HealthExecWire

This webinar will summarize the top 10 actuarial issues of a health exchange. These issues will include whether the exchange is mandatory vs. voluntary, whether to merge the individual and small group markets, and other issues. We plan to discuss in-depth the Basic Health Program and risk adjusters, a description of which follows:

Basic Health Program: The Affordable Care Act establishes the option for states to create a Basic Health Program to provide healthcare coverage for individuals between 133% of the Federal Poverty Level (FPL) and 200% of the FPL. The federal government will provide subsidies for premium and cost sharing that would otherwise have been provided to consumers to offset the cost of premiums and out-of-pocket expenses in the insurance exchange. This portion of the session will focus on the primary assumptions and considerations of making this program decision. Specifically, we will explore:

The cost of these individuals under a Medicaid type benefit
The cost of these individuals in a Commercial exchange benefit
The federal subsidies offered
Other implications of this program such as access to benefits and continuation of coverage

Risk adjustment methods: Under the ACA, each State must apply risk adjustment to equalize actuarial risk among its healthcare insurers. In this part, we will discuss the important considerations when adopting risk adjustment in an insurance exchange. In particular, we will address:

the key decision points when selecting a risk adjustment system
applicability of existing risk adjustment systems to the uninsured population
state vs. federal considerations
risk adjustment inside and outside the exchanges

This program will assist:

State and Federal employees working on building their states' exchanges by providing the conceptual and detailed information involved in development of an exchange, including identification and discussion of key decision points.
State employees looking to optimize their Federal subsidy of the low income population through the Basic Health Program option.
Health plan and other interested executives and staff looking to better understand complexities and detailed applicable issues and provisions of the exchanges.
Attendees in exploring the primary assumptions and considerations involved in state decisions to exercise the option to establish a Basic Health Program.
Attendees to ascertain the concepts involved in application of risk adjustment to equalize actuarial risk among exchange insurers and the important considerations when adopting risk adjustment in an insurance exchange.
Attendees to engage in interactive learning through online question submission, attendee feedback and opportunity for follow up questions, and networking with attendees, faculty and other professionals through dedicated LinkedIn group.

Interested attendees would include:

State Medicaid Directors and Staff
State Insurance Commissioners and Staff
Legal, Regulatory and Policy Executives and Staff
Strategy and Planning Executives and Staff
Compliance Executives and Staff
Business Development Executives and Staff
Marketing Executives and Staff
Business Intelligence Staff

Attendees would represent organizations including:

Government Agencies
Health Plans
Agents and Benefit Consultants
Pharmaceutical Benefit Management Organization
Solutions Providers
Associations, Institutes and Research Organizations
Media
Other Interested Parties

Individual Registration Fee: $195. Audio Conference CD-ROM: $40 for attendees; $255 for non-attendees after the event. State and Federal Government agencies qualify for a 50% registration discount, and may use the discount code "GOV" when registering.

Corporate Site licensing also available. Click here to register or call 209.577.4888 We look forward to your participation in this event!

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