Download or read book Rating and Underwriting for Health Plans written by John Van Steenwyk and published by . This book was released on 2006 with total page 192 pages. Available in PDF, EPUB and Kindle. Book excerpt: Brief Description of Book Rating and Underwriting for Health Plans In managed health care plans, the underwriter has a key function: making sure that premiums meet expenses. This requires skill, and also knowledge: of actuarial principles; rate regulation by States; the marketplace for employee benefits; the mathematical tools of the trade; and the history and precedents which shape industry practices. This book is an essential resource for health plans, offering a practical exposition of the subject. The book was first prepared as text for training sessions and workshops conducted by Health Economics, Inc. With expanded text and additional material, it is now available for purchase.
Download or read book Coverage Matters written by Institute of Medicine and published by National Academies Press. This book was released on 2001-10-27 with total page 204 pages. Available in PDF, EPUB and Kindle. Book excerpt: Roughly 40 million Americans have no health insurance, private or public, and the number has grown steadily over the past 25 years. Who are these children, women, and men, and why do they lack coverage for essential health care services? How does the system of insurance coverage in the U.S. operate, and where does it fail? The first of six Institute of Medicine reports that will examine in detail the consequences of having a large uninsured population, Coverage Matters: Insurance and Health Care, explores the myths and realities of who is uninsured, identifies social, economic, and policy factors that contribute to the situation, and describes the likelihood faced by members of various population groups of being uninsured. It serves as a guide to a broad range of issues related to the lack of insurance coverage in America and provides background data of use to policy makers and health services researchers.
Download or read book Health Care Utilization as a Proxy in Disability Determination written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2018-04-02 with total page 161 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Social Security Administration (SSA) administers two programs that provide benefits based on disability: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. This report analyzes health care utilizations as they relate to impairment severity and SSA's definition of disability. Health Care Utilization as a Proxy in Disability Determination identifies types of utilizations that might be good proxies for "listing-level" severity; that is, what represents an impairment, or combination of impairments, that are severe enough to prevent a person from doing any gainful activity, regardless of age, education, or work experience.
Download or read book Employment and Health Benefits written by Institute of Medicine and published by National Academies Press. This book was released on 1993-02-01 with total page 381 pages. Available in PDF, EPUB and Kindle. Book excerpt: The United States is unique among economically advanced nations in its reliance on employers to provide health benefits voluntarily for workers and their families. Although it is well known that this system fails to reach millions of these individuals as well as others who have no connection to the work place, the system has other weaknesses. It also has many advantages. Because most proposals for health care reform assume some continued role for employers, this book makes an important contribution by describing the strength and limitations of the current system of employment-based health benefits. It provides the data and analysis needed to understand the historical, social, and economic dynamics that have shaped present-day arrangements and outlines what might be done to overcome some of the access, value, and equity problems associated with current employer, insurer, and government policies and practices. Health insurance terminology is often perplexing, and this volume defines essential concepts clearly and carefully. Using an array of primary sources, it provides a store of information on who is covered for what services at what costs, on how programs vary by employer size and industry, and on what governments doâ€"and do not doâ€"to oversee employment-based health programs. A case study adapted from real organizations' experiences illustrates some of the practical challenges in designing, managing, and revising benefit programs. The sometimes unintended and unwanted consequences of employer practices for workers and health care providers are explored. Understanding the concepts of risk, biased risk selection, and risk segmentation is fundamental to sound health care reform. This volume thoroughly examines these key concepts and how they complicate efforts to achieve efficiency and equity in health coverage and health care. With health care reform at the forefront of public attention, this volume will be important to policymakers and regulators, employee benefit managers and other executives, trade associations, and decisionmakers in the health insurance industry, as well as analysts, researchers, and students of health policy.
Download or read book Health Benefits Coverage Under Federal Law written by and published by . This book was released on 2010 with total page 108 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Health Insurance written by Ermanno Pitacco and published by Springer. This book was released on 2014-11-04 with total page 172 pages. Available in PDF, EPUB and Kindle. Book excerpt: Health Insurance aims at filling a gap in actuarial literature, attempting to solve the frequent misunderstanding in regards to both the purpose and the contents of health insurance products (and ‘protection products’, more generally) on the one hand, and the relevant actuarial structures on the other. In order to cover the basic principles regarding health insurance techniques, the first few chapters in this book are mainly devoted to the need for health insurance and a description of insurance products in this area (sickness insurance, accident insurance, critical illness covers, income protection, long-term care insurance, health-related benefits as riders to life insurance policies). An introduction to general actuarial and risk-management issues follows. Basic actuarial models are presented for sickness insurance and income protection (i.e. disability annuities). Several numerical examples help the reader understand the main features of pricing and reserving in the health insurance area. A short introduction to actuarial models for long-term care insurance products is also provided. Advanced undergraduate and graduate students in actuarial sciences; graduate students in economics, business and finance; and professionals and technicians operating in insurance and pension areas will find this book of benefit.
Download or read book Essentials of Managed Health Care written by Peter Reid Kongstvedt and published by Jones & Bartlett Learning. This book was released on 2003 with total page 918 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Essentials of Managed Health Care written by and published by Jones & Bartlett Publishers. This book was released on 2013 with total page 715 pages. Available in PDF, EPUB and Kindle. Book excerpt: Peter Kongstvedt provides an authoritative and comprehensive overview of the key strategic, tactical, and operational aspects of managed health care and health insurance. With a primary focus on the commercial sector, the book also addresses managed health care in Medicare, Medicaid, and military medical care. An historical overview and a discussion of taxonomy and functional differences between different forms of managed health care provide the framework for the operational aspects of the industry as well.
Download or read book Voluntary Health Insurance in Europe Country Experience written by Sagan A. and published by World Health Organization. This book was released on 2016-07-20 with total page 163 pages. Available in PDF, EPUB and Kindle. Book excerpt: No two markets for voluntary health insurance (VHI) are identical. All differ in some way because they are heavily shaped by the nature and performance of publicly financed health systems and by the contexts in which they have evolved. This volume contains short structured profiles of markets for VHI in 34 countries in Europe. These are drawn from European Union member states plus Armenia Iceland Georgia Norway the Russian Federation Switzerland and Ukraine. The book is aimed at policy-makers and researchers interested in knowing more about how VHI works in practice in a wide range of contexts. Each profile written by one or more local experts identifies gaps in publicly-financed health coverage describes the role VHI plays outlines the way in which the market for VHI operates summarises public policy towards VHI including major developments over time and highlights national debates and challenges. The book is part of a study on VHI in Europe prepared jointly by the European Observatory on Health Systems and Policies and the WHO Regional Office for Europe. A companion volume provides an analytical overview of VHI markets across the 34 countries.
Download or read book Insurance for Dummies written by Jack Hungelmann and published by John Wiley & Sons. This book was released on 2009-06-09 with total page 384 pages. Available in PDF, EPUB and Kindle. Book excerpt: Now updated — your guide to getting the best insurance policy Are you intimidated by insurance? Have no fear — this easy-to-understand guide explains everything you need to know, from getting the most coverage at the best price to dealing with adjusters, filing claims, and more. Whether you're looking for personal or business insurance, you'll see how to avoid common pitfalls, lower your costs, and get what you deserve at claim time. Get to know the basics — understand how to make good insurance decisions and reduce the chances of a financial loss in your life Take your insurance on the road — manage your personal automobile risks, handle special situations, insure recreational vehicles, and deal with insurance adjusters Understand homeowner's and renter's insurance — know what is and isn't covered by typical policies, common exclusions and pitfalls, and how to cover yourself against personal lawsuits Buy the right umbrella policy — discover the advantages, and coordinate your policies to cover the gaps Manage life, health, and disability risks — explore individual and group policies, understand Medicare basics, and evaluate long-term disability and long-term-care insurance Open the book and find: The best life, health, home, and auto policies Strategies for handling the claims process to get what you deserve Tips on adjusting your deductible to suit your lifestyle How to navigate healthcare policies Ways to reduce your risk and your premiums Common traps and loopholes Considerations for grads, freelancers, and remote workers
Download or read book Group Insurance written by William F. Bluhm and published by ACTEX Publications. This book was released on 2012 with total page 914 pages. Available in PDF, EPUB and Kindle. Book excerpt: This text is a comprehensive treatment of all aspects of group insurance in the United States and Canada. It addresses life and health insurance as well as government programs and more specialized forms of insurance. Emphasis is placed on the actuarial aspects of this important field of insurance including pricing, regulation, underwriting, financial reporting, and modeling. Since its original publication in 1992, Group Insurance has become the resource of choice for experts as well as beginners. It is an essential tool for anyone who wishes to practice in the group benefits field. The Sixth Edition has been updated for the industry and regulatory changes which have occurred since 2007. Of particular note is the impact that healthcare reform in the United States will have on all facets of this topic.
Download or read book The Affordable Care Act written by Tamara Thompson and published by Greenhaven Publishing LLC. This book was released on 2014-12-02 with total page 130 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Patient Protection and Affordable Care Act (ACA) was designed to increase health insurance quality and affordability, lower the uninsured rate by expanding insurance coverage, and reduce the costs of healthcare overall. Along with sweeping change came sweeping criticisms and issues. This book explores the pros and cons of the Affordable Care Act, and explains who benefits from the ACA. Readers will learn how the economy is affected by the ACA, and the impact of the ACA rollout.
Download or read book Pooling Health Insurance Risks written by Mark V. Pauly and published by A E I Press. This book was released on 1999 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: How are the costs of health insurance premiums determined? Should costs vary according to indicators of risk? How much do premiums vary with risk? Do the healthy subsidize the unhealthy? Should public subsidies vary according to economic status and risk? This book examines these questions.
Download or read book Encyclopedia of Corporate Social Responsibility written by Samuel O. Idowu and published by Springer. This book was released on 2013-01-27 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: The role of Corporate Social Responsibility in the business world has developed from a fig leaf marketing front into an important aspect of corporate behavior over the past several years. Sustainable strategies are valued, desired and deployed more and more by relevant players in many industries all over the world. Both research and corporate practice therefore see CSR as a guiding principle for business success. The “Encyclopedia of Corporate Social Responsibility” has been conceived to assist researchers and practitioners to align business and societal objectives. All actors in the field will find reliable and up to date definitions and explanations of the key terms of CSR in this authoritative and comprehensive reference work. Leading experts from the global CSR community have contributed to make the “Encyclopedia of Corporate Social Responsibility” the definitive resource for this field of research and practice.
Download or read book Property and Casualty Insurance Concepts Simplified written by Christopher J. Boggs and published by Lulu.com. This book was released on 2010 with total page 200 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book details key property and casualty concepts rarely discussed or found in print; rather they are often left to be "discovered" over time. These important concepts are now written down for all insurance practitioners to easily access. Examples of the topics and concepts found in this book include rules for reading ANY insurance policy; why losses are excluded; contractual risk transfer; legal liability theories; "COPE" details; and the proper explanation of coinsurance concepts. Also included is a rather extensive glossary of insurance and insurance-related terms. Readers will: 1) Gain a deeper understanding of insurance theories; 2) Be better prepared to explain insurance concepts to their clients; and 3) Develop a greater appreciation and understanding of the claims valuation process.
Download or read book Moral Hazard in Health Insurance written by Amy Finkelstein and published by Columbia University Press. This book was released on 2014-12-02 with total page 161 pages. Available in PDF, EPUB and Kindle. Book excerpt: Addressing the challenge of covering heath care expenses—while minimizing economic risks. Moral hazard—the tendency to change behavior when the cost of that behavior will be borne by others—is a particularly tricky question when considering health care. Kenneth J. Arrow’s seminal 1963 paper on this topic (included in this volume) was one of the first to explore the implication of moral hazard for health care, and Amy Finkelstein—recognized as one of the world’s foremost experts on the topic—here examines this issue in the context of contemporary American health care policy. Drawing on research from both the original RAND Health Insurance Experiment and her own research, including a 2008 Health Insurance Experiment in Oregon, Finkelstein presents compelling evidence that health insurance does indeed affect medical spending and encourages policy solutions that acknowledge and account for this. The volume also features commentaries and insights from other renowned economists, including an introduction by Joseph P. Newhouse that provides context for the discussion, a commentary from Jonathan Gruber that considers provider-side moral hazard, and reflections from Joseph E. Stiglitz and Kenneth J. Arrow. “Reads like a fireside chat among a group of distinguished, articulate health economists.” —Choice
Download or read book Health Insurance Industry Practices written by United States. Congress. House. Committee on Energy and Commerce. Subcommittee on Oversight and Investigations and published by . This book was released on 1995 with total page 504 pages. Available in PDF, EPUB and Kindle. Book excerpt:
