Terms & Conditions
Overview: The Affordable Care Act (ACA) brought extensive changes to the individual health insurance market. Accolades as well as concerns have been raised by stakeholders as the market evolves under the new structure. Many are questioning the sustainability of the system over the long run.
The Robert Wood Johnson Foundation (“RWJF” or “Sponsor”) has engaged Milliman, Inc. (“Administrator” or “Milliman”) to administer a collaborative Actuarial Challenge to test different approaches to increasing stability in the individual health insurance market. The Actuarial Challenge is targeted to elicit innovative ideas and proposals from informed actuaries to move the individual insurance market further toward the goal of universal access to quality health services and providers in a financially secure and stable way with consideration of the costs the solution places upon individuals, employers, health care providers, taxpayers (present and future), and other health sector stakeholders.
A successful conclusion to the challenge would result in realistic, innovative solutions, which further stimulate discussion about moving the individual health insurance market forward. The results of the challenge will be publicly disseminated and shared with policymakers.
Intent to Participate: The Actuarial Challenge will begin on Monday, September 26, 2016 at 10:00 a.m. Central Time (“CT”). Anyone wishing to participate must complete an online application between that time and Friday, November 11, 2016 at 5:00 p.m. CT (“Participant Identification Term”). You are responsible for knowing the time zone and date in your location. It is recommended not to wait until the last moment to apply. Proof of application submission is not proof of receipt. Applications must be submitted via the Actuarial Challenge website, challenge.actuary.org, hosted by the American Academy of Actuaries (the “Website”). The Website is the official timekeeping device for the Actuarial Challenge.
You can enter as part of a team you form yourself (a team of one is also acceptable) or as an individual to be placed on a team. No individual may participate more than one time or on more than one team. Individuals requesting to be placed on a team will be notified of that arrangement shortly after the Participant Identification Term closes. Each entrant must complete all the required fields on the Actuarial Challenge application including indication agreeing to these Terms and Conditions.
If an intent to participate is made on behalf of a group of individuals (a “Team”), the person making the submission on behalf of the Team (the “Leader”) must: (a) disclose as part of the initial submission the name of the company or organization, if any, and the names of all individuals participating in the challenge (“Team Members”); (b) certify that the Leader has the right to act on behalf of the Team (be it an entity or a group of individuals) and all Team Members; and (c) agree to these Terms and Conditions on behalf of the Team and all Team Members.
In addition, each member of each team will be sent an acknowledgement email upon application (using contact information supplied in the initial application) and will be required to individually register on the Actuarial Challenge website and accept these Terms and Conditions during the Participant Identification Term. Failure to do so may result in disqualification of the submitted application from further consideration for support as part of this Actuarial Challenge. No responsibility is assumed for faulty email addresses or any delay or failure in email transmissions.
Who Can Participate: Participation is open to any individual who is (a) a member of one of the five principal actuarial organizations in the United States1 or currently enrolled in an actuarial science program at an accredited university, and (b) at least 18 years of age (or the age of majority in his/her place of residence if it is higher than 18), and (c) be a permanent resident or citizen of the United States. The Actuarial Challenge is not open to persons or entities in any jurisdiction where the Actuarial Challenge would be prohibited or restricted by law. Actuarial Challenge judges and individuals employed by Robert Wood Johnson Foundation or Milliman and their respective directors, trustees, subsidiaries, affiliates, agents, and their immediate families and people living in their households, are not eligible to participate. Milliman, at its sole discretion, shall determine eligibility of any individual or entity, and may disqualify any Participant at any time for any reason.
How to Submit a Reform Idea: Each Team will have the opportunity to prepare and submit a paper outlining the Team’s reform ideas. Reform ideas must be submitted via the Website, and will be accepted beginning on Friday, November 11, 2016 at 10:00 a.m. CT, through Wednesday, November 23, 2016 at 5:00 p.m. CT (“Idea Generation Term”). You are responsible for knowing the time zone and date in your location. It is recommended not to wait until the last moment to submit your reform ideas. Proof of submission is not proof of receipt. All submissions must be in English. Only one submission will be allowed per Team.
Submission Process: All sections of the submission forms must be completed to create a valid submission into the Actuarial Challenge (“Submission”). Submissions may be changed or modified by the Team until the end of the Idea Generation Term. Teams may amend already-submitted proposals by resubmitting the revised proposal (please alert Darleen Jeske that this revision overrides the previous version). All Submissions are deemed to be final at the end of the Idea Generation Term.
LIMIT: ONE (1) SUBMISSION PER TEAM. Subsequent Submissions from the same Team or email address will be disqualified. Each Submission should be made only by the Team Leader for the Team making the Submission. In the event of a dispute over identity, the Submission will be deemed submitted by the authorized account holder of the email account associated with the Submission. “Authorized account holder” is defined as the natural person who is assigned to an email address by an Internet access provider, online service provider, or other organization (e.g., business, educational institution, etc.) that is responsible for assigning email addresses for the domain associated with the submitted email address.
No responsibility is assumed for: (i) lost, late, incomplete, invalid, illegible, incorrect, inaccurate, or misdirected Submissions, all of which are void; (ii) failed, partial, or garbled computer transmissions; (iii) any failure, problem, or technical malfunction including, but not limited to, any telephone or other network or lines, computer online systems, servers or providers, computer equipment, software, email, web browser on account of technical problems, traffic congestion or the Internet or at any website, any combination thereof, or otherwise, including without limitation injury or damage to your or to any other person’s computer related to or resulting from participating in or uploading materials for the Actuarial Challenge; or (iv) for any error, human, technical, or otherwise that may occur in the processing of Submissions. Milliman, at its sole discretion, reserves the right to disqualify any Submission not in compliance with these Terms and Conditions for any reason.
Submission Form Requirements: Each Submission must include a response to all four (4) sections outlined below:
- The solution: Describe your proposed reform changes. How do they address the problem?
- How will your proposal affect consumers? Address at least access to health insurance (impact on uninsured), premium and cost sharing affordability, and access to health care providers. Focus should be concentrated on the individual commercial marketplace.
- How will your proposal affect providers? Address quality of care and supply of providers.
- How will your proposal affect insurers and other health plan issuers? Address at least viability of plan offerings and regulatory burden.
Round One Submissions are not required to provide a quantitative analysis, but should support the expected direction of impact of the proposed reforms to the individual health market, the uninsured, and other affected sectors. Such support can include such items as published research, market metrics, or government data; all sources should be cited appropriately. As described below, Round Two submissions must include a quantitative analysis based on modeling results provided by Milliman.
Submissions may not contain advertisements, commercial endorsements, or any material that is indecent, obscene, hateful, discriminatory, defamatory, slanderous, libelous, unlawful, or otherwise inappropriate as determined by Milliman in its absolute discretion. Any inappropriate Submissions or material may be disqualified by Milliman in its absolute discretion.
Evaluation of Submissions: Evaluation of Submissions will occur in two (2) rounds. The decisions of the judges will be final in all instances.
Round One—Submissions will be screened for basic compliance with the entry requirements and procedures, including but not limited to whether the reform ideas in the Submission address the individual health insurance market and the uninsured and provide directional effects the proposals may have on other health financing sectors (e.g., employer group, Medicaid, Medicare). Round One Submissions are not required to provide a quantitative analysis of the impact of the proposed changes. Submissions meeting those requirements will be eligible to become published on the Actuarial Challenge Website for public viewing. No guarantee is made that any particular Submission will or will not be published or as to the length of time between finalization of the Submission and publication. Any ineligible Submission will be disqualified and not published.
Round Two—On or about December 22, 2016, the judges will select up to five (5) of the Submissions to move on to Round Two, and the Teams that made those Submissions will be invited to participate in a modeling exercise of their respective reform ideas. In this round, each selected Team will have an opportunity to model its proposed reform idea using Milliman’s Health Care Reform Financing Model (HCRFM). The Teams will be provided with assumption templates representing a baseline scenario assuming no changes to the current individual health insurance environment. Milliman will provide an overview of the baseline scenario and discussion of each assumption in the template. With Milliman’s assistance, each Team will be allowed to adjust the template based on assumed market parameters it thinks its reform idea will impact and submit its template to Milliman. Milliman will run the model and provide projected results relative to the baseline scenario. Each Team can modify its assumption template at most two (2) additional times to refine its results.
Teams will prepare a final paper and presentation for consideration on or about Tuesday, February 28, 2017, incorporating the modeling results. These final papers and presentations will be reviewed and will be eligible for public presentation at an event sponsored by the RWJF at the conclusion of the Challenge.
Judging in Round Two will be conducted by a review board of individuals chosen by the Robert Wood Johnson Foundation and Milliman. The judges will consist of actuaries in the health care and insurance environment and ideally will include individuals with knowledge of insurers, consumers, providers, and regulators. Judging will be based on multiple criteria relating to the practicality, feasibility, impact, effectiveness, and cost of the proposed reform ideas. Exact criteria (and the relative weight assigned to each) will be communicated to the Teams upon invitation to participate in Round Two. Without limiting the foregoing, the criteria are anticipated to include at least the following:
- Access to health insurance, such as incentive for insurers to participate in the market and offer multiple plans and the impact on the uninsured population.
- Affordability to consumers, including premium levels, cost sharing, and penalties.
- Overall taxpayer investment through subsidies for the five year projection period.
- Impact on health care delivery, such as provider supply and quality of care.
- Overall feasibility to implement the changes.
Actuarial Challenge Recognition: Recognition of the top Teams and their respective reform ideas will occur through a public event sponsored by the RWJF to be held at the conclusion of the Challenge. The event will be by invitation. Attendance is not required for recognition, and any travel costs to the event will be the responsibility of the Team and/or Team Members if they wish to attend. In its discretion, Sponsor may choose to invite some or all of the Teams from Round Two to present their reform ideas and modeling results at the public event.
Legal Rights in Submitted Materials:
Certification of Rights: By submitting any materials, you represent and warrant that: (i) you are able to comply with these Terms and Conditions and that such materials are not subject to any conflicting obligations that would prevent or interfere with your compliance with these Terms and Conditions; (ii) the materials do not make unauthorized use of or violate in any way any rights of any 3rd party, including but not limited to copyright, trademark, patent, trade secret, or rights of publicity; and (iii) no one else’s permission is required for you to submit such materials in this Actuarial Challenge or to use your reform idea as contemplated under these Terms and Conditions. Without limiting the foregoing, you represent and warrant that you have complied with any requirements of your employer, if any, to allow your participation in the Actuarial Challenge, including but not limited to making your Submission and accepting any recognition award you may receive.
Grant of Usage Rights: You retain all ownership rights in any materials you submit. However, by participating you acknowledge that any such materials may become published on the Actuarial Challenge Website, and you further agree that each of Milliman and RWJF and anyone they designate has the unrestricted and non-exclusive right to adapt, publish, copy, display, perform, broadcast, excerpt, and otherwise use any or all of your Submission, in whole or in part, alone or in combination with other material, in any and all media, whether now known or later discovered, in perpetuity, without restriction of any kind whatsoever, without further compensation to you or anyone else, and may identify you as a creator or co-creator in connection therewith.
General Conditions: By participating in the Actuarial Challenge, you are agreeing to these Terms and Conditions, the decisions of the judges, and the use of any materials you submit by Milliman and/or RWJF and their respective designees as contemplated herein.
Milliman reserves the right, in its sole discretion, to disqualify any person or Participant it reasonably suspects has attempted to undermine the legitimate operation of the Actuarial Challenge by cheating, deception, or other unfair practices, or has tampered with any websites related to the Actuarial Challenge, the submission process, the judging process, or has violated these terms and conditions, or has acted in an unsportsmanlike or disruptive manner, or who annoys, abuses, threatens, or harasses Milliman, the Sponsor, their respective agents, assigns, or any other Participant.
Governing Law: The Actuarial Challenge and the rights and obligations of all participants and Submissions shall be governed by and construed in accordance with the laws of the State of New York. The New York courts (state and federal) have sole jurisdiction of any controversies regarding the Actuarial Challenge, and you agree to waive any objections to jurisdiction and venue in those courts and hereby submit to the jurisdiction of those courts. Should any provision of these Terms and Conditions be held to be void, invalid, unenforceable, or illegal by a proper legal authority, the validity and enforceability of the other provisions shall not be affected.
Sponsor: The sponsor for this Actuarial Challenge is the Robert Wood Johnson Foundation, P.O. Box 2316, Princeton, NJ 08543-2316, USA, a New Jersey non-profit corporation.
By entering a Submission into the Actuarial Challenge, you are agreeing to the transfer of your personal information and your Submission to the United States where Milliman and Sponsor and its data processors are located. If you have any questions about the use of your personal information, please either write to us at the address above or contact Darleen Jeske via the Contact Us page on the Website.
 The five qualified actuarial organizations are: 1) American Academy of Actuaries; 2) American Society of Pension Professionals & Actuaries; 3) Casualty Actuarial Society; 4) Conference of Consulting Actuaries; and, 5) Society of Actuaries.