTIONS SYSTEM Industry Projections Occupational Projections Population Projections Labor Force Projections Labor Force.

Copyright © 2012, Elsevier Inc. All rights Reserved. 1 Chapter 7 Modeling Structure with Blocks.

1 RA III - Regional Training Seminar on CLIMAT&CLIMAT TEMP Reporting Buenos Aires, Argentina, 25 – 27 October 2006 Status of observing programmes in RA.

Adding Up In Chunks.

MaK_Full ahead loaded 1 Alarm Page Directory (F11)

Evaluation of Maine’s Dirigo Health Reform: Initial Experience and Lessons for Other States February 1, 2008 Debra J. Lipson and James M. Verdier Mathematica.

THE COMMONWEALTH FUND Figure 1. Three of Five Health Care Opinion Leaders Feel that Mixed Private-Public Group Insurance Is an Effective Approach to Achieving.

Commonwealth Connector Minimum Pharmacy Standards October 11, 2007.

Subtraction: Adding UP

Bell Busters! Unit 1 #1-61. Purposes of Government 1. Purposes of government 2. Preamble to the Constitution 3. Domestic tranquility 4. Common defense.

Converting a Fraction to %

Clock will move after 1 minute

A Real Intertemporal Model with Investment

Physics for Scientists & Engineers, 3rd Edition

Select a time to count down from the clock above

The Affordable Care Act: An Early Progress Report David Grande, MD, MPA Senior Fellow, Leonard Davis Institute of Health Economics Assistant Professor.

Public Opinion : Health Care Coverage, Costs, and Financing.

3 - 1 Copyright McGraw-Hill/Irwin, 2005 Markets Demand Defined Demand Graphed Changes in Demand Supply Defined Supply Graphed Changes in Supply Equilibrium.

Small-Group and Individual Coverage Deborah Chollet, Ph.D. Senior Fellow.

Background on Employer- Sponsored Health Insurance in the U.S. Jim Reschovsky, Ph.D. Senior Researcher Center for Studying Health System Change (

Legal/Regulatory Issues in Life and Health Insurance RMI 4115.

Health Reform: Major Congressional Proposals Joshua Goldberg State Coverage Initiatives National Meeting Albuquerque, NM July 30, 2009.

Massachusetts Health Care Reform Mandates

Presentation transcript:

Health Insurance Regulation: Pricing Presentation for the Alliance for Health Care Reform By Thomas F. Wildsmith, FSA, MAAA, CLU, ChFC Hay Group, Inc. October 17, 2008

Premiums must be: Adequate (solvency) Reasonable in relation to benefits (consumer protection – often measured by loss ratio)

Standards governing pricing State rules Rate regulations (directly) Solvency regulations (indirectly) Federal rules HIPAA COBRA Actuarial Standards of Practice (ASOPs) Other regulations, such as benefit mandates, also affect the cost of coverage.

Actuarial Standards for Rating Factors Objective Clearly related to the likely cost of providing coverage Practical to administer Consistent with applicable law Designed to protect the long-term viability of the insurance program "Risk Classification (for All Practice Areas)," Actuarial Standard of Practice No. 12, Actuarial Standards Board, December 2005

Health insurance is a buffet, not an iPod

Individual Market Premiums Source: Income, Individual Health Insurance : A Comprehensive Survey of Premiums, Availability and Benefits, AHIP, December Data

What Makes Large Employer Sponsored Coverage Work? Natural Groups Large Employer Contributions High Participation Rates Tax Preferences

How do you make guaranteed issue and community rating work together?

Wheres the real problem? Source: Income, Individual Health Insurance : A Comprehensive Survey of Premiums, Availability and Benefits, AHIP, December 2007; Income, Poverty, and Health Insurance Coverage in the United States: 2007, U.S. Census Bureau, August Data AgeAvg. Single PremiumUninsured Rate $1, % $1, % $1, $2, % $2, $3, % $3, $4, % $5,090

How do we keep the healthy? Bribe them? Twist their arms? Take them off the hook?

Why Are People Uninsured? Source: Uninsured in America: A Chart Book, Kaiser Family Foundation, May 2000 Most Important Reason

Premiums must be adequate To ensure solvency For insurers to be willing to offer coverage