Milliman's Top Ten Actuarial Issues for a Health Exchange

1. Mandatory or Voluntary?
2. To merge risk pools or not to merge
3. Implementation of risk adjusters and risk sharing
4. Creativity in Exchange design
5. Joining forces with other states
6. The large group factor
7. What if small groups elect to self-fund?
8. Is actuarial value the right comparison?
9. Organizational considerations
10. Information relevance in comparing health plans and benefits

Notes: Detailed discussion of each issue is provided in Milliman Health Care Reform Briefing Paper on this topic at referenced link below
Source: Mike Sturm, FSA, MAAA, Milliman Inc: Milliman Health Care Reform Briefing Paper, March 2011
Source URL: http://publications.milliman.com/publications/healthreform/p...

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