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Webinar Details

  • Pub Code: C4R21-11WEB
  • Speakers
    • David Tuomala
    • Janet Trautwein

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Public Exchange Enrollment-Mix and Claims Results: Implications for 2014 Performance and 2015 Planning

May 28, 2014 Webinar - Listen On-Demand or Get a CD!

With the vast majority of 2014 individual enrollments in the public insurance exchanges now in, there are starting to be data for assessing who signed up, what that means for the risk pool, and what the implications are for insurer and broker participation in 2015. Decisions on participation and rates for next year need to be made now, but should be based on an understanding of what is happening in 2014. What financial problems have surfaced, and how effective are and will be the federal risk-mitigation programs in offsetting them? What trends are likely in product and price changes in 2015? Hear from two industry experts who will provide a detailed analysis of what to expect — this year and next — in both the individual and small-business exchanges.

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The On-Demand recording will be available immediately upon purchase* as a link within a PDF file of the accompanying written materials. CDs and printed materials are shipped via USPS.

Sponsored by Atlantic Information Services, Inc., publisher of Inside Health Insurance Exchanges and Health Plan Week

Hear two experts from disparate segments of the industry — a veteran health plan actuarial consultant and the CEO of the National Association of Health Underwriters — assess the climate for 2015 and evaluate insurer and broker strategies for dealing with the complex climate. You’ll get reliable answers to questions such as:

  • What is the demographic and product mix in the 2014 enrollments in the individual-market exchanges? What does this mix suggest for the likely health of the populations in relation to expectations?
  • What does 2014’s lower-than-anticipated entry of previously uninsured customers into the exchanges mean for the risk characteristics of the pool? What strategies are likely in response?
  • What claims data from the new public exchanges are available so far, and what do they show?
  • What new trends are likely in 2015 in terms of changes in prices and products in the public exchanges?
  • How effective will the “3R” risk mitigation programs be in helping 2014 financial results, and what impact are they likely to have on 2015 pricing?
  • What early indicators of 2014 financial results for exchange participants are available? What do they show?
  • To what degree will brokers participate in the public exchanges, including the SHOP exchanges, in the remainder of 2014 and for 2015? What are the key factors that will determine this?
  • What can we expect to see in 2015 in terms of carriers dropping out of (or entering) the public exchange marketplace?


DAVID TUOMALA is vice president, risk optimization and growth consulting in the OptumInsight unit of UnitedHealth Group. Mr. Tuomala joined the organization in 2007 and leads the practice’s analysis of the impact of the Affordable Care Act. He works on pricing new and existing individual and group benefit health plans, and analysis of new state and federal laws and regulations, among other areas. An actuary with more than 20 years of experience with individual and group plan design, pricing and rate filings, Mr. Tuomala serves on the Federal Health Committee of the American Academy of Actuaries.

JANET TRAUTWEIN is CEO of the National Association of Health Underwriters (NAHU), which represents more than 100,000 professionals involved in the design, sale, implementation and management of U.S. health plans. Her responsibilities include oversight of all NAHU activities and representing the association with government agencies and elected officials. Prior to becoming CEO in 2005, Ms. Trautwein served for many years as the head of NAHU’s government affairs department. Her expertise includes issues related to health insurance pools, risk and reinsurance pooling, and national health reform.

Moderator: Jim Gutman, managing editor of AIS's Medicare Advantage News

Designed Especially For

  • Health plan CEOs, CFOs, chief operating officers, product development and sales and marketing executives, government affairs and compliance directors, market research executives, actuaries, accountants and attorneys.
  • Insurance brokers, agents and third-party administrators
  • Employee benefits executives at self-insured and insured employers
  • Executives of pharmaceutical companies and PBMs
  • Attorneys, consultants and actuaries

Shipping Information

CDs (and accompanying written materials) are shipped via UPS. Please give us your street address when you order (UPS does not deliver to PO boxes). You should receive your order within two weeks.* Shipping and handling cost is $12.

The On-Demand Recording will be delivered as a link within a PDF file of the accompanying written materials. Shipping will NOT be charged for this item.

  • If you order the On-Demand Recording before the conference date (by itself or in combination with the live Webinar), you will be sent an e-mail with the PDF file attached once the recording is available.*
  • After the On-Demand Recording is available*, if you order on this website through our secure shopping cart, you will receive an e-mail, immediately after submitting your order, with a link directing you to download the PDF file. If you order through our customer service department (by phone, mail, fax or e-mail), you will be sent an e-mail with the PDF file attached.

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*On-Demand recordings will be available within a week of the conference and CDs will be available within two weeks.

Written Materials

Listeners will also receive practical written information to supplement information covered by the Webinar speakers. A copyright release in the Printed Materials will permit you to make photocopies for each person listening to the Webinar and/or the On-Demand Recording.

Public Exchange Enrollment-Mix and Claims Results: Implications for 2014 Performance and 2015 Planning

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