Misalignment Between Premiums and Coverage Generosity Imposes Heavy Cost Burdens on Consumers in Health Insurance Exchanges
One of the most underappreciated cornerstones of the Affordable Care Act (ACA) is that premium variation...
California Health Plan Market Summary
In California, the DMHC and DOI facilitate a transparent and accessible means to look up rates and rating information for plans in the individual and small group market. However, gathering a market-encompassing view of the...
Health Actuary vs Data Scientist: What is the difference?
Our firm recently hired its first data scientist to complement the consulting team of health actuaries and clinicians. The Actuarial profession is very small and niche, with many people outside of the insurance and pension industries...
What Good Will Come Out Of COVID-19?
Nine months ago, we gathered in our conference room to talk about COVID-19 and what it may look like in the coming months. When you put a bunch of data geeks with healthcare expertise in a room the opinions were diverse...
The ACA’s Silver Bulletin
What if I told you that two sentences in a rate filing guidance could potentially add $5 billion of federal subsidies to the individual market and bring substantial premium relief...
It Didn’t Cost a Pennie
The Affordable Care Act (ACA) provides states with multiple opportunities to improve their local markets. Most options involve a significant investment, both staff time and financial resources. Earlier this year...
An Actuary’s Role in Healthcare Mergers & Acquisitions
While health insurers and health plans have historically assumed most of the risk associated with managing the healthcare dollar, recent trends towards capitation and bundled payments show providers having an increased appetite...
2nd Annual ACA Consumer Value State Rankings
Last year I developed a ranking system for analyzing consumer value in ACA markets across all 50 states[1]. It was a fun and enlightening exercise. Please see the link below for last year’s rankings which will include the details of...
History of Competition Between “Blues” Health Plans and a Recent Antitrust Settlement
Many people think Blue Cross and Blue Shield is the name of a health insurance company. When asked, we often hear people say, “My health insurance is through Blue Cross”. They get confused when followed-up with...
Cost Disparities in Employer-Sponsored Health Insurance
The general election is less than a month away as of this writing. Health care is at the top of mind for many as an issue this election—as it was in the last election and the one before that. Access to health care has gained...