2. Today’s Talk 2 Expanding opportunities due to the Affordable Care Act (ACA) Examples in L.A. Care Health Plan tasks Questions

3. ACA Creates New Opportunities in Healthcare 3 Affordable Care Act (ACA), otherwise known as Obamacare, is the driving force. Health Plans are expanding to meet expected enrollment growth. Actuaries and healthcare analytics play an important role.

4. L.A. Care Health Plan as an example 4 2011 Revenue: $1.2 Billion Current Revenue: $3.3 Billion Projected 2017 Revenue: $7.5 Billion Current Member Enrollment: 1.3 million lives 200,000 Medi-Cal enrollees added in January 2014. 40,000 Exchange/Marketplace enrollees since January 2014. 20,000 Dual eligibles (Medi-Cal and Medicare) during this year.

5. Health Plan Tasks Set insurance premiums Establish provider rates Develop risk stabilization and mitigation programs Reinsurance Risk adjusters Risk corridors Estimates reserves (IBNP) 5

6. Questions? 6