Risk-Based Capital Considerations for Self-Funded Plans
Two of the main reasons why businesses choose to self-fund their employee health care benefits are (1) to have more flexibility of the plan administration, and (2) to reduce costs...
Streamline Your Healthcare Analytics by Embedding Benchmarking
Too often meaningless and unnecessarily complex healthcare analysis is prepared and presented to leadership without explaining what it means or answering the key question “what do I do with this?”...
ACA Premium Changes: We Need a New Measuring Stick
Guilty!!! I wrote the lead article in the February edition of the Society of Actuaries Social Insurance and Public Finance Section newsletter In The Public Interest. I highlighted that 2019...
Health Care Affordability Index: 2019
The American health care industry is a leviathan. Health care has swelled to dominate 18% of national GDP, and health care spending is expected to outpace overall economic growth[1]...
A Beginner’s Guide to Model Validation
Models inform business decisions by using a variety of techniques to explain relationships among variables, entities, or events. In addition to actuaries, other stakeholders in the healthcare...
Take A Number: Would Long Wait Times In US Healthcare Be Acceptable?
With all the talk of Medicare For All in the media, I started to think about American healthcare culture as we see it today and wonder if Americans really could function under...
Talkin’ Bout a Revolution
My father is an immigrant who fled the Civil War in El Salvador during the 1980s and my mother [...]
RBC in an ACA World: Determining an Optimal Surplus Range
The Patient Protection and Affordable Care Act (ACA) brought new risks and volatility to the world of health insurance. The prospect of insuring a previously uninsured population...
Fields of Gold: Reaping a Harvest from the ACA
American migration and gold have a long history. People have uprooted and undertaken dangerous expeditions in search of the precious element with hope of ‘striking it rich’...
Making Rate Review Great Again
The Patient Protection and Affordable Care Act (ACA) is known for its non-intuitive paradoxical mechanics in the individual market. The defunding of cost-sharing subsidies increases...