Market Projection

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "2010-2020 Market Projection"

Transcription

1 M e d i c a r e S u p p l e m e n t Market Projection By Bryan R. Neary FSA, MAAA and Brynn Korolchuk, MBA Research Paper 1

2 Introduction The Medicare Supplement market appears to offer long-term sustainability. More than 62.3 million individuals are expected to be enrolled in the Medicare program by the year Our research indicates despite decreasing Medicare Supplement enrollments over the last five years opportunities for insurance carriers, agents, and marketing organizations in the Medicare Supplement market will actually increase over the next 10 years (Graph 1). Here we present a summary of our research method (with assumptions) and conclusions. Method Surprisingly, we found very little research results on Medicare Supplement market projections. So we collected data and then used it to develop actuarial models for projecting future Medicare Supplement enrollments and premium levels over the next 10 years. Current Medicare Eligibility Assessment To determine how Medicare Supplement would shake out, 10 years from now, we first had to look at the big picture Medicare eligibility. We know the overall Medicare population is going to grow over the next 10 years. The question is, how much? Answering this question first is critical, given the influx of individuals entering Medicare. We built a proprietary projection model, which projects growth in Medicare beneficiaries over a 10 year period, using the following demographic factors: Age Eligibility Status (Aged vs. Disabled) Gender Income Level Region (Urban vs. Rural) Reported Health Status Type of Supplement Health Insurance (Med Supp, Med Advantage, etc.) 2

3 Table 1, following, provides a snapshot of percentage distributions of each of these characteristics used in our projection. Table 1 Medicare Beneficiary Demographic Data (in 000's) Category All Enrollees Medicare Supplement Medicare Advantage Total Enrollment % Number % Dist. Number % Dist. Number % Dist. Part A 46, % 9, % 11, % Part B 42, % 9, % 11, % Eiligibilty Status Aged 38, % 8, % 9, % Disabled 7, % % 1, % Age Under 19 Years 3 0.0% 0 0.0% - 0.0% Years % % % Years 3, % % % Years 3, % % % Years 20, % 4, % 5, % Years 12, % 2, % 3, % 85 Years or Over 5, % 1, % 1, % Gender Male 20, % 3, % 4, % Female 25, % 5, % 6, % Income $10,000 or less 8, % % 1, % $10,001-$20,000 12, % 2, % 2, % $20,001-$30,000 8, % 2, % 1, % $30,001-$40,000 8, % 1, % 1, % $40,001 or more 8, % 2, % 1, % Metro Status Urban 37, % 6, % 8, % Rural 9, % 3, % % Health Status Excellent 19, % 4, % 4, % Very good 14, % 3, % 3, % Fair 9, % 1, % 2, % Poor 3, % % % Sources: Medicare and Medicaid Statistical Supplement 2. Current Medicare Beneficiary Survey Kaiser Family Foundation analysis of the CMS Medicare Current Beneficiary Survey Disclaimer: Limited information was available for some of the categories and certain assumptions have been made based on analysis of the data. 3

4 Medicare Eligibility Projection (i.e. Baby Boomer Impact) Our Medicare beneficiary projection is shown in Table 2, following. To validate the projection, we compared the results to the Center for Medicare and Medicaid Office of the Actuary projection of future Medicare Beneficiaries. Table 2 Total Medicare Beneficiaries (Aged & Disabled) in 000s CSG Actuarial % Increase Office of the Actuary % Increase Year Projection By Year CMS Projection (1) By Year ,385 44, , % 45, % , % 46, % , % 48, % , % 49, % , % 50, % , % 52, % , % 53, % , % 55, % , % 57, % , % 58, % , % 60, % , % N/A N/A Source: (1) Projection taken from April 22, 2010 Letter from the CMS Office of the Actuary. Footnote: Years 2008 and 2009 are provided as a reference point and are taken from the 2009 and 2008 Medicare Statistical Supplement. Historical Medicare Supplement Assessment To project the future of Medicare Supplement, we had to understand historical market trends. Overall, the total number of Medicare Supplement policies has declined over the last five years. Table 3, following, features a summary of data found in the NAIC Medicare Supplement Loss Ratio reports showing total policies and premiums by year. We then added a column showing percentage of Medicare Supplement policies, within the broader Medicare market. Table 3 Historical Medicare Supplement #'s (in 000s) 1 Total Policies Total Average % of Medicare Year Inforce Premium Premium Eligibles ,361 $18,749,062 $1, % ,260 $19,433,500 $1, % ,102 $19,224,000 $1, % ,546 $18,494,000 $1, % ,491 $19,025,000 $2, % ,452 $19,467,000 $2, % Source: (1) Annual NAIC Medicare Supplement Loss Ratio Reports 4

5 So, why the decline? We had to identify the determining factors of decline before making our projections. It is especially surprising, given that the market is set up for success due to: Hundreds of plans are available, in every part of the U.S. Distribution of the plans continues to evolve, including traditional agents, telephonic sales, direct mail, and internet sales. With expanding Medicare cost-sharing components, the need for Medicare Supplement grows. Our analysis of the data and broader market research suggest several reasons for the decline. First, Medicare Advantage (MA) enrollment has increased from 4.8mm (2004) to 11.9mm (2010). Increasing subsidies to MA plans, rebates to enrollees (lower cost sharing, additional benefits, or enhanced drug coverage), and the introduction of Medicare Part D in 2006 have caused beneficiaries to re-evaluate their Medicare coverage. As a result, MA plans have become more attractive than traditional private fee-for-service Medicare and Medicare Supplement persistency and new sales have declined. Second, as shown in Table 3, the cost of Medicare Supplement insurance coverage has increased from According to Kaiser Family Foundation, almost half of all Medicare beneficiaries (47%) had an income below 200% of the Federal poverty level. Sixteen percent are actually below the standard Federal poverty level. Table 3 displays the average cost of Medicare Supplement insurance over the last 5 years, which has risen 13.8%. So, as the cost of Medicare Supplement insurance continued to grow ( ), a smaller percentage of the population was able to afford Medicare Supplement plans. Third, and similar to the second reason, the number of individuals enrolled in Medicare Part B has decreased, which is required for the purchase of Medicare Supplement. When comparing Part B data from 2000 to 2010, enrollment has declined from 95% to 91%. One of our assumptions is that the decline may be related to the rising costs of Part B premiums, having increased from $45.50 per month in 2000 to $ in These reasons/factors were included in the development of our projection. Naturally, we were especially curious to learn whether or not the declining market trend would continue. 5

6 Medicare Supplement Projection Our Medicare Supplement projection is featured in Table 4, following. Assumptions made include: Demographics of current Medicare Beneficiaries are accurate. Demographics of future Medicare Beneficiaries will not experience dramatic change in the future. Mortality Rates 2000 U.S. life table with mortality improvements (disabled individuals were projected, assuming a 50% higher lapse rate). Current policy lapse rate and replacement rates will not experience dramatic change in the future. Annual Medicare Supplement rate increase trends will not experience dramatic change in the future. We also considered the effect of trends in Medicare Advantage, retiree health benefits, and other types of supplemental coverage. Table 4 Historical & Projected Medicare Supplement #'s (in 000s) Total Policies Total Average % of Medicare Year Inforce Premium Premium Eligibles ,361 $18,749,062 $1, % ,260 $19,433,500 $1, % ,102 $19,224,000 $1, % ,546 $18,494,000 $1, % ,491 $19,025,000 $2, % ,452 $19,467,000 $2, % ,474 $20,053,541 $2, % ,603 $20,876,468 $2, % ,825 $21,897,346 $2, % ,021 $22,860,142 $2, % ,235 $23,851,537 $2, % ,517 $24,995,072 $2, % ,678 $25,809,891 $2, % ,955 $26,861,260 $2, % ,192 $27,756,788 $2, % ,378 $28,436,088 $2, % ,581 $29,050,397 $2, % NOTE: Factors that would increase the likelihood of a sustained decline in the Medicare Supplement market, through 2020 include: Repeal of the current health care reform law. Dramatic increases in health care costs. Continued economic hardships. 6

7 Conclusions Data suggest the Medicare Supplement market, despite historical decline, show signs of growth. We conclude there are four opportunities for agents, agencies, and carriers to consider, based on our findings. Opportunity #1 Baby Boomers As our projection shows, the total population of Medicare eligible individuals will increase by more than 15.4 million people over the next 10 years. This should provide some lift to Medicare Supplement sales, even if the overall penetration continues to decline. Opportunity #2 Medicare Advantage (MA) Reductions The recent health care law includes certain Medicare provisions that, beginning in 2012, will gradually reduce subsidies paid to Medicare Advantage plans, resulting in less generous benefit packages. According to the CMS Office of the Actuary, when these MA provisions are fully phased in, enrollment in MA plans will be lower by about 50%, from 14.8 million (projected level under the prior law) to 7.4 million (projected level under the new law). Our Medicare projection does anticipate some decline in Medicare Advantage enrollments over the next ten years, though not as a dramatic as the CMS projection. Our assumption is that MA plans, under the new star rating program and the bonuses available under this program, will still be able to provide quality benefit packages. In any event the impact of health care reform on Medicare Advantage should benefit Medicare Supplement into the future. Opportunity #3 Decrease in Retiree Health Benefits Economic issues and accounting changes continue to force many companies and municipalities to eliminate or alter health care benefits for their retirees, who will in turn (along with Medicare) incur more health care burden. According to the Medicare Beneficiary Survey, the number of individuals receiving retiree health benefits has decreased 25% over the last 20 years. Opportunity #4 New Medicare Supplement plans The new health care law has a little known provision that directs the NAIC to research additional new plans that would be introduced in the year The purpose of these new plans would be to eliminate first dollar coverage, as is provided by today s Plan F. As was seen with the introduction of new Plans M & N in 2010, any changes to a commodity product such as Medicare Supplement, will create buzz in the marketplace and possibly generate an increase in sales. Another possible benefit would be forcing the market to move away from high cost, first dollar coverage and toward lower cost plans. These plans are available today but are often ignored in favor of Plan F. Lowering the cost of Medicare Supplement could open the market up to individuals that could otherwise not afford supplement coverage. For More Information... On this project or to learn how CSG Actuarial could help with your own project, please contact us by ing 7

8 About The Authors Bryan R. Neary FSA, MAAA Bryan is President and founder of CSG Actuarial. With more than 14 years of actuarial experience, at all levels, he provides uniquely relevant and business-smart services. Bryan is a Fellow of the Society of Actuaries and a Member of the American Academy of Actuaries. He holds a Bachelor of Science in Actuarial Science from the University of Nebraska, Lincoln. Call him at (402) or Brynn Korolchuk, MBA Brynn is a tenacious researcher who is responsible for CSG s growing Competitive Intelligence business. She started her career in insurance underwriting Monoline Workman s Compensation risk in the Western U.S. Brynn holds a Bachelor of Science in Marketing from Creighton University and a MBA from the University of Nebraska at Omaha. Call her at (402) or 8

9 Competitive Intelligence and Actuarial Consulting For the insurance industry. About CSG Actuarial CSG Actuarial is a competitive intelligence and consulting firm that gets the data, checks the data, and provides the data N 50th St Omaha, NE

Revolution or Evolution: What s Happening Next for MedAdv and Prescription Drug Plans

Revolution or Evolution: What s Happening Next for MedAdv and Prescription Drug Plans Revolution or Evolution: What s Happening Next for MedAdv and Prescription Drug Plans Issues & Trends in Medicare Supplement Insurance 2012 Conference Presented by: T. Scott Bentley, FSA, MAAA Consulting

More information

Affordable Care Act (ACA) Shifts Wealth From Millennials to Baby Boomers

Affordable Care Act (ACA) Shifts Wealth From Millennials to Baby Boomers Affordable Care Act (ACA) Shifts Wealth From Millennials to Baby Boomers April 6, 2015 Brittany Clifton, Gail Werner-Robertson Scholar Creighton Institute for Economic Inquiry Affordable Care Act (ACA)

More information

ACA Premium Impact Variability of Individual Market Premium Rate Changes Robert M. Damler, FSA, MAAA Paul R. Houchens, FSA, MAAA

ACA Premium Impact Variability of Individual Market Premium Rate Changes Robert M. Damler, FSA, MAAA Paul R. Houchens, FSA, MAAA ACA Premium Impact Variability of Individual Market Premium Rate Changes Robert M. Damler, FSA, MAAA Paul R. Houchens, FSA, MAAA BACKGROUND The Patient Protection and Affordable Care Act (ACA) introduces

More information

Medicare Supplement Market Overview. Stacy Varney VP, Marketing & Account Management

Medicare Supplement Market Overview. Stacy Varney VP, Marketing & Account Management Medicare Supplement Market Overview Stacy Varney VP, Marketing & Account Management Proprietary Notice The material contained in this presentation has been prepared solely for informational purposes by

More information

ESTIMATED PREMIUM IMPACTS OF ANNUAL FEES ASSESSED ON HEALTH INSURANCE PLANS OCTOBER 31, 2011 CHRIS CARLSON, FSA, MAAA

ESTIMATED PREMIUM IMPACTS OF ANNUAL FEES ASSESSED ON HEALTH INSURANCE PLANS OCTOBER 31, 2011 CHRIS CARLSON, FSA, MAAA ESTIMATED PREMIUM IMPACTS OF ANNUAL FEES ASSESSED ON HEALTH INSURANCE PLANS OCTOBER 31, 2011 CHRIS CARLSON, FSA, MAAA CONTENTS 1. Executive summary... 1 2. Background... 2 3. Data... 4 Base premiums...

More information

Article from: Health Watch. January 2013 Issue 71

Article from: Health Watch. January 2013 Issue 71 Article from: Health Watch January 2013 Issue 71 Similarities between Medicare Prescription Drug Plans and Commercial Exchanges By Shelly S. Brandel and Douglas A. Proebsting The Affordable Care Act (ACA)

More information

Prescription Drugs as a Starting Point for Medicare Reform Testimony before the Senate Budget Committee

Prescription Drugs as a Starting Point for Medicare Reform Testimony before the Senate Budget Committee Prescription Drugs as a Starting Point for Medicare Reform Testimony before the Senate Budget Committee Marilyn Moon The nonpartisan Urban Institute publishes studies, reports, and books on timely topics

More information

Patient Protection and Affordable Care Act (ACA) ACA Guide for Group Employers Agent and Broker Information

Patient Protection and Affordable Care Act (ACA) ACA Guide for Group Employers Agent and Broker Information Patient Protection and Affordable Care Act (ACA) ACA Guide for Group Employers Agent and Broker Information DISCLAIMER 2 This information is being provided in an effort to alert you to changes required

More information

Office of the Actuary

Office of the Actuary DEPARTMENT OF HEALTH & HUMAN SERVICES Centers for Medicare & Medicaid Services 7500 Security Boulevard, Mail Stop N3-01-21 Baltimore, Maryland 21244-1850 Office of the Actuary DATE: March 25, 2008 FROM:

More information

MEDICARE ADVANTAGE ENROLLMENT AND QUALITY: IMPACT ON PAYMENT REFORM

MEDICARE ADVANTAGE ENROLLMENT AND QUALITY: IMPACT ON PAYMENT REFORM MEDICARE ADVANTAGE ENROLLMENT AND QUALITY: IMPACT ON PAYMENT REFORM Timothy D. McBride Leah Kemper Abigail Barker Keith Mueller July 2013 International Health Economics Association Sydney, Australia Washington

More information

The Costs of a Medicare Prescription Drug Benefit: A Comparison of Alternatives

The Costs of a Medicare Prescription Drug Benefit: A Comparison of Alternatives This executive summary provides an overview of work that is described in more detail in The Costs of a Medicare Prescription Drug Benefit: A Comparison of Alternatives, RAND MR-1529.0-NIA, by Dana P. Goldman,

More information

Patient Protection and Affordable Care Act (ACA) ACA Guide for Group Employers Employer Information

Patient Protection and Affordable Care Act (ACA) ACA Guide for Group Employers Employer Information Patient Protection and Affordable Care Act (ACA) ACA Guide for Group Employers Employer Information DISCLAIMER 2 This information is being provided in an effort to alert you to changes required by the

More information

The Continued Need for Reform: Building a Sustainable Health Care System

The Continued Need for Reform: Building a Sustainable Health Care System The Continued Need for Reform: Building a Sustainable Health Care System Sustainable reform must address cost and quality, while expanding coverage through a vibrant and functional marketplace As the largest

More information

CUPA-HR New York Metro Chapter Fall Event

CUPA-HR New York Metro Chapter Fall Event CUPA-HR New York Metro Chapter Fall Event Introduction to Panel Discussion on Health Care Reform and Compliance Strategies October 18, 2012 The Compliance Timeline 2011 Plan Year 2011 2012 2013 2014 2018

More information

Healthcare Exchanges: Are They a Viable Option for Your Organization?

Healthcare Exchanges: Are They a Viable Option for Your Organization? Healthcare Exchanges: Are They a Viable Option for Your Organization? By: Lori Kacin, GBA, Analyst Cowden Associates, Inc. Spring 2015 Employers that have not yet evaluated their exchange marketplace options

More information

Health Economics Program

Health Economics Program Health Economics Program Issue Brief 2006-05 August 2006 Medicare Supplemental Coverage and Prescription Drug Use, 2004 Medicare is a federal health insurance program that provides coverage for the elderly

More information

Chartpack. August 2008

Chartpack. August 2008 Chartpack Examining Sources of Coverage Among Medicare Beneficiaries: Supplemental Insurance, Medicare Advantage, and Prescription Drug Coverage Findings from the Medicare Current Beneficiary Survey, 2006

More information

ACA Impact on Premium Rates in the Individual and Small Group Markets

ACA Impact on Premium Rates in the Individual and Small Group Markets ACA Impact on Premium Rates in the Individual and Small Group Markets Paul R. Houchens, FSA, MAAA BACKGROUND The Patient Protection and Affordable Care Act (ACA) introduces significant changes in covered

More information

Current Trends in Medicare Supplement

Current Trends in Medicare Supplement Southeastern Actuaries Club Pinehurst, NC June 21, 2012 Paula Hines, ASA, MAAA Director, Government Products Pricing BlueCross BlueShield of Tennessee, Inc., an Independent Licensee of the BlueCross BlueShield

More information

Federal exchange auto-enrollment: Emerging data and new proposals

Federal exchange auto-enrollment: Emerging data and new proposals Federal exchange auto-enrollment: Emerging data and new proposals Jason A. Clarkson, FSA, MAAA William A. Gibula, ASA, MAAA Paul R. Houchens, FSA, MAAA EXECUTIVE SUMMARY The U.S. Department of Health and

More information

The Future of General Health and Medicare Insurance Programs SEAC Annual Meeting November 15, 2012

The Future of General Health and Medicare Insurance Programs SEAC Annual Meeting November 15, 2012 The Future of General Health and Medicare Insurance Programs SEAC Annual Meeting November 15, 2012 Greg Winkler, FSA, MAAA GregW@Wakely.com, 727-507-9858 x7473 2 History of Medicare (pre ACA) Social Security

More information

Health Reform Employer Impact Analysis. Sample Employer. Prepared for. Date

Health Reform Employer Impact Analysis. Sample Employer. Prepared for. Date Health Reform Employer Impact Analysis Prepared for Sample Employer Date 2 Health Reform Employer Impact Analysis Overview Beginning in 2014, an applicable large employer becomes subject to what are referred

More information

Cost-sharing Charges in Marketplace Health Insurance Plans - Part II

Cost-sharing Charges in Marketplace Health Insurance Plans - Part II September 2013 Cost-sharing Charges in Marketplace Health Insurance Plans - Part II Starting in January 2014, new health insurance marketplaces (also called exchanges) will provide a way for people to

More information

Section 5: Public Health Insurance Programs

Section 5: Public Health Insurance Programs 1 Section 5: Public Health Insurance Programs Medicare Medical Assistance (Medicaid) MinnesotaCare General Assistance Medical Care (GAMC) Minnesota Comprehensive Health Association (MCHA) A summary of

More information

The Affordable Care Act

The Affordable Care Act The Affordable Care Act What does it mean for internists? Joshua Becker MD 10/14/2015 VII. 2015 Reforms and Beyond Payment Penalties under Medicare s Pay-for-Reporting Program Value-Based Payment Modifier

More information

Medicare Supplement. Southeastern Actuaries Conference Annual Meeting November 19 21, 2014. Robert Himmelstein, Second Vice President ASA, MAAA

Medicare Supplement. Southeastern Actuaries Conference Annual Meeting November 19 21, 2014. Robert Himmelstein, Second Vice President ASA, MAAA Medicare Supplement Southeastern Actuaries Conference Annual Meeting November 19 21, 2014 Robert Himmelstein, Second Vice President ASA, MAAA Proprietary Notice The material contained in this presentation

More information

Panorama Rooms Thursday 5 March, 2015 14:00. Mr David Abernethy. Health Policy & Government Relations Consultant, Washington, DC

Panorama Rooms Thursday 5 March, 2015 14:00. Mr David Abernethy. Health Policy & Government Relations Consultant, Washington, DC Panorama Rooms Thursday 5 March, 2015 14:00 Mr David Abernethy Health Policy & Government Relations Consultant, Washington, DC U.S. Private Insurance Solutions in the US Social Insurance System for the

More information

HEALTH CARE REFORM AND STOP LOSS INSURANCE APRIL, 2013

HEALTH CARE REFORM AND STOP LOSS INSURANCE APRIL, 2013 HEALTH CARE REFORM AND STOP LOSS INSURANCE APRIL, 2013 Bruce A. Richards, FSA, MAAA, FCA Partner, Chief Healthcare Actuary & Quality Leader Mercer Health and Benefits, LLC Richmond Key Elements of Health

More information

Policy Options to Improve the Performance of Low Income Subsidy Programs for Medicare Beneficiaries

Policy Options to Improve the Performance of Low Income Subsidy Programs for Medicare Beneficiaries Policy Options to Improve the Performance of Low Income Subsidy Programs for Medicare Beneficiaries January 2012 Stephen Zuckerman, Baoping Shang, Timothy Waidmann Introduction One of the principal goals

More information

Medicare Advantage: The Basics

Medicare Advantage: The Basics : The Basics Gretchen Jacobson, Ph.D. Associate Director, Program on Policy Kaiser Family Foundation Monday, June 10, 2013 Exhibit 1 More than one quarter of beneficiaries are enrolled in a private plan

More information

Session 89 PD, Future of the Long-Term Care Insurance Industry Moderator: Allen J. Schmitz, FSA, MAAA

Session 89 PD, Future of the Long-Term Care Insurance Industry Moderator: Allen J. Schmitz, FSA, MAAA Session 89 PD, Future of the Long-Term Care Insurance Industry Moderator: Allen J. Schmitz, FSA, MAAA Presenters: Anthony C. Laudato, FSA, MAAA Allen J. Schmitz, FSA, MAAA The Future of the LTC Industry

More information

Table of Contents. Background and Certification Page 2 Introduction Page 3. Amortization Method Page 4

Table of Contents. Background and Certification Page 2 Introduction Page 3. Amortization Method Page 4 Racine County School Office Accounting and Sample Funding Report of Liabilities for Participants Post Employment Benefits as of January 1, 2011 Thru End of the Year December 31, 2011 January 2012 This

More information

Medicare Managed Care Employer Group Issues

Medicare Managed Care Employer Group Issues Medicare Managed Care Employer Group Issues Presented by Amy Hafey, Senior Counsel, Legal and Government Relations Robert Raffel, Director, Group Medicare Sales and Account Management Sheila Rankin, Vice

More information

Health Meeting June 10-12, 2013 Baltimore, MD. Session 7 PD, Changes Coming to Medicare Supplement and Medicare Advantage

Health Meeting June 10-12, 2013 Baltimore, MD. Session 7 PD, Changes Coming to Medicare Supplement and Medicare Advantage Health Meeting June 10-12, 2013 Baltimore, MD Session 7 PD, Changes Coming to Medicare Supplement and Medicare Advantage Moderator: Ivy Dong, FSA, MAAA Presenters: T Scott Bentley FSA,MAAA Mark J Cary

More information

Latest House Republican Budget Threatens Medicare and Shreds the Safety Net

Latest House Republican Budget Threatens Medicare and Shreds the Safety Net Latest House Republican Budget Threatens Medicare and Shreds the Safety Net Instead of Reducing Health Care Costs, Blueprint Shifts Costs to Seniors, Providers, Businesses, and States Topher Spiro March

More information

Significance of the Coverage Gap Under Medicare Part D

Significance of the Coverage Gap Under Medicare Part D June 8, 2006 Significance of the Coverage Gap Under Medicare Part D The gap in coverage between spending levels of $2,250 and $3,600 in true out-of-pocket spending is one of the most discussed aspects

More information

Medicare Advantage Funding Cuts and the Impact on Beneficiary Value

Medicare Advantage Funding Cuts and the Impact on Beneficiary Value Medicare Advantage Funding Cuts and the Impact on Beneficiary Value Commissioned by Better Medicare Alliance Prepared by: Milliman, Inc. Brett L. Swanson, FSA, MAAA Consulting Actuary Eric P. Goetsch,

More information

Nevada Health Insurance Market Study

Nevada Health Insurance Market Study Nevada Health Insurance Market Study Prepared for the State of Nevada March 2012 Gorman Actuarial, LLC 210 Robert Road Marlborough, MA 01752 Bela Gorman, FSA, MAAA Don Gorman Jenn Smagula, FSA, MAAA Gorman

More information

The Changing Face of Employer-Sponsored Retiree Prescription Benefits. Long-term strategies for a rapidly evolving market

The Changing Face of Employer-Sponsored Retiree Prescription Benefits. Long-term strategies for a rapidly evolving market The Changing Face of Employer-Sponsored Retiree Prescription Benefits Long-term strategies for a rapidly evolving market February 2015 Executive Summary The past decade has seen fundamental changes in

More information

Consumer Options When Medicare Advantage Plans Withdraw or Change Their Benefits

Consumer Options When Medicare Advantage Plans Withdraw or Change Their Benefits HEALTH POLICY BRIEF MARCH 2010 Consumer Options When Advantage Plans Withdraw or Change Their Benefits SUMMARY Advantage Plans, private plan alternatives to traditional, will likely undergo a lot of changes

More information

Written Testimony of. Consumers Union. Medicare Premium Support Proposals

Written Testimony of. Consumers Union. Medicare Premium Support Proposals Written Testimony of Consumers Union on Medicare Premium Support Proposals Submitted to U.S. House of Representatives Committee on Ways and Means Subcommittee on Health April 27, 2012 Introduction Consumers

More information

Patient Protection and Affordable Care Act of 2009: Immediate Health Insurance Market Reforms

Patient Protection and Affordable Care Act of 2009: Immediate Health Insurance Market Reforms Patient Protection and Affordable Care Act of 2009: Immediate Health Insurance Market Reforms Provision Notes Standards Development Applicability Effective Date PPACA Statutory Annual and Lifetime Limits

More information

Part D payment system

Part D payment system Part D payment system paymentbasics Revised: October 204 This document does not reflect proposed legislation or regulatory actions. 425 I Street, NW Suite 70 Washington, DC 2000 ph: 202-220-3700 fax: 202-220-3759

More information

The Truth About Gov. Romney s Medicare and Medicaid Reforms

The Truth About Gov. Romney s Medicare and Medicaid Reforms The Truth About Gov. Romney s Medicare and Medicaid Reforms These Changes Would Shift Costs to Seniors, Health Care Providers, Businesses, and States By Topher Spiro July 2012 Introduction Republican presidential

More information

RE: Center for Medicaid and CHIP Services Revisions to Medicaid Managed Care Regulations

RE: Center for Medicaid and CHIP Services Revisions to Medicaid Managed Care Regulations Cynthia Mann, J.D. Deputy Administrator Centers for Medicare & Medicaid Services Director Center for Medicaid and CHIP Services 7500 Security Boulevard Mail Stop: S2-26-12 Baltimore, MD 21244 RE: Center

More information

Valuation Actuary Symposium September 23-24, 2013 Indianapolis, IN. 29 PD, New Health Care Receivables Exhibit. Moderator: F Kevin Russell FSA,MAAA

Valuation Actuary Symposium September 23-24, 2013 Indianapolis, IN. 29 PD, New Health Care Receivables Exhibit. Moderator: F Kevin Russell FSA,MAAA Valuation Actuary Symposium September 23-24, 2013 Indianapolis, IN 29 PD, New Health Care Receivables Exhibit Moderator: F Kevin Russell FSA,MAAA Presenters: Susan Lynn Mateja FSA,MAAA,FCA Session 29PD

More information

Ronald Riner, MD. The Riner Group, Inc. 5811 Pelican Bay Blvd., Suite 210 Naples, FL 34108 800.965.8485 www.rinergroup.com

Ronald Riner, MD. The Riner Group, Inc. 5811 Pelican Bay Blvd., Suite 210 Naples, FL 34108 800.965.8485 www.rinergroup.com Impact of Healthcare Reform on Small Business January 12, 2011 Ronald Riner, MD The Riner Group, Inc. 5811 Pelican Bay Blvd., Suite 210 Naples, FL 34108 800.965.8485 www.rinergroup.com Healthcare Reform

More information

Sources of supplemental coverage among noninstitutionalized Medicare beneficiaries, 2011

Sources of supplemental coverage among noninstitutionalized Medicare beneficiaries, 2011 3 Chart 3-1. Sources of supplemental coverage among noninstitutionalized Medicare beneficiaries, 2011 No supplemental coverage 13.5% Medigap 17.3% Medicare managed care 29.8% Employersponsored insurance

More information

Overview of STRS Ohio s Health Care Program

Overview of STRS Ohio s Health Care Program Overview of STRS Ohio s Health Care Program Tim Myers, Retirement Board Member 2015 Public Pension Funding Forum Berkeley, CA Agenda STRS Ohio Health Care Program Snapshot Eligibility History Demographics

More information

RUPRI Center for Rural Health Policy Analysis Rural Policy Brief

RUPRI Center for Rural Health Policy Analysis Rural Policy Brief RUPRI Center for Rural Health Policy Analysis Rural Policy Brief Brief No. 2009-5 June 2009 www.unmc.edu/ruprihealth A Rural-Urban Comparison of a Building Blocks Approach to Covering the Uninsured By

More information

Maryland Medicaid Program

Maryland Medicaid Program Maryland Medicaid Program Maryland s Pharmacy Discount Waiver Tuesday, November 19, 2002 Debbie I. Chang Deputy Secretary for Health Care Financing Maryland Department of Health and Mental Hygiene Overview

More information

The Public Cost of Privatized Medicare

The Public Cost of Privatized Medicare The Public Cost of Privatized Medicare How Medicare Advantage is hurting Medicare beneficiaries and other New York taxpayers Prepared by USAction Education Fund For release by Citizen Action of New York

More information

Medicare Part D Frequently Asked Questions: Eligibility & Enrollment

Medicare Part D Frequently Asked Questions: Eligibility & Enrollment Medicare Part D Frequently Asked Questions: Eligibility & Enrollment This list of Frequently Asked Questions regarding eligibility and enrollment issues in the new Medicare Part D prescription drug benefit

More information

Information for Individuals who Qualify for. Medicare Only

Information for Individuals who Qualify for. Medicare Only Information for Individuals who Qualify for Medicare Only How to enroll in Medicare An individual can only enroll into Medicare Parts A and B during certain times: Initial Enrollment Period (3-1-3): o

More information

Medicare Advantage Part C Revenue: Challenges Ahead

Medicare Advantage Part C Revenue: Challenges Ahead Medicare Advantage Part C Revenue: Challenges Ahead By Tim Courtney, FSA, MAAA Senior Consulting Actuary, Wakely Consulting, Inc. The Centers for Medicare & Medicaid Services (CMS) recently issued a press

More information

Health Care Receivables Follow-up Study

Health Care Receivables Follow-up Study Health Annual Statement New Exhibit 3A Health Care Receivables Follow-up Study F. Kevin Russell, FSA, MAAA Chairperson, Health Care Receivables Factors Work Group Susan Mateja, FSA, MAAA Member, Health

More information

7/31/2014. Medicare Advantage: Time to Re-examine Your Engagement Strategy. Avalere Health. Eric Hammelman, CFA. Overview

7/31/2014. Medicare Advantage: Time to Re-examine Your Engagement Strategy. Avalere Health. Eric Hammelman, CFA. Overview Medicare Advantage: Time to Re-examine Your Engagement Strategy July 2014 avalerehealth.net Avalere Health Avalere Health delivers research, analysis, insight & strategy to leaders in healthcare policy

More information

The Medicare Drug Benefit (Part D)

The Medicare Drug Benefit (Part D) THE BASICS The Medicare Drug Benefit (Part D) The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) established a voluntary outpatient prescription drug benefit for Medicare

More information

Strengthening Community Health Centers. Provides funds to build new and expand existing community health centers. Effective Fiscal Year 2011.

Strengthening Community Health Centers. Provides funds to build new and expand existing community health centers. Effective Fiscal Year 2011. Implementation Timeline Reflecting the Affordable Care Act 2010 Access to Insurance for Uninsured Americans with a Pre-Existing Condition. Provides uninsured Americans with pre-existing conditions access

More information

Medicare Part D Creditable Coverage

Medicare Part D Creditable Coverage Medicare Part D Creditable Coverage What employers need to do If you are an employer (Plan Sponsor) who will be offering prescription drug coverage to any Medicare Eligible individuals in 2012, you are

More information

Prescription drugs are a critical component of health care. Because of the role of drugs in treating conditions, it is important that Medicare ensures that its beneficiaries have access to appropriate

More information

MASSACHUSETTS UNDER THE AFFORDABLE CARE ACT: EMPLOYER-RELATED ISSUES AND POLICY OPTIONS

MASSACHUSETTS UNDER THE AFFORDABLE CARE ACT: EMPLOYER-RELATED ISSUES AND POLICY OPTIONS MASSACHUSETTS UNDER THE AFFORDABLE CARE ACT: EMPLOYER-RELATED ISSUES AND POLICY OPTIONS JULY 2012 Fredric Blavin, Linda J. Blumberg, Matthew Buettgens, and Jeremy Roth of the Urban Institute ABOUT THE

More information

Medicare Cost Sharing and Supplemental Coverage

Medicare Cost Sharing and Supplemental Coverage Medicare Cost Sharing and Supplemental Coverage Topics to be Discussed Medicare costs to beneficiaries Review Medicare premiums and cost sharing Background on Medicare beneficiary income Current role of

More information

Warwick Public School System

Warwick Public School System Warwick Public School System Actuarial Valuation Post Employment Benefits Other Than Pensions as of July 1, 2011 under Governmental Accounting Standards Board Statement No. 45 (GASB 45) (Estimated Disclosures

More information

How ACA is Changing Employer Health Benefits and the Marketplace Presented by:

How ACA is Changing Employer Health Benefits and the Marketplace Presented by: North Carolina State Health Plan How ACA is Changing Employer Health Benefits and the Marketplace Presented by: J. Richard Johnson Senior Vice President, Public Sector Health Practice Leader rjohnson@segalco.com

More information

The State of the Medigap Market in Massachusetts

The State of the Medigap Market in Massachusetts 1 The State of the Medigap Market in Massachusetts By Michael Miller, Health Care for All Nancy Turnbull, Harvard School of Public Health EXECUTIVE SUMMARY Medicare, the federal health insurance program

More information

Proposed changes to 2014 Medicare Advantage payment methodology and the effect on Medicare Advantage organizations and beneficiaries

Proposed changes to 2014 Medicare Advantage payment methodology and the effect on Medicare Advantage organizations and beneficiaries Proposed changes to 2014 Medicare Advantage payment methodology and the effect on Medicare Advantage organizations and beneficiaries February 26, 2013 GLENN GIESE FSA, MAAA CHRIS CARLSON FSA, MAAA CONSIDERATIONS

More information

Article from: Health Watch. May 2015 Issue 78

Article from: Health Watch. May 2015 Issue 78 Article from: Health Watch May 2015 Issue 78 A Practical Guide to Private Exchanges By Karen Shelton and David Petta Karen A. Shelton, FSA, MAAA, is an actuary at UnitedHealthcare in Richmond, Va. She

More information

Cost Sharing for Medicare Advantage Plans

Cost Sharing for Medicare Advantage Plans Cost Sharing for Medicare Advantage Plans CMS/CMSO/DEHPG/DEEO: 5/9/07 Questions have been raised by States, providers and Medicare Advantage plans regarding the obligations of State Medicaid programs,

More information

ACA Health Insurer Fee Estimated Impact on State Medicaid Programs and Medicaid Health Plans. January 2014 Update

ACA Health Insurer Fee Estimated Impact on State Medicaid Programs and Medicaid Health Plans. January 2014 Update ACA Health Insurer Fee Estimated Impact on Medicaid Programs and Medicaid Health Plans Prepared for: Medicaid Health Plans of America Prepared by: Milliman, Inc. John D. Meerschaert, FSA, MAAA Principal

More information

WHAT S DRIVING GROWTH IN YOUR PLAN

WHAT S DRIVING GROWTH IN YOUR PLAN WHAT S DRIVING GROWTH IN YOUR PLAN Where are new members coming from? Enrollment in Medicare Advantage (MA) plans continues to grow do not miss out on what is fueling this growth. It is not just about

More information

AHIP Comments to House Ways and Means Committee Work Groups Urging Repeal of the ACA Health Insurance Tax

AHIP Comments to House Ways and Means Committee Work Groups Urging Repeal of the ACA Health Insurance Tax AHIP Comments to House Ways and Means Committee Work Groups Urging Repeal of the ACA Health Insurance Tax April 12, 2013 I. Introduction America s Health Insurance Plans (AHIP) is the national trade association

More information

Restructuring Medicare Cost Sharing: Options and Implications

Restructuring Medicare Cost Sharing: Options and Implications Restructuring Medicare Cost Sharing: Options and Implications Alliance for Health Reform Washington, D.C. Juliette Cubanski, Ph.D. Associate Director, Program on Medicare Policy Kaiser Family Foundation

More information

Health Care Reform: Ready or Not, Here it Comes! Presented by:

Health Care Reform: Ready or Not, Here it Comes! Presented by: Broader Perspective. Business Solutions. Health Care Reform: Ready or Not, Here it Comes! Presented by: Ryan Fridborg, MAOD, SPHR Executive Vice President, Employee Benefits rfridborg@boltonco.com Marilyn

More information

North Carolina Department of Insurance

North Carolina Department of Insurance North Carolina Department of Insurance North Carolina Actuarial Memorandum Requirements for Rate Submissions Effective 1/1/2016 and Later Small Group Market Non grandfathered Business These actuarial memorandum

More information

2012 Commercial health insurance: Overview of financial results

2012 Commercial health insurance: Overview of financial results Commercial health insurance:, FSA, MAAA INTRODUCTION With the Patient Protection and Affordable Care Act (ACA) enactment in March, health insurers have had to comply with minimum loss ratio requirements,

More information

Health care reform at-a-glance. August 2014

Health care reform at-a-glance. August 2014 Health care reform at-a-glance August 2014 Employer mandate Shared responsibility payment for failing to offer coverage to at least 95%* of all fulltime employees (FTE) and children if any FTE gets subsidy

More information

The Future of Long Term Care Insurance

The Future of Long Term Care Insurance The Future of International Association of Black Actuaries (IABA) Annual Meeting August 7, 2014 2015 Genworth Financial, Inc. All rights reserved. Summer Sales Meeting Program 1 Historical Perspectives

More information

Gale P. Arden, Director ~ Disabled and Elderly Healt~Programs Group. Medicaid Obligations for Cost-Sharing in Medicare Part C Plans

Gale P. Arden, Director ~ Disabled and Elderly Healt~Programs Group. Medicaid Obligations for Cost-Sharing in Medicare Part C Plans DEPARTMENT OF HEALTH & HUMAN SERVICES Centers for Medicare & Medicaid Services 7500 Security Boulevard, Mail Stop S2-14-26 Baltimore, Maryland 21244-1850 CENTERS formed/care & MEDICAID SERVICES Center

More information

Allsup Medicare Advisor Seniors Survey

Allsup Medicare Advisor Seniors Survey Allsup Medicare Advisor Seniors Survey Examining Medicare Plan Selection Matters For Seniors October 2011 Satisfaction, confidence and health condition 2-5 Changing Medicare plans and challenges 6-9 Current

More information

Health Insurance Coverage in Nebraska Kelly Shaw-Sutherland and Jim P. Stimpson

Health Insurance Coverage in Nebraska Kelly Shaw-Sutherland and Jim P. Stimpson Health Insurance Coverage in Nebraska Kelly Shaw-Sutherland and Jim P. Stimpson S U M M A R Y 217,100 Nebraskans lack health insurance. Nebraska s uninsured rate for the population younger than 65 years

More information

Statistical Modeling and Analysis of Stop- Loss Insurance for Use in NAIC Model Act

Statistical Modeling and Analysis of Stop- Loss Insurance for Use in NAIC Model Act Statistical Modeling and Analysis of Stop- Loss Insurance for Use in NAIC Model Act Prepared for: National Association of Insurance Commissioners Prepared by: Milliman, Inc. James T. O Connor FSA, MAAA

More information

The Affordable Care Act in New Hampshire

The Affordable Care Act in New Hampshire The State of New Hampshire Insurance Department 21 South Fruit Street, Suite 14 Concord, NH 03301 (603) 271-2261 Fax (603) 271-1406 TDD Access: Relay NH 1-800-735-2964 The Affordable Care Act in New Hampshire

More information

2013 Commercial health insurance: Overview of financial results

2013 Commercial health insurance: Overview of financial results Paul R. Houchens, FSA, MAAA Jason A. Clarkson, FSA, MAAA Colin R. Gray, ASA, MAAA INTRODUCTION With the Patient Protection and Affordable Care Act (ACA) enactment in March 2010, health insurers have had

More information

Overview of Policy Options to Sustain Medicare for the Future

Overview of Policy Options to Sustain Medicare for the Future Overview of Policy Options to Sustain Medicare for the Future Juliette Cubanski, Ph.D. Associate Director, Program on Medicare Policy Kaiser Family Foundation jcubanski@kff.org Medicare NewsGroup Journalism

More information

New Hampshire Health Insurance Market Analysis

New Hampshire Health Insurance Market Analysis New Hampshire Health Insurance Market Analysis REPORT PREPARED FOR NEW HAMPSHIRE INSURANCE DEPARTMENT BY JULIA LERCHE, FSA, MAAA, MSPH CHIA YI CHIN BRITTNEY PHILLIPS AUGUST 18, 2014 TABLE OF CONTENTS 1.

More information

2015 Medicare Advantage rates: Perspectives for payors

2015 Medicare Advantage rates: Perspectives for payors 2015 Medicare Advantage rates: Perspectives for payors On April 7, the Centers for Medicare and Medicaid Services (CMS) released the final 2015 Rate Announcement and Call Letter for Medicare Advantage

More information

Patient Protection and Affordable Care Act (H.R. 3590)

Patient Protection and Affordable Care Act (H.R. 3590) on Health Reform Passing comprehensive health care reform has been a priority of the President and Congress. The U.S. House of Representatives passed the Affordable Health Care for America Act on November

More information

Premium Tax Credits: Answers to Frequently Asked Questions

Premium Tax Credits: Answers to Frequently Asked Questions Updated July 2013 Premium Tax Credits: Answers to Frequently Asked Questions Beginning in 2014, millions of Americans will become eligible for a new premium tax credit that will help them pay for health

More information

Timeline: Key Feature Implementations of the Affordable Care Act

Timeline: Key Feature Implementations of the Affordable Care Act Timeline: Key Feature Implementations of the Affordable Care Act The Affordable Care Act, signed on March 23, 2010, puts in place health insurance reforms that will roll out incrementally over the next

More information

Medicare Supplemental Coverage in Minnesota

Medicare Supplemental Coverage in Minnesota Medicare Supplemental Coverage in Minnesota December 2002 h ealth e conomics p rogram Health Policy and Systems Compliance Division Minnesota Department of Health Medicare Supplemental Coverage in Minnesota

More information

The Medicare Shared Savings Program and the Pioneer Accountable Care Organizations

The Medicare Shared Savings Program and the Pioneer Accountable Care Organizations The Medicare Shared Savings Program and the Accountable Care Organizations Promoting and evaluating accountable care organizations Victoria Boyarsky, FSA, MAAA Rob Parke, FIA, ASA, MAAA Peer reviewed by

More information

Data Concerns in Out-of-Pocket Spending Comparisons between Medicare and Private Insurance. Cristina Boccuti and Marilyn Moon

Data Concerns in Out-of-Pocket Spending Comparisons between Medicare and Private Insurance. Cristina Boccuti and Marilyn Moon Data Concerns in Out-of-Pocket Spending Comparisons between Medicare and Private Insurance Cristina Boccuti and Marilyn Moon As Medicare beneficiaries double over the next 30 years, controlling per enrollee

More information

The Medicare Advantage program: Status report

The Medicare Advantage program: Status report C h a p t e r13 The Medicare Advantage program: Status report R E C O M M E N D A T I O N S (The Commission reiterates its March 2014 recommendations on improving the bidding rules in the Medicare Advantage

More information

MEDIGAP: Spotlight on Enrollment, Premiums, and Recent Trends. Jennifer Huang Policy Analyst, Program on Medicare Policy Kaiser Family Foundation

MEDIGAP: Spotlight on Enrollment, Premiums, and Recent Trends. Jennifer Huang Policy Analyst, Program on Medicare Policy Kaiser Family Foundation MEDIGAP: Spotlight on Enrollment, Premiums, and Recent Trends Jennifer Huang Policy Analyst, Program on Medicare Policy Kaiser Family Foundation AcademyHealth 2013 Annual Research Meeting Tuesday, June

More information

LONG-TERM CARE INSURANCE PERSISTENCY EXPERIENCE

LONG-TERM CARE INSURANCE PERSISTENCY EXPERIENCE A 2006 Report LONG-TERM CARE INSURANCE PERSISTENCY EXPERIENCE A JOINT STUDY SPONSORED BY LIMRA INTERNATIONAL AND THE SOCIETY OF ACTUARIES LTC EXPERIENCE COMMITTEE Marianne Purushotham, FSA Product Research

More information

THE MEDICAID PROGRAM AT A GLANCE. Health Insurance Coverage

THE MEDICAID PROGRAM AT A GLANCE. Health Insurance Coverage on on medicaid and and the the uninsured March 2013 THE MEDICAID PROGRAM AT A GLANCE Medicaid, the nation s main public health insurance program for low-income people, covers over 62 million Americans,

More information

Impact of the Health Insurance Annual Fee Tax

Impact of the Health Insurance Annual Fee Tax Impact of the Health Insurance Annual Fee Tax Robert A. Book, Ph.D. February 20, 2014 Executive Summary The Affordable Care Act's "annual fee on health insurance is a unique tax levied on health insurance

More information

The Health Benefit Exchange and the Commercial Insurance Market

The Health Benefit Exchange and the Commercial Insurance Market The Health Benefit Exchange and the Commercial Insurance Market Overview The federal health care reform law directs states to set up health insurance marketplaces, called Health Benefit Exchanges, that

More information