Actuarial Outpost
 
Go Back   Actuarial Outpost > Actuarial Discussion Forum > Health - Disability
FlashChat Actuarial Discussion Preliminary Exams CAS/SOA Exams Cyberchat Around the World Suggestions



Reply
 
Thread Tools Search this Thread Display Modes
  #41  
Old 07-15-2015, 10:53 AM
cincinnatikid cincinnatikid is offline
Member
SOA
 
Join Date: Jul 2005
Posts: 2,175
Default

Quote:
Originally Posted by exponentialpi View Post
Is anyone getting inquiries on 2016 rate filings concerning the 2014 risk adjustment results?
Plenty of them. They started coming before we even had 2014 results and haven't stopped yet.
Reply With Quote
  #42  
Old 09-11-2015, 10:31 AM
Sloop John B's Avatar
Sloop John B Sloop John B is offline
Member
SOA
 
Join Date: Sep 2009
Location: The Windy Apple
Posts: 2,409
Default

I'm looking at these payment transfer reports again and was hoping someone could help me figure something out.

Does anyone know how the "Issuer Market Risk Pool PLRS" is calculated? I thought that I could take the weighted average of "Total Member Billable Months" and "PLRS" sumproduct(billableMMs*PLRS)/sum(billableMMs) and it would be identical to the "Issuer Market Risk Pool PLRS" but the two are way off.
Reply With Quote
  #43  
Old 06-30-2016, 12:43 PM
lifishing007's Avatar
lifishing007 lifishing007 is offline
Member
SOA
 
Join Date: Feb 2009
Studying for Advanced
Posts: 2,704
Default

Is today the judgement day for a few small carriers when CMS release risk adjustment?
__________________
Exam: GHCORE GHADV GHSPE
Module: HF FE PRFM DMAC
Reply With Quote
  #44  
Old 06-30-2016, 12:57 PM
New York Actuary New York Actuary is offline
Member
SOA
 
Join Date: Jul 2012
College: Alumni
Posts: 359
Default

Quote:
Originally Posted by lifishing007 View Post
Is today the judgement day for a few small carriers when CMS release risk adjustment?
Results are expected to be released today, so it could very well be judgement day for some carriers.
Reply With Quote
  #45  
Old 06-30-2016, 02:10 PM
cincinnatikid cincinnatikid is offline
Member
SOA
 
Join Date: Jul 2005
Posts: 2,175
Default

I wouldn't any immediate impacts until after risk corridor results are available and carriers can see how much more of their 2014 accruals will get paid.
Reply With Quote
  #46  
Old 06-30-2016, 03:42 PM
exponentialpi's Avatar
exponentialpi exponentialpi is offline
Member
SOA AAA
 
Join Date: Nov 2008
Location: Po
Studying for ACA
College: Graduate of hard knocks
Favorite beer: Cold Smoke
Posts: 1,402
Default

Quote:
Originally Posted by lifishing007 View Post
Is today the judgement day for a few small carriers when CMS release risk adjustment?
I would be more worried about being a recipient and one of these co-ops that went bust is supposed to pay in and didn't book it.
Reply With Quote
  #47  
Old 06-30-2016, 06:12 PM
lifishing007's Avatar
lifishing007 lifishing007 is offline
Member
SOA
 
Join Date: Feb 2009
Studying for Advanced
Posts: 2,704
Default

Report is out.

https://www.cms.gov/CCIIO/Programs-a...5CR-063016.pdf
__________________
Exam: GHCORE GHADV GHSPE
Module: HF FE PRFM DMAC
Reply With Quote
  #48  
Old 06-30-2016, 08:44 PM
Sloop John B's Avatar
Sloop John B Sloop John B is offline
Member
SOA
 
Join Date: Sep 2009
Location: The Windy Apple
Posts: 2,409
Default

Yikes at Health Republic in the small group market
Reply With Quote
  #49  
Old 07-05-2016, 10:47 PM
exponentialpi's Avatar
exponentialpi exponentialpi is offline
Member
SOA AAA
 
Join Date: Nov 2008
Location: Po
Studying for ACA
College: Graduate of hard knocks
Favorite beer: Cold Smoke
Posts: 1,402
Default

Quote:
Originally Posted by New York Actuary View Post
Results are expected to be released today, so it could very well be judgement day for some carriers.
Well it seems it was and my concern about not getting paid seems noteworthy.

http://www.investors.com/politics/po...-ops-at-least/

Quote:
On June 30, just before the Department of Health and Human Services informed the Land of Lincoln co-op of its $32 million risk-adjustment bill, the Illinois Department of Insurance fired off a letter to the Obama administration saying that the assessment could precipitate the immediate liquidation of the insurer.

To avoid marketplace disruption and "extreme financial harm" to the company's 49,000 plan members, the state's acting insurance director, Anne Dowling, said Illinois would prohibit any payment until policyholder claims are settled for 2016.

Dowling further asserted that Land of Lincoln wouldn't pay its risk-adjustment assessment until after the U.S. Court of Claims has ruled on whether the government must pay insurers what was owed under ObamaCare's risk-corridors program.
That temporary program was designed to recoup 50% of insurer losses beyond a certain level, but the Obama administration belatedly informed insurers that full payment might be subject to appropriation, and Congress refused to foot the bill.
It was also mentioned on the co-op thread that the CT Insurance Department has placed HealthyCT under an immediate order of supervision. Policy holders will be covered through the end of the current policy and they will need to choose new carriers for next year.
Reply With Quote
  #50  
Old 07-06-2016, 08:28 AM
WhosOnFirst WhosOnFirst is offline
Member
Non-Actuary
 
Join Date: Mar 2015
Posts: 77
Default

What really boggles my mind about these stories (Land of Lincoln and HealthyCT) is that these carriers had the some of the lowest rates in the market. You can expect that to attract the best risk. Why weren't they reserving for their payment into the RA programs?
Reply With Quote
Reply

Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off


All times are GMT -4. The time now is 06:56 AM.


Powered by vBulletin®
Copyright ©2000 - 2018, Jelsoft Enterprises Ltd.
*PLEASE NOTE: Posts are not checked for accuracy, and do not
represent the views of the Actuarial Outpost or its sponsors.
Page generated in 0.22114 seconds with 9 queries