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Some Thoughts on Self-Funded Health Insurance in a (Post) Covid World
Today we are nearing the fourth quarter of 2021 and the world has been augmented in major ways since the pandemic began nearly 18 months ago. Not long-ago masks were hardly seen outside [...]
Land of the Free
“If you think health care is expensive now—just wait until it’s free.” —P.J. O’Rourke Health care is expensive in the United States. If you have paid attention to the Society of Actuaries [...]
An Actuarial Guide to Medicare Direct Contracting
On April 1, 2021, the Global and Professional Direct Contracting (GPDC) Model began its first performance year. Effective through 2026, the CMS GPDC Model introduces risk sharing arrangements with the goal of reducing [...]
Misalignment Between Premiums and Coverage Generosity Imposes Heavy Cost Burdens on Consumers in Health Insurance Exchanges
Summary One of the most underappreciated cornerstones of the Affordable Care Act (ACA) is that premium variation in the individual insurance market should reflect differences between plans, not differences between the people [...]
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 [...]
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 [...]