WorldWideScience

Sample records for insurance benefit mandate

  1. State Mandated Benefits and Employer Provided Health Insurance

    OpenAIRE

    Jonathan Gruber

    1992-01-01

    One popular explanation for this low rate of employee coverage is the presence of numerous state regulations which mandate that group health insurance plans must include certain benefits. By raising the minimum costs of providing any health insurance coverage, these mandated benefits make it impossible for firms which would have desired to offer minimal health insurance at a low cost to do so. I use data on insurance coverage among employees in small firms to investigate whether this problem ...

  2. Health Benefits Mandates and Their Potential Impacts on Racial/Ethnic Group Disparities in Insurance Markets.

    Science.gov (United States)

    Charles, Shana Alex; Ponce, Ninez; Ritley, Dominique; Guendelman, Sylvia; Kempster, Jennifer; Lewis, John; Melnikow, Joy

    2017-08-01

    Addressing racial/ethnic group disparities in health insurance benefits through legislative mandates requires attention to the different proportions of racial/ethnic groups among insurance markets. This necessary baseline data, however, has proven difficult to measure. We applied racial/ethnic data from the 2009 California Health Interview Survey to the 2012 California Health Benefits Review Program Cost and Coverage Model to determine the racial/ethnic composition of ten health insurance market segments. We found disproportional representation of racial/ethnic groups by segment, thus affecting the health insurance impacts of benefit mandates. California's Medicaid program is disproportionately Latino (60 % in Medi-Cal, compared to 39 % for the entire population), and the individual insurance market is disproportionately non-Latino white. Gender differences also exist. Mandates could unintentionally increase insurance coverage racial/ethnic disparities. Policymakers should consider the distribution of existing racial/ethnic disparities as criteria for legislative action on benefit mandates across health insurance markets.

  3. The spillover effects of health insurance benefit mandates on public insurance coverage: Evidence from veterans.

    Science.gov (United States)

    Li, Xiaoxue; Ye, Jinqi

    2017-09-01

    This study examines how regulations in private health insurance markets affect coverage of public insurance. We focus on mental health parity laws, which mandate private health insurance to provide equal coverage for mental and physical health services. The implementation of mental health parity laws may improve a quality dimension of private health insurance but at increased costs. We graphically develop a conceptual framework and then empirically examine whether the regulations shift individuals from private to public insurance. We exploit state-by-year variation in policy implementation in 1999-2008 and focus on a sample of veterans, who have better access to public insurance than non-veterans. Using data from the Current Population Survey, we find that the parity laws reduce employer-sponsored insurance (ESI) coverage by 2.1% points. The drop in ESI is largely offset by enrollment gains in public insurance, namely through the Veterans Affairs (VA) benefit and Medicaid/Medicare programs. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. The effects of mandated health insurance benefits for autism on out-of-pocket costs and access to treatment.

    Science.gov (United States)

    Chatterji, Pinka; Decker, Sandra L; Markowitz, Sara

    2015-01-01

    As of 2014, 37 states have passed mandates requiring many private health insurance policies to cover diagnostic and treatment services for autism spectrum disorders (ASDs). We explore whether ASD mandates are associated with out-of-pocket costs, financial burden, and cost or insurance-related problems with access to treatment among privately insured children with special health care needs (CSHCNs). We use difference-in-difference and difference-in-difference-in-difference approaches, comparing pre--post mandate changes in outcomes among CSHCN who have ASD versus CSHCN other than ASD. Data come from the 2005 to 2006 and the 2009 to 2010 waves of the National Survey of CSHCN. Based on the model used, our findings show no statistically significant association between state ASD mandates and caregivers' reports about financial burden, access to care, and unmet need for services. However, we do find some evidence that ASD mandates may have beneficial effects in states in which greater percentages of privately insured individuals are subject to the mandates. We caution that we do not study the characteristics of ASD mandates in detail, and most ASD mandates have gone into effect very recently during our study period.

  5. Effects of state contraceptive insurance mandates.

    Science.gov (United States)

    Dills, Angela K; Grecu, Anca M

    2017-02-01

    Using U.S. Natality data for 1996 through 2009 and an event analysis specification, we investigate the dynamics of the effects of state insurance contraceptive mandates on births and measures of parental investment: prenatal visits, non-marital childbearing, and risky behaviors during pregnancy. We analyze outcomes separately by age, race, and ethnicity. Among young Hispanic women, we find a 4% decline in the birth rate. There is evidence of a decrease in births to single mothers, consistent with increased wantedness. We also find evidence of selection into motherhood, which could explain the lack of a significant effect on birth outcomes. Copyright © 2016 Elsevier B.V. All rights reserved.

  6. The Efficiency of a Group-Specific Mandated Benefit Revisited: The Effect of Infertility Mandates

    Science.gov (United States)

    Lahey, Joanna N.

    2012-01-01

    This paper examines the labor market effects of state health insurance mandates that increase the cost of employing a demographically identifiable group. State mandates requiring that health insurance plans cover infertility treatment raise the relative cost of insuring older women of child-bearing age. Empirically, wages in this group are…

  7. Assessing Early Implementation of State Autism Insurance Mandates

    Science.gov (United States)

    Baller, Julia Berlin; Barry, Colleen L.; Shea, Kathleen; Walker, Megan M.; Ouellette, Rachel; Mandell, David S.

    2016-01-01

    In the United States, health insurance coverage for autism spectrum disorder treatments has been historically limited. In response, as of 2015, 40 states and Washington, DC, have passed state autism insurance mandates requiring many health plans in the private insurance market to cover autism diagnostic and treatment services. This study examined…

  8. Postoperative outcomes in bariatric surgical patients participating in an insurance-mandated preoperative weight management program.

    Science.gov (United States)

    Schneider, Andrew; Hutcheon, Deborah A; Hale, Allyson; Ewing, Joseph A; Miller, Megan; Scott, John D

    2018-02-02

    Many insurance companies require patient participation in a medically supervised weight management program (WMP) before offering approval for bariatric surgery. Clinical data surrounding benefits of participation are limited. To evaluate the relationship between preoperative insurance-mandated WMP participation and postoperative outcomes in bariatric surgery patients. Regional referral center and teaching hospital. A retrospective review of patients who underwent vertical sleeve gastrectomy or Roux-en-Y gastric bypass between January 2014 and January 2016 was performed. Patients (N = 354) were divided into 2 cohorts and analyzed according to presence (n = 266) or absence (n = 88) of an insurance-mandated WMP requirement. Primary endpoints included rate of follow-up and percent of excess weight loss (%EWL) at postoperative months 1, 3, 6, and 12. All patients, regardless of the insurance-mandated WMP requirement, followed a program-directed preoperative diet. The majority of patients with an insurance-mandated WMP requirement had private insurance (63.9%). Both patient groups experienced a similar proportion of readmissions and reoperations, rate of follow-up, and %EWL at 1, 3, 6, and 12 months (P = NS). Median operative duration and hospital length of stay were also similar between groups. Linear regression analysis revealed no significant improvement in %EWL at 12 months in the yes-WMP group. These data show that patients who participate in an insurance-mandated WMP in addition to completing a program-directed preoperative diet experience no significant benefit to rate of readmission, reoperation, follow-up, or %EWL up to 12 months postoperation. Our findings suggest that undergoing bariatric surgery without completing an insurance-mandated WMP is safe and effective. Copyright © 2018 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  9. Setting a national minimum standard for health benefits: how do state benefit mandates compare with benefits in large-group plans?

    Science.gov (United States)

    Frey, Allison; Mika, Stephanie; Nuzum, Rachel; Schoen, Cathy

    2009-06-01

    Many proposed health insurance reforms would establish a federal minimum benefit standard--a baseline set of benefits to ensure that people have adequate coverage and financial protection when they purchase insurance. Currently, benefit mandates are set at the state level; these vary greatly across states and generally target specific areas rather than set an overall standard for what qualifies as health insurance. This issue brief considers what a broad federal minimum standard might look like by comparing existing state benefit mandates with the services and providers covered under the Federal Employees Health Benefits Program (FEHBP) Blue Cross and Blue Shield standard benefit package, an example of minimum creditable coverage that reflects current standard practice among employer-sponsored health plans. With few exceptions, benefits in the FEHBP standard option either meet or exceed those that state mandates require-indicating that a broad-based national benefit standard would include most existing state benefit mandates.

  10. The distributional effects of employer and individual health insurance mandates.

    Science.gov (United States)

    Holahan, J; Winterbottom, C; Zedlewski, S

    This paper assesses the impact of different kinds of employer and individual mandates on the cost to individuals, business, and government. We also examine the distribution of health care expenditures across individuals in different income groups, assuming that individuals ultimately bear the cost of employer payments through lower wages and the cost of government payments through tax contributions. A major conclusion is that net benefits to lower income individuals improve under all alternatives to the current system with relatively small increases in payments by individuals in any income group. Additionally, while employer mandates reduce individuals' direct payments, individual mandates can have lower costs to the government and better distributional outcomes. A 50% employer mandate also has many desirable features.

  11. Did the US Infertility Health Insurance Mandates Affect the Timing of First Birth?

    NARCIS (Netherlands)

    Ohinata, A.

    2011-01-01

    From 1977-2001, 15 US states mandated health insurance providers to offer coverage for infertility treatment. Although the majority of the past literature has studied impacts on older women who are likely to seek treatment, this paper proposes that the mandates may have had a wider impact on the US

  12. Loss of benefits resulting from mandated nuclear plant shutdowns

    International Nuclear Information System (INIS)

    Peerenboom, J.P.; Buehring, W.A.

    1982-01-01

    This paper identifies and discusses some of the important consequences of nuclear power plant unavailability, and quantifies a number of technical measures of loss of benefits that result from regulatory actions such as licensing delays and mandated nuclear plant outages. The loss of benefits that accompany such regulatory actions include increased costs of systems generation, increased demand for nonnuclear and often scarce fuels, and reduced system reliability. This paper is based on a series of case studies, supplemented by sensitivity studies, on hypothetical nuclear plant shutdowns. These studies were developed by Argonne in cooperation with four electric utilities

  13. 24 CFR 207.259 - Insurance benefits.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Insurance benefits. 207.259 Section... Contract of Insurance § 207.259 Insurance benefits. (a) Method of payment. Upon either an assignment of the... of mortgage. If the mortgage is assigned to the Commissioner, the insurance benefits shall be paid in...

  14. Counseling as an Insured Benefit: Perspectives from the Insurance Industry

    Science.gov (United States)

    Fulton, Wallace C.

    1974-01-01

    Article discusses the feasibility of marriage counseling as an insurance benefit in the future. It is suggested that the physician be used as a marriage counselor in that insurance companies will pay for medical services. (EK)

  15. 24 CFR 241.885 - Insurance benefits.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Insurance benefits. 241.885 Section... § 241.885 Insurance benefits. (a) Method of payment. Payment of claims shall be made in the following... acceptable assignment of the note and security instrument to the Commissioner, the insurance benefits shall...

  16. Mandating nutrient menu labeling in restaurants: potential public health benefits.

    Science.gov (United States)

    Stran, Kimberly A; Turner, Lori W; Knol, Linda

    2013-03-01

    Many Americans have replaced home-cooked meals with fast food and restaurants meals. This contributes to increased incidences of overweight and obesity. Implementing policies that require restaurants to disclose nutrition information has the potential to improve nutrition knowledge and food behaviors. The purpose of this paper was to examine the potential health benefits of nutrient menu labeling in restaurants, the progress of this legislation and to provide results regarding the implementation of these policies. Data sources were obtained from a search of multiple databases including PubMed, Science Direct, Academic Search Premier, and Google Scholar. Study inclusion criteria were publication in the past ten years, obesity prevention, and utilization of nutrition labeling on menus in restaurants. The initial policies to provide consumers with nutrition information in restaurant settings began at the state levels in 2006. These laws demonstrated success, other states followed, and a national law was passed and is being implemented. Mandating nutrient menu disclosure has the potential to influence a large number of people; this legislation has the opportunity to impact Americans who dine at a fast food or chain restaurant. Given the growing obesity epidemic, continued research is necessary to gauge the effectiveness of this new law and its effects on the health status of the American people.

  17. Law, Economics, and Culture: Theory of Mandated Benefits and Evidence from Maternity Leave Policies

    OpenAIRE

    Yehonatan Givati; Ugo Troiano

    2012-01-01

    Why do some countries mandate a long maternity leave, while others mandate only a short one? We incorporate into a standard mandated-benefit model social tolerance of gender-based discrimination, showing that the optimal length of maternity leave depends on it. The less tolerant a society is of gender-based discrimination, the longer the maternity leave it will mandate. Relying on recent research in psychology and linguistics according to which patterns in languages offer a window into their ...

  18. The Great Recession, insurance mandates, and the use of in vitro fertilization services in the United States.

    Science.gov (United States)

    Kiatpongsan, Sorapop; Huckman, Robert S; Hornstein, Mark D

    2015-02-01

    To investigate the relationship between economic activities, insurance mandates, and the use of in vitro fertilization (IVF) in the United States. We examined the correlation between the coincident index (a proxy for overall economic conditions) and IVF use at the national level from 2000 to 2011. We then analyzed the relationship at the state level through longitudinal regression models. The base model tested the correlation at the state level. Additional models examined whether this relationship was affected, both separately and jointly, by insurance mandates and the Great Recession. Not applicable. Not applicable. None. Direction and magnitude of the relationship between the coincident index and IVF use, and influences of insurance mandates and the Great Recession. The coincident index was positively correlated with IVF use at the national level (correlation coefficient = 0.89). At the state level, an increase of one unit in the coincident index was associated with an increase of 16 IVF cycles per 1 million women, with a significantly greater increase in IVF use in states with insurance mandates than in states without mandates (27 versus 15 IVF cycles per 1 million women). The Great Recession did not alter the relationship between the coincident index and IVF use. Our study demonstrates a positive relationship between the economy and IVF use, with greater magnitude in states with insurance mandates. This relationship was not affected by the Great Recession regardless of mandated insurance coverage. Copyright © 2015 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  19. 24 CFR 232.885 - Insurance benefits.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Insurance benefits. 232.885 Section 232.885 Housing and Urban Development Regulations Relating to Housing and Urban Development (Continued....885 Insurance benefits. (a) Method of payment. Payment of claim shall be made in the following manner...

  20. Benefit Reentitlement Conditions in Unemployment Insurance Schemes

    DEFF Research Database (Denmark)

    Andersen, Torben M.; Christoffersen, Mark Strøm; Svarer, Michael

    and employment requirements are substitute instruments in affecting job search incentives and thus gross unemployment. We analyse the optimal design of the unemployment insurance system (benefit levels, duration and employment requirements) under a utilitarian social welfare function. Simulations show...

  1. Insurance denials for cancer clinical trial participation after the Affordable Care Act mandate.

    Science.gov (United States)

    Mackay, Christine B; Antonelli, Kaitlyn R; Bruinooge, Suanna S; Saint Onge, Jarron M; Ellis, Shellie D

    2017-08-01

    The Affordable Care Act (ACA) includes a mandate requiring most private health insurers to cover routine patient care costs for cancer clinical trial participation; however, the impact of this provision on cancer centers' efforts to accrue patients to clinical trials has not been well described. First, members of cancer research centers and community-based institutions (n = 252) were surveyed to assess the status of insurance denials, and then, a focused survey (n = 77) collected denial details. Univariate and multivariate analyses were used to examine associations between the receipt of denials and site characteristics. Overall, 62.7% of the initial survey respondents reported at least 1 insurance denial during 2014. Sites using a precertification process were 3.04 times more likely to experience denials (95% confidence interval, 1.55-5.99; P ≤ .001), and similar rates of denials were reported from sites located in states with preexisting clinical trial coverage laws versus states without them (82.3% vs 85.1%; χ = 50.7; P ≤ .001). Among the focused survey sites, academic centers reported denials more often than community sites (71.4% vs 46.4%). The failure of plans to cover trial participation was cited as the most common reason provided for denials (n = 33 [80.5%]), with nearly 80% of sites (n = 61) not receiving a coverage response from the insurer within 72 hours. Despite the ACA's mandate for most insurers to cover routine care costs for cancer clinical trial participation, denials and delays continue. Denials may continue because some insurers remain exempt from the law, or they may signal an implementation failure. Delays in coverage may affect patient participation in trials. Additional efforts to eliminate this barrier will be needed to achieve federal initiatives to double the pace of cancer research over the next 5 years. Future work should assess the law's effectiveness at the patient level to inform these efforts

  2. 41 CFR 60-741.25 - Health insurance, life insurance and other benefit plans.

    Science.gov (United States)

    2010-07-01

    ... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true Health insurance, life insurance and other benefit plans. 60-741.25 Section 60-741.25 Public Contracts and Property Management... Health insurance, life insurance and other benefit plans. (a) An insurer, hospital, or medical service...

  3. Disability Insurance Benefits and Labor Supply

    OpenAIRE

    Jonathan Gruber

    2000-01-01

    Disability Insurance (DI) is a public program that provides income support to persons unable to continue work due to disability. The difficulty of defining disability, however, has raised the possibility that this program may be subsidizing the early retirement of workers who are not truly disabled. A critical input for assessing the optimal size of the DI program is therefore the elasticity of labor force participation with respect to benefits generosity. Unfortunately, this parameter has be...

  4. Pricing unit-linked insurance with guaranteed benefit

    Science.gov (United States)

    Iqbal, M.; Novkaniza, F.; Novita, M.

    2017-07-01

    Unit-linked insurance is an investment-linked insurance, that is, the given benefit is the premium investment out-come. Recently, the most widely marketed insurance in the industry is unit-linked insurance with guaranteed benefit. With guaranteed benefit applied, the insurance benefits form is similar to the payoff form of European call option. Thereby, pricing European call option is involved in pricing unit-linked insurance with guaranteed benefit. The dynamics of investment outcome is assumed to follow stochastic interest rate. Hence, change of measure methods is used in pricing unit-linked insurance. The discount factor with stochastic interest rate needs to be modified as well to be zero coupon bond price. Eventually, the insurance premium is calculated by equivalence principle with guaranteed benefit and insurance period explicitly given.

  5. Geographic variation in health insurance benefit in Qianjiang District, China

    OpenAIRE

    Ye, Ting; Wu, Yue; Zhang, Liang

    2017-01-01

    Background: Health insurance coverage is of great importance; yet, it is unclear whether there is some geographic variation in health insurance benefit for urban and rural patients covered by a same basic health insurance, especially in China.Objective: To identify the potential geographic variation in health insurance benefit and its possible socioeconomic and geographical factors at the town level.Methods: All the beneficiaries underthe health insurance who had the in-hospital experience in...

  6. 41 CFR 60-300.25 - Health insurance, life insurance and other benefit plans.

    Science.gov (United States)

    2010-07-01

    ... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true Health insurance, life... VETERANS, AND ARMED FORCES SERVICE MEDAL VETERANS Discrimination Prohibited § 60-300.25 Health insurance, life insurance and other benefit plans. (a) An insurer, hospital, or medical service company, health...

  7. 41 CFR 60-250.25 - Health insurance, life insurance and other benefit plans.

    Science.gov (United States)

    2010-07-01

    ... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true Health insurance, life... SEPARATED VETERANS, AND OTHER PROTECTED VETERANS Discrimination Prohibited § 60-250.25 Health insurance, life insurance and other benefit plans. (a) An insurer, hospital, or medical service company, health...

  8. The association between state mandates of colorectal cancer screening coverage and colorectal cancer screening utilization among US adults aged 50 to 64 years with health insurance

    Directory of Open Access Journals (Sweden)

    Virgo Katherine

    2011-01-01

    Full Text Available Abstract Background Several states in the US have passed laws mandating coverage of colorectal cancer (CRC screening tests by health insurance plans. The impact of these state mandates on the use of colorectal cancer screening has not been evaluated among an age-eligible target population with access to care (i.e., health care insurance coverage. Methods We collected information on state mandates implemented by December 31, 2008 and used data on insured adults aged 50 and 64 years from the Behavioral Risk Factor Surveillance System between 2002 and 2008 to classify individual-level exposure to state mandates for at least 1 year. Multivariate logistic regression models (with state- and year- fixed effects, and patient demographic and socioeconomic characteristics were used to estimate the effect of state mandates on recent endoscopy screening (either flexible sigmoidoscopy or colonoscopy during the past year. Results From 1999-2008, twenty-two states in the US, including the District of Columbia passed comprehensive laws requiring health insurance coverage of CRC screening including endoscopy tests. Residence in states with CRC screening coverage mandates in place for at least 1 year was associated with a 1.4 percentage point increase in the probability of utilization of recent endoscopy (i.e., 17.5% screening rates in those with mandates versus 16.1% in those without, Adjusted OR = 1.10, 95% CI: 1.02 - 1.20, p = 0.02. Conclusions The findings suggest a positive, albeit small, impact of state mandates on the use of recent CRC screening endoscopy among the target eligible population with health insurance. However, more research is needed to evaluate potential effects of mandates across health insurance types while including controls for other system-level factors (e.g. endoscopy and primary care capacity. National health insurance reform should strive towards a system that expands access to recommended CRC screening tests.

  9. 20 CFR 404.467 - Nonpayment of benefits; individual entitled to disability insurance benefits or childhood...

    Science.gov (United States)

    2010-04-01

    ... type of substantial gainful activity. (b) Childhood disability benefits. An individual who has attained... Nonpayments of Benefits § 404.467 Nonpayment of benefits; individual entitled to disability insurance benefits... definition of disability for disability insurance benefits purposes based on statutory blindness, as defined...

  10. Enhancing employee capacity to prioritize health insurance benefits.

    Science.gov (United States)

    Danis, Marion; Goold, Susan Dorr; Parise, Carol; Ginsburg, Marjorie

    2007-09-01

    To demonstrate that employees can gain understanding of the financial constraints involved in designing health insurance benefits. While employees who receive their health insurance through the workplace have much at stake as the cost of health insurance rises, they are not necessarily prepared to constructively participate in prioritizing their health insurance benefits in order to limit cost. Structured group exercises. Employees of 41 public and private organizations in Northern California. Administration of the CHAT (Choosing Healthplans All Together) exercise in which participants engage in deliberation to design health insurance benefits under financial constraints. Change in priorities and attitudes about the need to exercise insurance cost constraints. Participants (N = 744) became significantly more cognizant of the need to limit insurance benefits for the sake of affordability and capable of prioritizing benefit options. Those agreeing that it is reasonable to limit health insurance coverage given the cost increased from 47% to 72%. It is both possible and valuable to involve employees in priority setting regarding health insurance benefits through the use of structured decision tools.

  11. Diagnosis and Treatment of Diminished Ovarian Reserve in ART Cycles of Women Up to Age 40 Years: The Role of Insurance Mandates

    Science.gov (United States)

    Butts, Samantha F.; Ratcliffe, Sarah; Dokras, Anuja; Seifer, David B.

    2012-01-01

    Summary Objective To explore correlates of diminished ovarian reserve (DOR) and predictors of ART treatment outcome in DOR cycles using the SART-CORS database. We hypothesized that state insurance coverage for ART is associated with the prevalence of DOR diagnosis in ART cycles and with treatment outcomes in DOR cycles. Design Cross sectional study using ART cycles between 2004–2007. Setting United States ART registry data. Patients 182,779 fresh, non-donor, initial ART cycles in women up to age 40. Interventions None. Main Outcome Measures Prevalence of DOR and elevated FSH, odds ratio of DOR and elevated FSH in ART mandated vs. non-mandated states, live birth rates. Results Compared to cycles performed in states with mandated ART coverage, cycles in states with no ART mandate were more likely to have DOR (AOR 1.43 95% CI 1.37–1.5, pcycles. Conclusions A significant association was observed between lack of mandated insurance for ART and the proportion of cycles treating DOR or elevated FSH. The presence or absence of state mandated ART coverage could impact access to care and the mix of patients that pursue and initiate ART cycles. Additional studies are needed that consider the coalescence of insurance mandates, patient and provider factors, and state level variables on the odds of specific infertility diagnoses and treatment prognosis. PMID:23102859

  12. Impact of a private health insurance mandate on public sector autism service use in Pennsylvania.

    Science.gov (United States)

    Stein, Bradley D; Sorbero, Mark J; Goswami, Upasna; Schuster, James; Leslie, Douglas L

    2012-08-01

    Many states have implemented regulations (commonly referred to as waivers) to increase access to publicly insured services for autism spectrum disorders (ASD). In recent years, several states have passed legislation requiring improved coverage for ASD services by private insurers. This study examines the impact of such legislation on use of Medicaid-funded ASD services. We used Medicaid claims data from July 1, 2006, through June 30, 2010, to identify children with ASD and to assess their use of behavioral health services and psychotropic medications. Service and medication use were examined in four consecutive 12-month periods: the 2 years preceding passage of the legislation, the year after passage but before implementation, and the year after implementation. We examined differences in use of services and medications, and used growth rates from nonwaiver children to estimate the impact of the legislation on Medicaid spending for waiver-eligible children with ASD. The number of children with ASD receiving Medicaid services increased 20% from 2006-2007 to 2009-2010. The growth rate among children affected by the legislation was comparable to that of other groups before passage of the legislation but decreased after the legislation's passage. We project that, without the legislation, growth in this population would have been 46% greater in 2009-2010 than observed, associated with spending of more than $8 million in 2009-2010. Passage of legislation increasing private insurance coverage of ASD services may decrease the number of families seeking eligibility to obtain Medicaid-funded services, with an associated substantial decrease in Medicaid expenditures. Copyright © 2012 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

  13. The views of low-income employees regarding mandated comprehensive employee benefits for the sake of health.

    Science.gov (United States)

    Adikes, Katherin A; Hull, Sara C; Danis, Marion

    2010-01-01

    Socioeconomic factors stand in the way of good health for low-income populations. We suggest that employee benefits might serve as a means of improving the health of low-wage earners. We convened groups of low-income earners to design hypothetical employee benefit packages. Qualitative analysis of group discussions regarding state-mandated benefits indicated that participants were interested in a great variety of benefits, beyond health care, that address socioeconomic determinants of health. Long-term financial and educational investments were of particular value. These results may facilitate the design of employee benefits that promote the health of low-income workers.

  14. The Views of Low-Income Employees Regarding Mandated Comprehensive Employee Benefits for the Sake of Health

    Science.gov (United States)

    Adikes, Katherin A.; Hull, Sara C.; Dams, Marion

    2013-01-01

    Socioeconomic factors stand in the way of good health for low-income populations. We suggest that employee benefits might serve as a means of improving the health of low-wage earners. We convened groups of low-income earners to design hypothetical employee benefit packages. Qualitative analysis of group discussions regarding state-mandated benefits indicated that participants were interested in a great variety of benefits, beyond health care, that address socioeconomic determinants of health. Long-term financial and educational investments were of particular value. These results may facilitate the design of employee benefits that promote the health of low-income workers. PMID:20391255

  15. Benefit distribution of social health insurance: evidence from china's urban resident basic medical insurance.

    Science.gov (United States)

    Pan, Jay; Tian, Sen; Zhou, Qin; Han, Wei

    2016-09-01

    Equity is one of the essential objectives of the social health insurance. This article evaluates the benefit distribution of the China's Urban Residents' Basic Medical Insurance (URBMI), covering 300 million urban populations. Using the URBMI Household Survey data fielded between 2007 and 2011, we estimate the benefit distribution by the two-part model, and find that the URBMI beneficiaries from lower income groups benefited less than that of higher income groups. In other words, government subsidy that was supposed to promote the universal coverage of health care flew more to the rich. Our study provides new evidence on China's health insurance system reform, and it bears meaningful policy implication for other developing countries facing similar challenges on the way to universal coverage of health insurance. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  16. Unemployment Insurance Benefit Levels and Consumption Changes

    DEFF Research Database (Denmark)

    Browning, Martin; Crossley, Thomas

    We use a survey of unemployed people to examine how a job loss impacts on household expenditures. The principal focus is on the effect of the level of income replacement provided by Unemployment Insurance. We restrict attention to a sub-sample of respondents who are still in their first spell...... of unemployment after six months. For this group we find large consumption falls, averaging about 16% of total expenditure. The actual fall depends on a variety of factors of which the most important is the pre-job loss ratio of the respondent's income to household income. The effects of varying the replacement...... within the household and hence on other facets of behaviour such as job search, unemployment duration and the quality of any new job taken...

  17. A flexible benefits tax credit for health insurance and more.

    Science.gov (United States)

    Etheredge, Lynn

    2001-01-01

    This essay outlines a concept for a "flexible benefits" tax credit for expanding health insurance coverage and other purposes such as retirement savings plans (with potential withdrawals for higher education, first-home ownership, and catastrophic medical expenses). Two examples are presented. The advantages of a flexible benefits tax credit are considered in terms of efficient use of the budget surplus to help meet the varied (and changing) needs of American families, to eliminate major national gaps in health insurance and pension coverage, and to advance other objectives. If the budget surplus is used wisely, political decisionmakers could achieve health insurance coverage for most uninsured workers and children and assure a future with real economic security for American families.

  18. Life insurance, living benefits, and physician-assisted death.

    Science.gov (United States)

    Parker, Frederick R; Rubin, Harvey W; Winslade, William J

    2004-01-01

    One of the most significant concerns about the legalization of physician-assisted death in the United States relates to the possibility that a chronically or terminally ill person would choose to end her or his life for financial reasons. Because we believe that the life insurance industry is uniquely poised to help minimize any such incentive, we submit that it has a moral obligation to do so. In particular, we propose that the industry encourage greater flexibility in the payout of policy benefits in the event an insured should be diagnosed with a terminal illness or suffer from intractable pain.

  19. Long-term care insurance matures as a benefit.

    Science.gov (United States)

    Davis, Elaine; Leach, Tom

    2002-12-01

    Forty-eight percent of U.S. businesses now offer long-term care insurance (LTCI) coverage, an increase of 15% since 1998. As more organizations realize the added value of LTCI in the employee benefit package, they have also found that motivation to buy varies with employee financial standing, gender and age, and that targeted employee education as part of retirement planning is essential.

  20. Pension Benefit Insurance and Pension Plan Portfolio Choice

    OpenAIRE

    Thomas Crossley; Mario Jametti

    2008-01-01

    Pension benefit guarantee policies have been introduced in several countries to pro- tect private pension plan members from the loss of income that would occur if a plan was underfunded when the sponsoring firm terminates a plan. Most of these public insurance schemes face financial dificulty and consequently policy reforms are being discussed or implemented. Economic theory suggests that such schemes will face moral hazard and adverse selection problems. In this note we test a specific theor...

  1. 45 CFR 618.440 - Health and insurance benefits and services.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 3 2010-10-01 2010-10-01 false Health and insurance benefits and services. 618....440 Health and insurance benefits and services. Subject to § 618.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its students, a recipient...

  2. 36 CFR 1211.440 - Health and insurance benefits and services.

    Science.gov (United States)

    2010-07-01

    ... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Health and insurance benefits... Activities Prohibited § 1211.440 Health and insurance benefits and services. Subject to § 1211.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its...

  3. 10 CFR 5.440 - Health and insurance benefits and services.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 1 2010-01-01 2010-01-01 false Health and insurance benefits and services. 5.440 Section... Education Programs or Activities Prohibited § 5.440 Health and insurance benefits and services. Subject to § 5.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or...

  4. 34 CFR 106.39 - Health and insurance benefits and services.

    Science.gov (United States)

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false Health and insurance benefits and services. 106.39... Prohibited § 106.39 Health and insurance benefits and services. In providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its students, a recipient shall not...

  5. 44 CFR 19.440 - Health and insurance benefits and services.

    Science.gov (United States)

    2010-10-01

    ... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Health and insurance benefits... Education Programs or Activities Prohibited § 19.440 Health and insurance benefits and services. Subject to § 19.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or...

  6. 24 CFR 3.440 - Health and insurance benefits and services.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Health and insurance benefits and... Activities Prohibited § 3.440 Health and insurance benefits and services. Subject to § 3.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its...

  7. 49 CFR 25.440 - Health and insurance benefits and services.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false Health and insurance benefits and services. 25.440... Basis of Sex in Education Programs or Activities Prohibited § 25.440 Health and insurance benefits and services. Subject to § 25.235(d), in providing a medical, hospital, accident, or life insurance benefit...

  8. 10 CFR 1042.440 - Health and insurance benefits and services.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Health and insurance benefits and services. 1042.440... in Education Programs or Activities Prohibited § 1042.440 Health and insurance benefits and services. Subject to § 1042.235(d), in providing a medical, hospital, accident, or life insurance benefit, service...

  9. 32 CFR 196.440 - Health and insurance benefits and services.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 2 2010-07-01 2010-07-01 false Health and insurance benefits and services. 196... Activities Prohibited § 196.440 Health and insurance benefits and services. Subject to § 196.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its...

  10. 29 CFR 36.440 - Health and insurance benefits and services.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true Health and insurance benefits and services. 36.440 Section... Education Programs or Activities Prohibited § 36.440 Health and insurance benefits and services. Subject to § 36.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or...

  11. 13 CFR 113.440 - Health and insurance benefits and services.

    Science.gov (United States)

    2010-01-01

    ... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Health and insurance benefits and....440 Health and insurance benefits and services. Subject to § 113.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its students, a recipient...

  12. 45 CFR 86.39 - Health and insurance benefits and services.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Health and insurance benefits and services. 86.39... Discrimination on the Basis of Sex in Education Programs or Activities Prohibited § 86.39 Health and insurance benefits and services. In providing a medical, hospital, accident, or life insurance benefit, service...

  13. 5 CFR 352.309 - Retirement, health benefits, and group life insurance.

    Science.gov (United States)

    2010-01-01

    ... Organizations § 352.309 Retirement, health benefits, and group life insurance. (a) Agency action. An employee... entitled to retain coverage for retirement, health benefits, and group life insurance purposes if he or she... he or she wishes to retain coverage under the retirement, health benefits, and group life insurance...

  14. 45 CFR 2555.440 - Health and insurance benefits and services.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Health and insurance benefits and services. 2555... Activities Prohibited § 2555.440 Health and insurance benefits and services. Subject to § 2555.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its...

  15. 7 CFR 15a.39 - Health and insurance benefits and services.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 1 2010-01-01 2010-01-01 false Health and insurance benefits and services. 15a.39... Programs and Activities Prohibited § 15a.39 Health and insurance benefits and services. In providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its students, a...

  16. Hierarchical Markov Model in Life Insurance and Social Benefit Schemes

    Directory of Open Access Journals (Sweden)

    Jiwook Jang

    2018-06-01

    Full Text Available We explored the effect of the jump-diffusion process on a social benefit scheme consisting of life insurance, unemployment/disability benefits, and retirement benefits. To do so, we used a four-state Markov chain with multiple decrements. Assuming independent state-wise intensities taking the form of a jump-diffusion process and deterministic interest rates, we evaluated the prospective reserves for this scheme in which the individual is employed at inception. We then numerically demonstrated the state of the reserves for the scheme under jump-diffusion and non-jump-diffusion settings. By decomposing the reserve equation into five components, our numerical illustration indicated that an extension of the retirement age has a spillover effect that would increase government expenses for other social insurance programs. We also conducted sensitivity analyses and examined the total-reserves components by changing the relevant parameters of the transition intensities, which are the average jump-size parameter, average jump frequency, and diffusion parameters of the chosen states, with figures provided. Our computation revealed that the total reserve is most sensitive to changes in average jump frequency.

  17. 28 CFR 54.440 - Health and insurance benefits and services.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Health and insurance benefits and... Discrimination on the Basis of Sex in Education Programs or Activities Prohibited § 54.440 Health and insurance... insurance benefit, service, policy, or plan to any of its students, a recipient shall not discriminate on...

  18. 6 CFR 17.440 - Health and insurance benefits and services.

    Science.gov (United States)

    2010-01-01

    ... 6 Domestic Security 1 2010-01-01 2010-01-01 false Health and insurance benefits and services. 17... Discrimination on the Basis of Sex in Education Programs or Activities Prohibited § 17.440 Health and insurance... insurance benefit, service, policy, or plan to any of its students, a recipient shall not discriminate on...

  19. 40 CFR 5.440 - Health and insurance benefits and services.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Health and insurance benefits and... Discrimination on the Basis of Sex in Education Programs or Activities Prohibited § 5.440 Health and insurance benefits and services. Subject to § 5.235(d), in providing a medical, hospital, accident, or life insurance...

  20. 38 CFR 23.440 - Health and insurance benefits and services.

    Science.gov (United States)

    2010-07-01

    ... Prohibited § 23.440 Health and insurance benefits and services. Subject to § 23.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its students, a... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Health and insurance...

  1. 22 CFR 229.440 - Health and insurance benefits and services.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Health and insurance benefits and services. 229... on the Basis of Sex in Education Programs or Activities Prohibited § 229.440 Health and insurance... insurance benefit, service, policy, or plan to any of its students, a recipient shall not discriminate on...

  2. 14 CFR 1253.440 - Health and insurance benefits and services.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Health and insurance benefits and services... Discrimination on the Basis of Sex in Education Programs or Activities Prohibited § 1253.440 Health and insurance... insurance benefit, service, policy, or plan to any of its students, a recipient shall not discriminate on...

  3. 18 CFR 1317.440 - Health and insurance benefits and services.

    Science.gov (United States)

    2010-04-01

    ... § 1317.440 Health and insurance benefits and services. Subject to § 1317.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its students, a recipient... 18 Conservation of Power and Water Resources 2 2010-04-01 2010-04-01 false Health and insurance...

  4. 41 CFR 101-4.440 - Health and insurance benefits and services.

    Science.gov (United States)

    2010-07-01

    ... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true Health and insurance... insurance benefits and services. Subject to § 101-4.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its students, a recipient shall not...

  5. 31 CFR 28.440 - Health and insurance benefits and services.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Health and insurance benefits and... Discrimination on the Basis of Sex in Education Programs or Activities Prohibited § 28.440 Health and insurance... insurance benefit, service, policy, or plan to any of its students, a recipient shall not discriminate on...

  6. 22 CFR 146.440 - Health and insurance benefits and services.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Health and insurance benefits and services. 146... the Basis of Sex in Education Programs or Activities Prohibited § 146.440 Health and insurance... insurance benefit, service, policy, or plan to any of its students, a recipient shall not discriminate on...

  7. 43 CFR 41.440 - Health and insurance benefits and services.

    Science.gov (United States)

    2010-10-01

    ... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Health and insurance benefits and services... Discrimination on the Basis of Sex in Education Programs or Activities Prohibited § 41.440 Health and insurance... insurance benefit, service, policy, or plan to any of its students, a recipient shall not discriminate on...

  8. 78 FR 4593 - Medicaid, Children's Health Insurance Programs, and Exchanges: Essential Health Benefits in...

    Science.gov (United States)

    2013-01-22

    ...'s Health Insurance Programs, and Exchanges: Essential Health Benefits in Alternative Benefit Plans...-2334-P] RIN 0938-AR04 Medicaid, Children's Health Insurance Programs, and Exchanges: Essential Health... 2010 (collectively referred to as the Affordable Care Act), and the Children's Health Insurance Program...

  9. A battle over birth "control": legal and legislative employer prescription contraception benefit mandates.

    Science.gov (United States)

    Loomis, C Keanin

    2002-12-01

    Under the Pregnancy Discrimination Act (PDA), employers are prohibited from discriminating against women by treating pregnancy and childbirth different from other medical conditions. Employers who offer medical benefits to their employees have thus been required to cover pregnancy-related medical costs on the same terms as other medical coverage. The cost of prescription contraception, however, has generally not been covered by employer-sponsored medical plans, even while other prescription drugs were. This Note examines the recent case of Erickson v. Bartell Drug Co., which challenged this practice of excluding prescription contraception coverage as discriminatory under the PDA, and argues that further federal legislation is necessary to ensure the equal treatment of women in the workplace.

  10. The health effects of US unemployment insurance policy: Does income from unemployment benefits prevent cardiovascular disease?

    NARCIS (Netherlands)

    S. Walter (Stefan); M.M. Glymour (Maria); M. Avendano Pabon (Mauricio)

    2014-01-01

    textabstractObjective: Previous studies suggest that unemployment predicts increased cardiovascular disease (CVD) risk, but whether unemployment insurance programs mitigate this risk has not been assessed. Exploiting US state variations in unemployment insurance benefit programs, we tested the

  11. Employee knowledge of value-based insurance design benefits.

    Science.gov (United States)

    Henrikson, Nora B; Anderson, Melissa L; Hubbard, Rebecca A; Fishman, Paul; Grossman, David C

    2014-08-01

    Value-based insurance designs (VBD) incorporate evidence-based medicine into health benefit design. Consumer knowledge of new VBD benefits is important to assessing their impact on health care use. To assess knowledge of features of a VBD. The eligible study population was employees receiving healthcare benefits in an integrated care system in the U.S. Pacific Northwest. In 2010, participants completed a web-based survey 2 months after rollout of the plan, including three true/false questions about benefit design features including copays for preventive care visits and chronic disease medications and premium costs. Analysis was completed in 2012. Knowledgeable was defined as correct response to all three questions; self-reported knowledge was also assessed. A total of 3,463 people completed the survey (response rate=71.7%). The majority of respondents were female (80.1%) Caucasians (79.6%) aged 35-64 years (79.0%), reflecting the overall employee population. A total of 45.7% had at least a 4-year college education, and 69.1% were married. About three quarters of respondents correctly answered each individual question; half (52.1%) of respondents answered all three questions correctly. On multivariate analysis, knowledge was independently associated with female gender (OR=1.80, 95% CI=1.40, 2.31); Caucasian race (OR=1.72, 95% CI=1.28, 2.32); increasing household income (OR for ≥$100,000=1.86, 95% CI=1.29, 2.68); nonunion job status (OR compared to union status=1.63, 95% CI=1.17, 2.26); and high satisfaction with the health plan (OR compared to low satisfaction=1.26; 95% CI=1.00, 1.57). Incomplete knowledge of benefits is prevalent in an employee population soon after VBD rollout. Copyright © 2014 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  12. 78 FR 6275 - Medicaid, Children's Health Insurance Programs, and Exchanges: Essential Health Benefits in...

    Science.gov (United States)

    2013-01-30

    ... Medicaid, Children's Health Insurance Programs, and Exchanges: Essential Health Benefits in Alternative...'s Health Insurance Programs, and Exchanges: Essential Health Benefits in Alternative Benefit Plans... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services 42 CFR Parts 430...

  13. 78 FR 42159 - Medicaid and Children's Health Insurance Programs: Essential Health Benefits in Alternative...

    Science.gov (United States)

    2013-07-15

    ... and 156 Medicaid and Children's Health Insurance Programs: Essential Health Benefits in Alternative... Secretary 45 CFR Parts 155 and 156 [CMS-2334-F] RIN 0938-AR04 Medicaid and Children's Health Insurance... Medicaid and the Children's Health Insurance Program (CHIP) eligibility notices, delegation of appeals, and...

  14. Estimating workers' marginal valuation of employer health benefits: would insured workers prefer more health insurance or higher wages?

    Science.gov (United States)

    Royalty, Anne Beeson

    2008-01-01

    In recent years the cost of health insurance has been increasing much faster than wages. In the face of these rising costs, many employers will have to make difficult decisions about whether to cut back health benefits or to compensate workers with lower wages or lower wage growth. In this paper, we ask the question, "Which do workers value more -- one additional dollar's worth of health benefits or one more dollar in their pockets?" Using a new approach to obtaining estimates of insured workers' marginal valuation of health benefits this paper estimates how much, on average, employees value the marginal dollar paid by employers for their workers' health insurance. We find that insured workers value the marginal health premium dollar at significantly less than the marginal wage dollar. However, workers value insurance generosity very highly. The marginal dollar spent on health insurance that adds an additional dollar's worth of observable dimensions of plan generosity, such as lower deductibles or coverage of additional services, is valued at significantly more than one dollar.

  15. How life insurance can benefit the business owner

    International Nuclear Information System (INIS)

    Byles, B.

    1993-01-01

    There are many situations when life insurance can fill the financial needs of business owners. Three of the most common needs are business continuation/value conservation (buy-sell agreement), asset conservation upon death or disability of a key employee (replace the value of a key employee upon death or disability), and the reward and retention of selected employees (bonus or deferred compensation). Let's take a closer look to see why life insurance makes sense in these three areas

  16. Breast Health Services: Accuracy of Benefit Coverage Information in the Individual Insurance Marketplace.

    Science.gov (United States)

    Hamid, Mariam S; Kolenic, Giselle E; Dozier, Jessica; Dalton, Vanessa K; Carlos, Ruth C

    2017-04-01

    The aim of this study was to determine if breast health coverage information provided by customer service representatives employed by insurers offering plans in the 2015 federal and state health insurance marketplaces is consistent with Patient Protection and Affordable Care Act (ACA) and state-specific legislation. One hundred fifty-eight unique customer service numbers were identified for insurers offering plans through the federal marketplace, augmented with four additional numbers representing the Connecticut state-run exchange. Using a standardized patient biography and the mystery-shopper technique, a single investigator posed as a purchaser and contacted each number, requesting information on breast health services coverage. Consistency of information provided by the representative with the ACA mandates (BRCA testing in high-risk women) or state-specific legislation (screening ultrasound in women with dense breasts) was determined. Insurer representatives gave BRCA test coverage information that was not consistent with the ACA mandate in 60.8% of cases, and 22.8% could not provide any information regarding coverage. Nearly half (48.1%) of insurer representatives gave coverage information about ultrasound screening for dense breasts that was not consistent with state-specific legislation, and 18.5% could not provide any information. Insurance customer service representatives in the federal and state marketplaces frequently provide inaccurate coverage information about breast health services that should be covered under the ACA and state-specific legislation. Misinformation can inadvertently lead to the purchase of a plan that does not meet the needs of the insured. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  17. Geographic variation in health insurance benefits in Qianjiang District, China: a cross-sectional study.

    Science.gov (United States)

    Wu, Yue; Zhang, Liang; Liu, Xuejiao; Ye, Ting; Wang, Yongfei

    2018-02-05

    Health insurance contributes to reducing the economic burden of disease and improving access to healthcare. In 2016, the Chinese government announced the integration of the New Cooperative Medical Scheme (NCMS) and Urban Resident Basic Medical Insurance (URBMI) to reduce system segmentation. Nevertheless, it was unclear whether there would be any geographic variation in health insurance benefits if the two types of insurance were integrated. The aim of this study was to identify the potential geographic variation in health insurance benefits and the related contributing factors. This cross-sectional study was carried out in Qianjiang District, where the NCMS and URBMI were integrated into Urban and Rural Resident Basic Medical Insurance Scheme (URRBMI) in 2010. All beneficiaries under the URRBMI were hospitalized at least once in 2013, totaling 445,254 persons and 65,877 person-times, were included in this study. Town-level data on health insurance benefits, healthcare utilization, and socioeconomic and geographical characteristics were collected through health insurance system, self-report questionnaires, and the 2014 Statistical Yearbook of Qianjiang District. A simplified Theil index at town level was calculated to measure geographic variation in health insurance benefits. Colored maps were created to visualize the variation in geographic distribution of benefits. The effects of healthcare utilization and socioeconomic and geographical characteristics on geographic variation in health insurance benefits were estimated with a multiple linear regression analysis. Different Theil index values were calculated for different towns, and the Theil index values for compensation by person-times and amount were 2.5028 and 1.8394 in primary healthcare institutions and 1.1466 and 0.9204 in secondary healthcare institutions. Healthcare-seeking behavior and economic factors were positively associated with health insurance benefits in compensation by person-times significantly

  18. Wage and Benefit Changes in Response to Rising Health Insurance Costs

    OpenAIRE

    Dana Goldman; Neeraj Sood; Arleen Leibowitz

    2005-01-01

    Many companies have defined-contribution benefit plans requiring employees to pay the full cost (before taxes) of more generous health insurance choices. Research has shown that employee decisions are quite responsive to these arrangements. What is less clear is how the total compensation package changes when health insurance premiums rise. This paper examines employee compensation decisions during a three-year period when health insurance premiums were rising rapidly. The data come from a si...

  19. Small employers and self-insured health benefits: too small to succeed?

    Science.gov (United States)

    Yee, Tracy; Christianson, Jon B; Ginsburg, Paul B

    2012-07-01

    Over the past decade, large employers increasingly have bypassed traditional health insurance for their workers, opting instead to assume the financial risk of enrollees' medical care through self-insurance. Because self-insurance arrangements may offer advantages--such as lower costs, exemption from most state insurance regulation and greater flexibility in benefit design--they are especially attractive to large firms with enough employees to spread risk adequately to avoid the financial fallout from potentially catastrophic medical costs of some employees. Recently, with rising health care costs and changing market dynamics, more small firms--100 or fewer workers--are interested in self-insuring health benefits, according to a new qualitative study from the Center for Studying Health System Change (HSC). Self-insured firms typically use a third-party administrator (TPA) to process medical claims and provide access to provider networks. Firms also often purchase stop-loss insurance to cover medical costs exceeding a predefined amount. Increasingly competitive markets for TPA services and stop-loss insurance are making self-insurance attractive to more employers. The 2010 national health reform law imposes new requirements and taxes on health insurance that may spur more small firms to consider self-insurance. In turn, if more small firms opt to self-insure, certain health reform goals, such as strengthening consumer protections and making the small-group health insurance market more viable, may be undermined. Specifically, adverse selection--attracting sicker-than-average people--is a potential issue for the insurance exchanges created by reform.

  20. Industrial accident compensation insurance benefits on cerebrovascular and heart disease in Korea.

    Science.gov (United States)

    Kim, Hyeong Su; Choi, Jae Wook; Chang, Soung Hoon; Lee, Kun Sei

    2003-01-01

    The purpose of this study is to present the importance of work-related cerebrovascular and heart disease from the viewpoint of expenses. Using the insurance benefit paid for the 4,300 cases, this study estimated the burden of insurance benefits spent on work-related cerebrovascular and heart disease. The number of cases with work-related cerebrovascular and heart disease per 100,000 insured workers were 3.36 in 1995; they were increased to 13.16 in 2000. By the days of occurrence, the estimated number of cases were 1,336 in 2001 (95% CI: 1,211-1,460 cases) and 1,769 in 2005 (CI: 1,610-1,931 cases). The estimated average insurance benefits paid per person with work-related cerebrovascular and heart disease was 75-19 million won for medical care benefit and 56 million won for other benefits except medical care. By considering the increase in insurance payment and average pay, the predicted insurance benefits for work-related cerebrovascular and heart disease was 107.9 billion won for the 2001 cohort and 192.4 billion won for the 2005 cohort. From an economic perspective, the results will be used as important evidence for the prevention and management of work-related cerebrovascular and heart disease. PMID:12923322

  1. Value-based insurance design: benefits beyond cost and utilization.

    Science.gov (United States)

    Gibson, Teresa B; Maclean, Ross J; Chernew, Michael E; Fendrick, A Mark; Baigel, Colin

    2015-01-01

    As value-based insurance design (VBID) programs proliferate, evidence is emerging on the impact of VBID. To date, studies have largely measured VBID impact on utilization, and a few studies have assessed its impact on quality, outcomes, and cost. In this commentary we discuss these domains, summarize evidence, and propose the extension of measurement of VBID impact into areas including workplace productivity and quality of life, employee and patient engagement, and talent attraction and retention. We contend that VBID evaluations should consider a broad variety of programmatic dividends on both humanistic and health-related outcomes.

  2. 15 CFR 8a.440 - Health and insurance benefits and services.

    Science.gov (United States)

    2010-01-01

    ... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false Health and insurance benefits and services. 8a.440 Section 8a.440 Commerce and Foreign Trade Office of the Secretary of Commerce... benefits and services. Subject to § 8a.235(d), in providing a medical, hospital, accident, or life...

  3. Switching benefits and costs in competitive health insurance markets: A conceptual framework and empirical evidence from the Netherlands.

    Science.gov (United States)

    Duijmelinck, Daniëlle M I D; Mosca, Ilaria; van de Ven, Wynand P M M

    2015-05-01

    Competitive health insurance markets will only enhance cost-containment, efficiency, quality, and consumer responsiveness if all consumers feel free to easily switch insurer. Consumers will switch insurer if their perceived switching benefits outweigh their perceived switching costs. We developed a conceptual framework with potential switching benefits and costs in competitive health insurance markets. Moreover, we used a questionnaire among Dutch consumers (1091 respondents) to empirically examine the relevance of the different switching benefits and costs in consumers' decision to (not) switch insurer. Price, insurers' service quality, insurers' contracted provider network, the benefits of supplementary insurance, and welcome gifts are potential switching benefits. Transaction costs, learning costs, 'benefit loss' costs, uncertainty costs, the costs of (not) switching provider, and sunk costs are potential switching costs. In 2013 most Dutch consumers switched insurer because of (1) price and (2) benefits of supplementary insurance. Nearly half of the non-switchers - and particularly unhealthy consumers - mentioned one of the switching costs as their main reason for not switching. Because unhealthy consumers feel not free to easily switch insurer, insurers have reduced incentives to invest in high-quality care for them. Therefore, policymakers should develop strategies to increase consumer choice. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  4. The individual insurance market before reform: low premiums and low benefits.

    Science.gov (United States)

    Whitmore, Heidi; Gabel, Jon R; Pickreign, Jeremy; McDevitt, Roland

    2011-10-01

    Based on analyses of individual market health plans sold through ehealthinsurance and enrollment information collected from individual market carriers, this article profiles the individual health insurance market in 2007, before health reform. The article examines premiums, plan enrollment, cost sharing, and covered benefits and compares individual and group markets. Premiums for the young are lower than in the group market but higher for older people. Cost sharing is substantial in the individual insurance market. Seventy-eight percent of people were enrolled in plans with deductibles for single coverage, which averaged $2,117. Annual out-of-pocket maximums averaged $5,271. Many plans do not cover important benefits. Twelve percent of individually insured persons had no coverage for office visits and only 43% have maternity benefits in their basic coverage. With the advent of health exchanges and new market rules in 2014, covered benefits may become richer, cost sharing will decline, but premiums for the young will rise.

  5. Generational status, health insurance, and public benefit participation among low-income Latino children.

    Science.gov (United States)

    DeCamp, Lisa Ross; Bundy, David G

    2012-04-01

    The objectives of this study were to (1) measure health insurance coverage and continuity across generational subgroups of Latino children, and (2) determine if participation in public benefit programs is associated with increased health insurance coverage and continuity. We analyzed data on 25,388 children income-eligible for public insurance from the 2003 to 2004 National Survey of Children's Health and stratified Latinos by generational status. First- and second-generation Latino children were more likely to be uninsured (58 and 19%, respectively) than third-generation children (9.5%). Second-generation Latino children were similarly likely to be currently insured by public insurance as third-generation children (61 and 62%, respectively), but less likely to have private insurance (19 and 29%, respectively). Second-generation Latino children were slightly more likely than third-generation children to have discontinuous insurance during the year (19 and 15%, respectively). Compared with children in families where English was the primary home language, children in families where English was not the primary home language had higher odds of being uninsured versus having continuous insurance coverage (OR: 2.19; 95% CI [1.33-3.62]). Among second-generation Latino children, participation in the Food Stamp (OR 0.26; 95% CI [0.14-0.48]) or Women, Infants, and Children (OR 0.40; 95% CI [0.25-0.66]) programs was associated with reduced odds of being uninsured. Insurance disparities are concentrated among first- and second-generation Latino children. For second-generation Latino children, connection to other public benefit programs may promote enrollment in public insurance.

  6. Medication Adherence and Health Insurance/Health Benefit in Adult Diabetics in Kingston, Jamaica.

    Science.gov (United States)

    Bridgelal-Nagassar, R J; James, K; Nagassar, R P; Maharaj, S

    2015-05-15

    To determine the association between health insurance/health benefit and medication adherence amongst adult diabetic patients in Kingston, Jamaica. This was a cross-sectional study. The target population was diabetics who attended the diabetic outpatient clinics in health centres in Kingston. Two health centres were selectively chosen in Kingston. All diabetic patients attending the diabetic clinics and over the age of 18 years were conveniently sampled. The sample size was 260. An interviewer-administered questionnaire was utilized which assessed health insurance/health benefit. Adherence was measured by patients' self-reports of medication usage in the previous week. The Chi-squared test was used to determine the significance of associations. Sample population was 76% female and 24% male. Type 2 diabetics comprised 93.8%. More than 95% of patients were over the age of 40 years. Approximately 32% of participants were employed. Approximately 75% of patients had health insurance/health benefit. Among those who had health insurance or health benefit, 71.5% were adherent and 28.5% were non-adherent. This difference was statistically significant (χ2 = 6.553, p = 0.01). Prevalence of medication non-adherence was 33%. AIn Kingston, diabetic patients who are adherent are more likely to have health insurance/health benefit ( p = 0.01).

  7. Switching benefits and costs in the Irish health insurance market: an analysis of consumer surveys

    OpenAIRE

    KEEGAN, CONOR; Teljeur, Conor; Turner, Brian; THomas, Steve

    2018-01-01

    PUBLISHED Relatively little analysis has taken place internationally on the consumer-reported benefits and costs to switching insurer in multi-payer health insurance markets. Ideally, consumers should be willing to switch out of consideration for price and quality and switching should be able to take place without incurring significant switching costs. Costs to switching come in many forms and understanding the nature of these costs is necessary if policy interventions to improve market co...

  8. [Participant structure and economic benefit of prevention bonus programmes in company health insurance funds].

    Science.gov (United States)

    Friedrichs, M; Friedel, H; Bödeker, W

    2009-10-01

    This study investigates differences in sex, age, and educational level between participants and non-participants of prevention bonus programmes. The differences in the utilisation of drugs, hospital care, and sickness absence before the start of the programmes between these groups are also shown. Finally the economic benefit of the health insurance funds attributed to these programmes is estimated. Data from some 5.2 million insured subjects of 74 company health insurance funds in Germany were linked to information on enrollment into a prevention bonus programme anonymously. In a descriptive analysis the differences in the sociodemographic patterns between both groups are shown as well as the differences in costs to the health insurances in the three sectors mentioned above. The benefit to the health insurance funds is estimated by means of an analysis of covariance. Prevention bonus programmes yields an annual benefit of at least 129 euro per participant. Men aged 40 and older and women aged 30 and older are more likely to opt into such a programme. The same is true for persons with a higher educational level. There are only few differences in health-care utilisation between the participants and non-participants of the programmes before enrollment. Only 1.4% of all insured persons participated in the programmes. There is at least a short-term gain to both involved parties: the insured and the health insurance funds. The programmes are not dominated by deadweight effects. Long-term effects and effectiveness of prevention bonus programmes still have to be investigated. Copyright Georg Thieme Verlag KG Stuttgart . New York.

  9. The Addiction Benefits Scorecard: A Framework to Promote Health Insurer Accountability and Support Consumer Engagement.

    Science.gov (United States)

    Danovitch, Itai; Kan, David

    2017-01-01

    Health care insurance plans covering treatment for substance use disorders (SUD) offer a wide range of benefits. Distinctions between health plan benefits are confusing, and consumers making selections may not adequately understand the characteristics or significance of the choices they have. The California Society of Addiction Medicine sought to help consumers make informed decisions about plan selections by providing education on the standard of care for SUD and presenting findings from an expert analysis of selected health plans. We developed an assessment framework, based on criteria endorsed by the American Society of Addiction Medicine, to rate the quality of SUD treatment benefits offered by a sample of insurance plans. We convened an expert panel of physicians to rate 16 policies of 10 insurance providers across seven categories. Data from published resources for 2014 insurance plans were extracted, categorized, and rated. The framework and ratings were summarized in a consumer-facing white paper. We found significant heterogeneity in benefits across comparable plans, as well as variation in the characterization and clarity of published services. This article presents findings and implications of the project. There is a pressing need to define requirements for SUD benefits and to hold health plans accountable for offering quality services in accordance with those benefits.

  10. Mid-mandate reports

    CERN Multimedia

    Staff Association

    2011-01-01

    Now half way through his mandate (2009-2013), our Director-General presented on 4th July a glowing report on both the scientific and technical fronts. This gives him, his team, and all CERN staff great satisfaction. Furthermore, despite a rather worrying economic situation in most of our Member States, he has managed to obtain the approval of the 2012 budget and the medium-term plan until 2016, which will allow our social security system, pensions and health insurance, to be considerably consolidated. The mandate of the President of the Staff Association lasts one year. So, where are we at half way through the mandate? Without doubt the pensions issue in particular kept us busy during the first six months. We explained to you during the two series of public meetings in April and June that we did not agree with the Management’s proposals for the new members and beneficiaries of the Fund and we showed you our own fairer proposals. However, under the continuous pressure of the Member States, almost...

  11. Who benefits from the Obio Community Health Insurance Scheme in Rivers State, Nigeria? A benefit incidence analysis.

    Science.gov (United States)

    Vaughan, Kelsey; Akwataghibe, Ngozi; Fakunle, Babatunde; Wolmarans, Liezel

    2016-11-01

    A key aspect of monitoring and evaluating health programs is ensuring that benefits are reaching their target population. We conducted a benefit incidence analysis (BIA) of a Shell-sponsored community health insurance scheme in Nigeria to determine the extent to which the target group (the poor) was benefitting. We examined a sample of 616 patients' hospital attendance, financial and administrative records from 2012-2013. We estimated annual utilization rates and average unit costs for inpatient and outpatient services. We multiplied the two to produce a total cost per patient, then deducted annual out-of-pocket expenditures to estimate the total community-based health insurance scheme benefit per person. Benefits were multiplied by the total number of persons in each socioeconomic group to aggregate benefits. We used concentration curves and dominance tests to determine statistical significance at 5% and 10% levels of significance. Collectively, the poorest 20% of the population received 12% of benefits while the richest quintile received the largest share (23%). Inpatient and outpatient benefits are weakly regressive (pro-rich), statistically significant at a 10% level of significance. Although the poor were found to benefit, this BIA revealed a tendency towards pro-rich distributions. Removing co-payments for the poorest, reducing long wait and visit times and using community volunteers to help increase access to health services may improve benefits for the poor. © The Author 2016. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  12. Retrenchments in unemployment insurance benefits and wage inequality: Longitudinal evidence from the Netherlands, 1985–2000

    NARCIS (Netherlands)

    Mooi-Reci, I.

    2012-01-01

    This study includes retrenchments in unemployment insurance (UI) benefits as an understudied mechanism to investigate possible explanations for wage inequality in the labor market. Using longitudinal data from the Dutch Labor Supply Panel (OSA) over the period 1985-2000, and adopting a

  13. Benefits to a life insurance company from providing radon tests for clients

    International Nuclear Information System (INIS)

    Cohen, B.L.

    1993-01-01

    If a life insurance company provided free radon tests to clients, clients' life expectancies would be extended and profits would thereby be increased. This effect is quantified and it is found that the direct monetary benefits to the company could be substantial. Several subsidiary advantages are also discussed

  14. College and University Employee Retirement and Insurance Benefits Cost Survey, 1992.

    Science.gov (United States)

    Teachers Insurance and Annuity Association, New York, NY. College Retirement Equities Fund.

    This report, the eighth in a regular biennial survey series, provides standardized comparative information on expenditures by colleges and universities for employee retirement and insurance benefits in 26 tables and 5 charts. The data, collected in 1992 from 577 institutions, reflect information supplied for either fiscal or calendar year 1981.…

  15. College and University Employee Retirement and Insurance Benefits Cost Survey, 1990.

    Science.gov (United States)

    Teachers Insurance and Annuity Association, New York, NY. College Retirement Equities Fund.

    This report, the seventh in a regular biennial survey series, provides standardized comparative information on expenditures by colleges and universities for employee retirement and insurance benefits in 25 tables and 5 charts. The data, collected in 1990 from 634 institutions, reflect information supplied for either fiscal or calendar year 1989.…

  16. Switching benefits and costs in the Irish health insurance market: an analysis of consumer surveys.

    Science.gov (United States)

    Keegan, Conor; Teljeur, Conor; Turner, Brian; Thomas, Steve

    2018-05-10

    Relatively little analysis has taken place internationally on the consumer-reported benefits and costs to switching insurer in multi-payer health insurance markets. Ideally, consumers should be willing to switch out of consideration for price and quality and switching should be able to take place without incurring significant switching costs. Costs to switching come in many forms and understanding the nature of these costs is necessary if policy interventions to improve market competition are to be successful. This study utilises data from consumer surveys of the Irish health insurance market collected between 2009 and 2013 (N [Formula: see text] 1703) to examine consumer-reported benefits and costs to switching insurer. Probit regression models are specified to examine the relationship between consumer characteristics and reported switching costs, and switching behaviour, respectively. Overall evidence suggests that switchers in the Irish market mainly did so out of consideration for price. Transaction cost was the most common switching cost identified, reported by just under 1 in 7 non-switchers. Psychological switching costs may also be impacting behaviour. Moreover, high-risk individuals were more likely to experience switching costs and this was reflected in actual switching behaviour. A recent information campaign launched by the market regulator may prove beneficial in reducing perceived transaction costs in the market, however, a more focused campaign aimed at high-risk consumers may be necessary to reduce inequalities. Policy-makers should also consider the impact insurer behaviour may have on decision-making.

  17. Health insurance benefit design and healthcare utilization in northern rural China.

    Directory of Open Access Journals (Sweden)

    Hong Wang

    Full Text Available BACKGROUND: Poverty due to illness has become a substantial social problem in rural China since the collapse of the rural Cooperative Medical System in the early 1980s. Although the Chinese government introduced the New Rural Cooperative Medical Schemes (NRCMS in 2003, the associations between different health insurance benefit package designs and healthcare utilization remain largely unknown. Accordingly, we sought to examine the impact of health insurance benefit design on health care utilization. METHODS AND FINDINGS: We conducted a cross-sectional study using data from a household survey of 15,698 members of 4,209 randomly-selected households in 7 provinces, which were representative of the provinces along the north side of the Yellow River. Interviews were conducted face-to-face and in Mandarin. Our analytic sample included 9,762 respondents from 2,642 households. In each household, respondents indicated the type of health insurance benefit that the household had (coverage for inpatient care only or coverage for both inpatient and outpatient care and the number of outpatient visits in the 30 days preceding the interview and the number of hospitalizations in the 365 days preceding the household interview. People who had both outpatient and inpatient coverage compared with inpatient coverage only had significantly more village-level outpatient visits, township-level outpatient visits, and total outpatient visits. Furthermore, the increased utilization of township and village-level outpatient care was experienced disproportionately by people who were poorer, whereas the increased inpatient utilization overall and at the county level was experienced disproportionately by people who were richer. CONCLUSION: The evidence from this study indicates that the design of health insurance benefits is an important policy tool that can affect the health services utilization and socioeconomic equity in service use at different levels. Without careful

  18. Health insurance benefit design and healthcare utilization in northern rural China.

    Science.gov (United States)

    Wang, Hong; Liu, Yu; Zhu, Yan; Xue, Lei; Dale, Martha; Sipsma, Heather; Bradley, Elizabeth

    2012-01-01

    Poverty due to illness has become a substantial social problem in rural China since the collapse of the rural Cooperative Medical System in the early 1980s. Although the Chinese government introduced the New Rural Cooperative Medical Schemes (NRCMS) in 2003, the associations between different health insurance benefit package designs and healthcare utilization remain largely unknown. Accordingly, we sought to examine the impact of health insurance benefit design on health care utilization. We conducted a cross-sectional study using data from a household survey of 15,698 members of 4,209 randomly-selected households in 7 provinces, which were representative of the provinces along the north side of the Yellow River. Interviews were conducted face-to-face and in Mandarin. Our analytic sample included 9,762 respondents from 2,642 households. In each household, respondents indicated the type of health insurance benefit that the household had (coverage for inpatient care only or coverage for both inpatient and outpatient care) and the number of outpatient visits in the 30 days preceding the interview and the number of hospitalizations in the 365 days preceding the household interview. People who had both outpatient and inpatient coverage compared with inpatient coverage only had significantly more village-level outpatient visits, township-level outpatient visits, and total outpatient visits. Furthermore, the increased utilization of township and village-level outpatient care was experienced disproportionately by people who were poorer, whereas the increased inpatient utilization overall and at the county level was experienced disproportionately by people who were richer. The evidence from this study indicates that the design of health insurance benefits is an important policy tool that can affect the health services utilization and socioeconomic equity in service use at different levels. Without careful design, health insurance may not benefit those who are most in need

  19. Potential impact of legislation mandating breast density notification: benefits, harms, and cost effectiveness of supplemental ultrasound screening

    Science.gov (United States)

    Sprague, Brian L.; Stout, Natasha K.; Schechter, Clyde; van Ravesteyn, Nicolien T.; Cevik, Mucahit; Alagoz, Oguzhan; Lee, Christoph I.; van den Broek, Jeroen J.; Miglioretti, Diana L.; Mandelblatt, Jeanne S.; de Koning, Harry J.; Kerlikowske, Karla; Lehman, Constance D.; Tosteson, Anna N. A.

    2014-01-01

    Background At least nineteen states have laws that require telling women with dense breasts and a negative screening mammogram to consider supplemental screening. The most readily available supplemental screening modality is ultrasound, yet little is known about its effectiveness. Objective To evaluate the benefits, harms, and cost-effectiveness of supplemental ultrasound screening for women with dense breasts. Design Comparative modeling with 3 validated simulation models. Data Sources Surveillance, Epidemiology, and End Results Program; Breast Cancer Surveillance Consortium; the medical literature. Target Population A contemporary cohort of women eligible for routine screening. Time Horizon Lifetime. Perspective Payer. Interventions Supplemental ultrasound screening for women with dense breasts following a negative screening mammogram. Outcome Measures Breast cancer deaths averted, quality-adjusted life years (QALYs) gained, false positive ultrasound biopsy recommendations, costs, costs per QALY gained. Results of Base-Case Analysis Supplemental ultrasound screening after a negative mammogram for women aged 50–74 with heterogeneously or extremely dense breasts averted 0.36 additional breast cancer deaths (range across models: 0.14–0.75), gained 1.7 QALYs (0.9–4.7), and resulted in 354 false-positive ultrasound biopsy recommendations (345–421) per 1000 women with dense breasts compared with biennial screening by mammography alone. The cost-effectiveness ratio was $325,000 per QALY gained ($112,000-$766,000). Restricting supplemental ultrasound screening to women with extremely dense breasts cost $246,000 per QALY gained ($74,000-$535,000). Results of Sensitivity Analysis The conclusions were not sensitive to ultrasound performance characteristics, screening frequency, or starting age. Limitations Provider costs for coordinating supplemental ultrasound were not considered. Conclusions Supplemental ultrasound screening for women with dense breasts undergoing

  20. The Affordable Care Act and health insurance exchanges: effects on the pediatric dental benefit.

    Science.gov (United States)

    Orynich, C Ashley; Casamassimo, Paul S; Seale, N Sue; Reggiardo, Paul; Litch, C Scott

    2015-01-01

    To examine the relationship between state health insurance Exchange selection and pediatric dental benefit design, regulation and cost. Medical and dental plans were analyzed across three types of state health insurance Exchanges: State-based (SB), State-partnered (SP), and Federally-facilitated (FF). Cost-analysis was completed for 10,427 insurance plans, and health policy expert interviews were conducted. One-way ANOVA compared the cost-sharing structure of stand-alone dental plans (SADP). T-test statistics compared differences in average total monthly pediatric premium costs. No causal relationships were identified between Exchange selection and the pediatric dental benefit's design, regulation or cost. Pediatric medical and dental coverage offered through the embedded plan design exhibited comparable average total monthly premium costs to aggregate cost estimates for the separately purchased SADP and traditional medical plan (P=0.11). Plan designs and regulatory policies demonstrated greater correlation between the SP and FF Exchanges, as compared to the SB Exchange. Parameters defining the pediatric dental benefit are complex and vary across states. Each state Exchange was subject to barriers in improving the quality of the pediatric dental benefit due to a lack of defined, standardized policy parameters and further legislative maturation is required.

  1. Entitlement to Sickness Benefits in Sweden: The Social Insurance Officers Experiences

    Directory of Open Access Journals (Sweden)

    Ulrika Müssener

    2008-01-01

    Full Text Available Background: Social insurance offices (SIOs handle a wide range of complex assessments of the entitlement to sickness benefits for an increasing number of clients on sick leave and consequently, the demands on the SIOs have increased considerably.Aim: To gain deeper knowledge of the problems experienced by the SIOs in their work associated with entitlement to sickness benefits.Method: A descriptive and explorative qualitative approach was used to analyse data from two focus-group interviews, including six participants in each group.Results: The participants discussed different dilemmas in regard to; physicians’ responsibility for issuing sickness certificates, interactions with the insured individuals, disclosure of decisions, communications with medical consultants, documentation of sickness benefit claims, threats in the workplace, as well as their own competence. The SIOs regarded incomplete information on sickness certificates as a main problem, because they frequently had to contact the client and the physicians who issued the certificates in order to obtain further details, leading to delays in the decision-making whether to grant sickness benefits.Conclusions: More knowledge regarding SIOs work is required to improve the methods used in the sickness insurance system and to ensure adequate training of new staff members.

  2. A Case Study on the Implementation of Local Health Insurance Benefit Packages

    Directory of Open Access Journals (Sweden)

    Supriyantoro Supriyantoro

    2015-06-01

    Full Text Available Background: The variation of benefit packages implemented by some local social health insurance schemes (Jamkesda become an important issue in the effort to integrating them into National Health Insurance (JKN. This study aims to describe implementation of Jamkesda’s benefit packages as a basic consideration in integration to JKN. Methods: Design of this study is case study with qualitative and quantitative aproaches, conducted 2013–2014 in all of districts/cities which already have Jamkesda. Primary and secondary data was collected. Primary data has been collected by focus group discussion, interview, observation, and self administered questioner. Secondary data collected from many sources such as articles, journal, official document, statistics data, and others. Results:Of this study show there is no significant relationship between fiscal capacity group and benefit packages (continuity correction, p value = 0.065. But, districts/cities with high fiscal capacity (high and very high seem likely to have probability 1,920 bigger than lower capacity districts/cities in giving equal or more benefit than existing national social health insurance (Jamkesmas (Mantel-Haenszel, Common Odds Ratio Estimates = 1.920; Confidence Interval 95% =1.008–3.658; asymp. Sig 2 sided = 0.047. There is variation of benefit packages between each Jamkesda. Qualitative results show there are many obstacles faced in giving benefit health services, such as limited community accessibility to health facilities, the absence of health workforce, and lack of health infrastructure and equipment. Recomendation: This study recommends to set a national minimum benefit packages and equalizing percetion of local decission maker.

  3. No survival benefit to gaining private health insurance coverage for post-lung transplant care in adults with cystic fibrosis.

    Science.gov (United States)

    Tumin, Dmitry; Foraker, Randi E; Tobias, Joseph D; Hayes, Don

    2016-03-01

    The use of public insurance is associated with diminished survival in patients with cystic fibrosis (CF) following lung transplantation. No data exist on benefits of gaining private health insurance for post-transplant care among such patients previously using public insurance. The United Network for Organ Sharing database was used to identify first-time lung transplant recipients participating in Medicare or Medicaid, diagnosed with CF, and transplanted between 2005 and 2015. Survival outcomes were compared between recipients gaining private insurance after transplantation and those maintaining public coverage throughout follow-up. Since implementation of the lung allocation score, 575 adults with CF received lung transplantation funded by Medicare or Medicaid and contributed data on insurance status post-transplant. There were 128 (22%) patients who gained private insurance. Multivariable analysis of time-varying insurance status found no survival benefit of gaining private insurance (HR = 0.822; 95% CI = 0.525, 1.286; p = 0.390). Further analysis demonstrated that resuming public insurance coverage was detrimental, relative to gaining and keeping private insurance (HR = 2.315; 95% CI = 1.020, 5.258; p = 0.045). Survival disadvantages of lung transplant recipients with CF who have public health insurance were not ameliorated by a switch to private coverage for post-transplant care. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  4. Should Governments engage health insurance intermediaries? A comparison of benefits with and without insurance intermediary in a large tax funded community health insurance scheme in the Indian state of Andhra Pradesh.

    Science.gov (United States)

    Nagulapalli, Srikant; Rokkam, Sudarsana Rao

    2015-09-10

    A peculiar phenomenon of engaging insurance intermediaries for government funded health insurance schemes for the poor, not usually found globally, is gaining ground in India. Rajiv Aarogyasri Scheme launched in the Indian state of Andhra Pradesh, is first largest tax funded community health insurance scheme in the country covering more than 20 million poor families. Aarogyasri Health Care Trust (trust), the scheme administrator, transfers funds to hospitals through two routes one, directly and the other through an insurance intermediary. The objective of this paper is to find out if engaging an insurance intermediary has any effect on cost efficiency of the insurance scheme. We used payment data of RAS for the period 2007-12, to find out the influence of insurance intermediary on the two variables, benefit cost ratio defined as benefit payment divided by premium payment, and claim denial ratio defined as benefit payment divided by treatment cost. Relationship between scheme expenditure and number of beds empanelled under the scheme is examined. OLS regression is used to perform all analyses. We found that adding an additional layer of insurance intermediary between the trust and hospitals reduced the benefit cost ratio under the scheme by 12.2% (p-value = 0.06). Every addition of 100 beds under the scheme increases the scheme payments by US$ 0.75 million (p-value insurance and trust modes narrowed down from 2.84% in government hospitals to 0.41% in private hospitals (p-value insurance intermediary has the twin effects of reduction in benefit payments to beneficiaries, and chocking fund flow to government hospitals. The idea of engaging insurance intermediary should be abandoned.

  5. The affect of loyal customer concentration benefits when choosing banking and insurance service provider, Case: Etelä-Karjalan Osuuspankki

    OpenAIRE

    Suhonen, Sari

    2013-01-01

    The objective of this thesis was to examine how the loyal customer concentration benefits affect when a customer is choosing a banking and insurance service provider. The loyal customer concentration benefits are used in OP-Pohjola Group but this research only concerns Etelä-Karjalan Osuuspankki’s loyal customer concentration benefits. The purpose of the research was also to gain information about what clients think about these benefits: what benefits are important and how these benefits can ...

  6. The Health Effects of US Unemployment Insurance Policy: Does Income from Unemployment Benefits Prevent Cardiovascular Disease?

    Science.gov (United States)

    Walter, Stefan; Glymour, Maria; Avendano, Mauricio

    2014-01-01

    Objective Previous studies suggest that unemployment predicts increased cardiovascular disease (CVD) risk, but whether unemployment insurance programs mitigate this risk has not been assessed. Exploiting US state variations in unemployment insurance benefit programs, we tested the hypothesis that more generous benefits reduce CVD risk. Methods Cohort data came from 16,108 participants in the Health and Retirement Study (HRS) aged 50–65 at baseline interviewed from 1992 to 2010. Data on first and recurrent CVD diagnosis assessed through biennial interviews were linked to the generosity of unemployment benefit programmes in each state and year. Using state fixed-effect models, we assessed whether state changes in the generosity of unemployment benefits predicted CVD risk. Results States with higher unemployment benefits had lower incidence of CVD, so that a 1% increase in benefits was associated with 18% lower odds of CVD (OR:0.82, 95%-CI:0.71–0.94). This association remained after introducing US census regional division fixed effects, but disappeared after introducing state fixed effects (OR:1.02, 95%-CI:0.79–1.31).This was consistent with the fact that unemployment was not associated with CVD risk in state-fixed effect models. Conclusion Although states with more generous unemployment benefits had lower CVD incidence, this appeared to be due to confounding by state-level characteristics. Possible explanations are the lack of short-term effects of unemployment on CVD risk. Future studies should assess whether benefits at earlier stages of the life-course influence long-term risk of CVD. PMID:25025281

  7. Benefit requirements for substance use disorder treatment in state health insurance exchanges.

    Science.gov (United States)

    Tran Smith, Bikki; Seaton, Kathleen; Andrews, Christina; Grogan, Colleen M; Abraham, Amanda; Pollack, Harold; Friedmann, Peter; Humphreys, Keith

    2018-01-01

    Established in 2014, state health insurance exchanges have greatly expanded substance use disorder (SUD) treatment coverage in the United States as qualified health plans (QHPs) within the exchanges are required to conform to parity provisions laid out by the Affordable Care Act and the Mental Health Parity and Addiction Equity Act (MHPAEA). Coverage improvements, however, have not been even as states have wide discretion over how they meet these regulations. How states regulate SUD treatment benefits offered by QHPs has implications for the accessibility and quality of care. In this study, we assessed the extent to which state insurance departments regulate the types of SUD services and medications plans must provide, as well as their use of utilization controls. Data were collected as part of the National Drug Abuse Treatment System Survey, a nationally-representative, longitudinal study of substance use disorder treatment. Data were obtained from state Departments of Insurance via a 15-minute internet-based survey. States varied widely in regulations on QHPs' administration of SUD treatment benefits. Some states required plans to cover all 11 SUD treatment services and medications we assessed in the study, whereas others did not require plans to cover anything at all. Nearly all states allowed the plans to employ utilization controls, but reported little guidance regarding how they should be used. Although some states have taken full advantage of the health insurance exchanges to increase access to SUD treatment, others seem to have done the bare minimum required by the ACA. By not requiring coverage for the entire SUD continuum of care, states are hindering client access to appropriate types of care necessary for recovery.

  8. Exploring participatory behaviour of disability benefit claimants from an insurance physician's perspective.

    Science.gov (United States)

    Sjobbema, Christiaan; van der Mei, Sijrike; Cornelius, Bert; van der Klink, Jac; Brouwer, Sandra

    2018-08-01

    In the Dutch social security system, insurance physicians (IPs) assess participatory behaviour as part of the overall disability claim assessment. This study aims to explore the views and opinions of IPs regarding participatory behaviour as well as factors related to inadequate participatory behaviour, and to incorporate these factors in the International Classification of Functioning, Disability and Health (ICF) biopsychosocial framework. This qualitative study collected data by means of open-ended questions in 10 meetings of local peer review groups (PRGs) which included a total of 78 IPs of the Dutch Social Security Institute. In addition, a concluding discussion meeting with 8 IPs was organized. After qualitative data analyses, four major themes emerged: (1) participation as an outcome, (2) efforts of disability benefit claimants in the process of participatory behaviour, (3) beliefs of disability benefit claimants concerning participation, and (4) recovery behaviour. Identified factors of inadequate participatory behaviour covered all ICF domains, including activities, environmental, and personal factors, next to factors related to health condition and body functions or structures. Outcomes of the discussion meeting indicated the impossibility of formulating general applicable criteria for quantifying and qualifying participatory behaviour. Views of IPs on disability benefit claimants' (in)adequate participatory behaviour reflect a broad biopsychosocial perspective. IPs adopt a nuanced tailor-made approach during assessment of individual disability benefit claimants' participatory behaviour and related expected activities aimed at recovery of health and RTW. Implications for Rehabilitation Within a biopsychosocial perspective, it is not possible to formulate general criteria for the assessment of participatory behaviour for each unique case. Individual disability benefit claimant characteristics and circumstances are taken into account. To optimize the return

  9. 78 FR 64873 - Federal Employees Health Benefits Program and Federal Employees Dental and Vision Insurance...

    Science.gov (United States)

    2013-10-30

    ... family members under the FEHB and the Federal Employees Dental and Vision Insurance Program (FEDVIP... procedure, Government employees, Health facilities, Health insurance, Health professions, Hostages, Iraq... Administrative practice and procedure, Government employees, Health insurance, Taxes, Wages. 5 CFR Part 894...

  10. Preferences for benefit packages for community-based health insurance: an exploratory study in Nigeria

    Directory of Open Access Journals (Sweden)

    Nnenna Tasie

    2010-06-01

    Full Text Available Abstract Background It is important that community-based health insurance (CBHI schemes are designed in such a way as to ensure the relevance of the benefit packages to potential clients. Hence, this paper provides an understanding of the preferred benefit packages by different economic status groups as well as urban and rural dwellers for CBHI in Southeast Nigeria. Methods The study took place in rural, urban and semi-urban communities of south-east Nigeria. A questionnaire was used to collect information from 3070 randomly picked household heads. Focus group discussions were used to collect qualitative data. Data was examined for links between preferences for benefit packages with SES and geographic residence of the respondents. Results Respondents in the rural areas and in the lower SES preferred a comprehensive benefit package which includes all inpatient, outpatient and emergencies services, while those in urban areas as well as those in the higher SES group showed a preference for benefit packages which will cover only basic disease control interventions. Conclusion Equity concerns in preferences for services to be offered by the CBHI scheme should be addressed for CBHI to succeed in different contexts.

  11. Preferences for benefit packages for community-based health insurance: an exploratory study in Nigeria.

    Science.gov (United States)

    Onwujekwe, Obinna; Onoka, Chima; Uguru, Nkoli; Nnenna, Tasie; Uzochukwu, Benjamin; Eze, Soludo; Kirigia, Joses; Petu, Amos

    2010-06-12

    It is important that community-based health insurance (CBHI) schemes are designed in such a way as to ensure the relevance of the benefit packages to potential clients. Hence, this paper provides an understanding of the preferred benefit packages by different economic status groups as well as urban and rural dwellers for CBHI in Southeast Nigeria. The study took place in rural, urban and semi-urban communities of south-east Nigeria. A questionnaire was used to collect information from 3070 randomly picked household heads. Focus group discussions were used to collect qualitative data. Data was examined for links between preferences for benefit packages with SES and geographic residence of the respondents. Respondents in the rural areas and in the lower SES preferred a comprehensive benefit package which includes all inpatient, outpatient and emergencies services, while those in urban areas as well as those in the higher SES group showed a preference for benefit packages which will cover only basic disease control interventions. Equity concerns in preferences for services to be offered by the CBHI scheme should be addressed for CBHI to succeed in different contexts.

  12. Reducing Employee Health Insurance Benefits: The Effect of McGann and the Americans with Disabilities Act.

    Science.gov (United States)

    Julian, Frank H.

    1994-01-01

    The impact of a court decision (McGann vs. H&H Music) concerning reduction of employee health insurance benefits in a case of Acquired Immune Deficiency Syndrome (AIDS) and the federal Americans with Disabilities Act on college decisions regarding reduction of benefits is examined. Recommendations for college are offered. (MSE)

  13. [Brachytherapy for Prostate Cancer: Potentials and Limitations of Social Health Insurance Data for Benefit Assessment].

    Science.gov (United States)

    Horenkamp-Sonntag, D; Linder, R; Engel, S; Verheyen, F

    2016-05-01

    Due to the insufficient data base the Federal Joint Committee (G-BA) had in 2009 after 7 years of deliberation decided to initiate consultation regarding ambulatory brachytherapy for localised prostate cancer for 10 years from social health insurance (SHI) benefits. The aim is to gain more findings by means of comparative studies. Based on the non-availability of clinical primary data of a methodologically acceptable level, it was analysed to what extent secondary data of the SHI may be used in order to arrive at valid conclusions for benefit aspects. As base approx. 8 million insured of TK with their data of cost reimbursement between 2006 and 2011 were considered. In SHI secondary data no clinical information regarding tumour stage and other prognostic factors are available. Therefore, a novel method with therapy-specific multisectoral inclusion and exclusion criteria, respectively, was developed in order to differentiate between localised and advanced tumours of the prostate. Overall survival, relapse-free survival, event-free survival and side-effects associated to prostate cancer were analysed. Out of 87 822 insured persons with the diagnosis prostate cancer, 795 with PBT, 10 936 with RP and 1 925 with EBRT were investigated in detail. The 4-year event-free survival rate was 73% for RP, 77% for PBT and 71% for EBRT. Many prostate cancer-specific side effects appeared already before intervention. Side effects of the intestinal tract (23.8%) and sexual impairments (26.5%) were more frequent for EBRT than for RP (17.1%/14.8%) and PBT (16.4%/13.2%). By means of SHI secondary data and adequate operationalisation important findings regarding relevant aspects of prostate cancer in healthcare research can be generated. However, these hold methodological limitations and are not suited to draw valid conclusions for benefit assessment. Based solely on SHI routine data valid statements regarding comparative benefit assessment are limited. Limitations could be

  14. Impact of state mandatory insurance coverage on the use of diabetes preventive care

    Directory of Open Access Journals (Sweden)

    Barker Lawrence

    2010-05-01

    Full Text Available Abstract Background 46 U.S. states and the District of Columbia have passed laws and regulations mandating that health insurance plans cover diabetes treatment and preventive care. Previous research on state mandates suggested that these policies had little impact, since many health plans already covered the benefits. Here, we analyze the contents of and model the effect of state mandates. We examined how state mandates impacted the likelihood of using three types of diabetes preventive care: annual eye exams, annual foot exams, and performing daily self-monitoring of blood glucose (SMBG. Methods We collected information on diabetes benefits specified in state mandates and time the mandates were enacted. To assess impact, we used data that the Behavioral Risk Factor Surveillance System gathered between 1996 and 2000. 4,797 individuals with self-reported diabetes and covered by private insurance were included; 3,195 of these resided in the 16 states that passed state mandates between 1997 and 1999; 1,602 resided in the 8 states or the District of Columbia without state mandates by 2000. Multivariate logistic regression models (with state fixed effect, controlling for patient demographic characteristics and socio-economic status, state characteristics, and time trend were used to model the association between passing state mandates and the usage of the forms of diabetes preventive care, both individually and collectively. Results All 16 states that passed mandates between 1997 and 1999 required coverage of diabetic monitors and strips, while 15 states required coverage of diabetes self management education. Only 1 state required coverage of periodic eye and foot exams. State mandates were positively associated with a 6.3 (P = 0.04 and a 5.8 (P = 0.03 percentage point increase in the probability of privately insured diabetic patient's performing SMBG and simultaneous receiving all three preventive care, respectively; state mandates were not

  15. The association between insured male expatriates' knowledge of health insurance benefits and lack of access to health care in Saudi Arabia.

    Science.gov (United States)

    Alkhamis, Abdulwahab A

    2018-03-15

    Insufficient knowledge of health insurance benefits could be associated with lack of access to health care, particularly for minority populations. This study aims to assess the association between expatriates' knowledge of health insurance benefits and lack of access to health care. A cross-sectional study design was conducted from March 2015 to February 2016 among 3398 insured male expatriates in Riyadh, Saudi Arabia. The dependent variable was binary and expresses access or lack of access to health care. Independent variables included perceived and validated knowledge of health insurance benefits and other variables. Data were summarized by computing frequencies and percentage of all quantities of variables. To evaluate variations in knowledge, personal and job characteristics with lack of access to health care, the Chi square test was used. Odds ratio (OR) and 95% confidence interval (CI) were recorded for each independent variable. Multiple logistic regression and stepwise logistic regression were performed and adjusted ORs were extracted. Descriptive analysis showed that 15% of participants lacked access to health care. The majority of these were unskilled laborers, usually with no education (17.5%), who had been working for less than 3 years (28.1%) in Saudi Arabia. A total of 23.3% worked for companies with less than 50 employees and 16.5% earned less than 4500 Saudi Riyals monthly ($1200). Many (20.3%) were young (English (16.7%) and lacked previous knowledge of health insurance (18%). For perceived knowledge of health insurance, 55.2% scored 1 or 0 from total of 3. For validated knowledge, 16.9% scored 1 or 0 from total score of 4. Multiple logistic regression analysis showed that only perceived knowledge of health insurance had significant associations with lack of access to health care ((OR) = 0.393, (CI) = 0.335-0.461), but the result was insignificant for validated knowledge. Stepwise logistic regression gave similar findings. Our results

  16. Increasing health insurance coverage through an extended Federal Employees Health Benefits Program.

    Science.gov (United States)

    Fuchs, B C

    2001-01-01

    The Federal Employees Health Benefits Program (FEHBP) could be combined with health insurance tax credits to extend coverage to the uninsured. An extended FEHBP, or "E-FEHBP," would be open to all individuals who were not covered through work or public programs and who also were eligible for the tax credits on the basis of income. E-FEHBP also would be open to employees of very small firms, regardless of their eligibility for tax credits. Most plans available to FEHBP participants would be required to offer enrollment to E-FEHBP participants, although premiums would be rated separately. High-risk individuals would be diverted to a separate high-risk pool, the cost of which would be subsidized by the federal government. E-FEHBP would be administered by the states, or if a state declined, by an entity that contracted with the Office of Personnel Management. While E-FEHBP would provide group insurance to people who otherwise could not get it, premiums could exceed the tax-credit amount and some people still might find the coverage unaffordable.

  17. Private health insurance and the Pharmaceutical Benefits Scheme: how effective has recent government policy been?

    Science.gov (United States)

    Richardson, Jeff R J; Segal, Leonie

    2004-01-01

    The cost to government of the Pharmaceutical Benefits Scheme (PBS) is rising at over 10 percent per annum. The government subsidy to Private Health Insurance (PHI) is about $2.4 billion and rising. Despite this, the queues facing public patients - which were the primary justification for the assistance to PHI - do not appear to be shortening. Against this backdrop, we seek to evaluate recent policies. It is shown that the reason commonly given for the support of PHI - the need to preserve the market share of private hospitals and relieve pressure upon public hospitals - is based upon a factually incorrect analysis of the hospital sector in the last decade. It is similarly true that the 'problem' of rising pharmaceutical expenditures has been exaggerated. The common element in both sets of policies is that they result in cost shifting from the public to the private purse and have little to do with the quality or quantity of health services.

  18. Health insurance systems in five Sub-Saharan African countries: medicine benefits and data for decision making.

    Science.gov (United States)

    Carapinha, João L; Ross-Degnan, Dennis; Desta, Abayneh Tamer; Wagner, Anita K

    2011-03-01

    Medicine benefits through health insurance programs have the potential to improve access to and promote more effective use of affordable, high quality medicines. Information is lacking about medicine benefits provided by health insurance programs in Sub-Saharan Africa. We describe the structure of medicine benefits and data routinely available for decision-making in 33 health insurance programs in Ghana, Kenya, Nigeria, Tanzania and Uganda. Most programs surveyed were private, for profit schemes covering voluntary enrollees, mostly in urban areas. Almost all provide both inpatient and outpatient medicine benefits, with members sharing the cost of medicines in all programs. Some programs use strategies that are common in high-income countries to manage the medicine benefits, such as formularies, generics policies, reimbursement limits, or price negotiation. Basic data to monitor performance in delivering medicine benefits are available in most programs, but key data elements and the resources needed to generate useful management information from the available data are typically missing. Many questions remain unanswered about the design, implementation, and effects of specific medicines policies in the emerging and expanding health insurance programs in Sub-Saharan Africa. These include questions about the most effective medicines policy choices, given different corporate and organizational structures and resources; impacts of specific benefit designs on quality and affordability of care and health outcomes; and ways to facilitate use of routine data for monitoring. Technical capacity building, strong government commitment, and international donor support will be needed to realize the benefits of medicines coverage in emerging and expanding health insurance programs in Sub-Saharan Africa. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  19. Private finance of services covered by the National Health Insurance package of benefits in Israel.

    Science.gov (United States)

    Engelchin-Nissan, Esti; Shmueli, Amir

    2015-01-01

    Private health expenditure in systems of national health insurance has raised concern in many countries. The concern is mainly about the accessibility of care to the poor and the sick, and inequality in use and in health. The concern thus refers specifically to the care financed privately rather than to private health expenditure as defined in the national health accounts. To estimate the share of private finance in total use of services covered by the national package of benefits. and to relate the private finance of use to the income and health of the users. The Central Bureau of Statistics linked the 2009 Health Survey and the 2010 Incomes Survey. Twenty-four thousand five hundred ninety-five individuals in 7175 households were included in the data. Lacking data on the share of private finance in total cost of care delivered, we calculated instead the share of uses having any private finance-beyond copayments-in total uses, in primary, secondary, paramedical and total care. The probability of any private finance in each type of care is then related, using random effect logistic regression, to income and health state. Fifteen percent of all uses of care covered by the national package of benefits had any private finance. This rate ranges from 10 % in primary care, 16 % in secondary care and 31 % in paramedical care. Twelve percent of all uses of physicians' services had any private finance, ranging from 10 % in family physicians to 20 % in pulmonologists, psychiatrists, neurologists and urologists. Controlling for health state, richer individuals are more likely to have any private finance in all types of care. Controlling for income, sick individuals (1+ chronic conditions) are 30 % in total care and 60 % in primary care more likely to have any private finance compared to healthy individuals (with no chronic conditions). The national accounts' "private health spending" (39 % of total spending in 2010) is not of much use regarding equity of and

  20. Did the Affordable Care Act's Dependent Coverage Mandate Increase Premiums?

    OpenAIRE

    Briggs Depew; James Bailey

    2014-01-01

    We investigate the impact of the Affordable Care Act's dependent coverage mandate on insurance premiums. The expansion of dependent coverage under the ACA allows young adults to remain on their parent's private health insurance plans until the age of 26. We find that the mandate has led to a 2.5-2.8 percent increase in premiums for health insurance plans that cover children, relative to single-coverage plans. We find no evidence that the mandate caused an increase in the amount of the employe...

  1. Health insurance in practice: international variations in financing, benefits, and problems

    National Research Council Canada - National Science Library

    Glaser, William G

    1991-01-01

    In "Health Insurance in practice", the author pinpoints the strengths and weaknesses of health insurance programs in developing countries and uses a lessons-from-abroad approach to offer suggestions...

  2. Longevity expectations in the pension fund, insurance, and employee benefits industries.

    Science.gov (United States)

    Zhavoronkov, Alex

    2015-01-01

    Considerable progress has been made in many areas of biomedical science since the 1960s, suggesting likely increases in life expectancy and decreases in morbidity and mortality in the adult population. These changes may pose substantial risks to the pensions and benefits industries. While there is no significant statistical evidence demonstrating rapid decreases in mortality rates, there are conflicting opinions among demographers and biogerontologists on the biological limits of the human lifespan and trends in life expectancy. We administered a survey of the International Employee Benefits Association (IEBA), a large, international industry group. Industry professionals employed by consulting (35%), insurance (24%), pension (14%), and other (27%) companies responded to 32 questions. Respondents showed reasonably conservative views on the future of longevity and retirement, including that for women. The respondents formed their personal longevity expectations based on their family history and, to a lesser degree, on the actuarial life tables. Most of the sample expressed no desire to life past age 100 years, even if the enabling technologies required to maintain a healthy youthful state were available, and only a few respondents in the sample expressed a desire to live for the maximum period (at least) offered by the survey question. The majority of the respondents would not undergo any invasive procedures, and only 56% of the respondents would opt for noninvasive therapies to extend their healthy lifespans to 150 years of age if these were available.

  3. What should health insurance cover? A comparison of Israeli and US approaches to benefit design under national health reform.

    Science.gov (United States)

    Nissanholtz Gannot, Rachel; Chinitz, David P; Rosenbaum, Sara

    2018-04-01

    What health insurance should cover and pay for represents one of the most complex questions in national health policy. Israel shares with the US reliance on a regulated insurance market and we compare the approaches of the two countries regarding determining health benefits. Based on review and analysis of literature, laws and policy in the United States and Israel. The Israeli experience consists of selection of a starting point for defining coverage; calculating the expected cost of covered benefits; and creating a mechanism for updating covered benefits within a defined budget. In implementing the Affordable Care Act, the US rejected a comprehensive and detailed approach to essential health benefits. Instead, federal regulators established broadly worded minimum standards that can be supplemented through more stringent state laws and insurer discretion. Notwithstanding differences between the two systems, the elements of the Israeli approach to coverage, which has stood the test of time, may provide a basis for the United States as it renews its health reform debate and considers delegating decisions about coverage to the states. Israel can learn to emulate the more forceful regulation of supplemental and private insurance that characterizes health policy in the United States.

  4. National health insurance scheme: Are the artisans benefitting in Lagos state, Nigeria?

    Directory of Open Access Journals (Sweden)

    Princess C Campbell

    2016-01-01

    Full Text Available Background: Health insurance (HI can serve as a vital risk protection for families and small businesses and also increase access to priority health services. This study determined the knowledge, attitude of artisans toward HI as well as their health-seeking pattern and willingness to join the HI scheme. Methodology: This descriptive cross-sectional survey used a multistage sampling technique to recruit 260 participants, using self-designed, pretested, interviewer-administered questionnaire. Data were analyzed using Epi-info version 7.0. Chi-square test, Fisher′s exact test, and logistic regression were used for associations; the level of significance was set at 5%. Results: The respondents were predominantly male, i.e., 195 (75.0%, with a mean age of 32.36 + 6.20 years and mean income of N 29,000 + 5798.5 ($1 ~ N 161. Majority of the respondents, i.e., 226 (86.9% were not aware of HI. The overall knowledge was poor (6.5% and the main source of information was through radio/television (41.2%. Nearly, half of the respondents (33 out of 67 identified the concept of HI as a pool of contributors′ fund for only healthcare service. A high proportion of the respondents (27 out of 34 were aware of the benefits of HI, although majority, i.e., 27 (79.4% identified access to medication as the benefit. The majority of the respondents, i.e., 228 (87.7% expressed negative attitude toward the scheme; however, 76.5% were willing to join the HI scheme. Conclusion: The artisans had low awareness/poor knowledge of HI which translated to a negative attitude toward the scheme. There is need for an aggressive stakeholders′ enlightenment campaign for increasing coverage.

  5. An actuarial analysis shows that offering lung cancer screening as an insurance benefit would save lives at relatively low cost.

    Science.gov (United States)

    Pyenson, Bruce S; Sander, Marcia S; Jiang, Yiding; Kahn, Howard; Mulshine, James L

    2012-04-01

    Lung cancer screening is not established as a public health practice, yet the results of a recent large randomized controlled trial showed that screening with low-dose spiral computed tomography reduces lung cancer mortality. Using actuarial models, this study estimated the costs and benefits of annual lung cancer screening offered as a commercial insurance benefit in the high-risk US population ages 50-64. Assuming current commercial reimbursement rates for treatment, we found that screening would cost about $1 per insured member per month in 2012 dollars. The cost per life-year saved would be below $19,000, an amount that compares favorably with screening for cervical, breast, and colorectal cancers. Our results suggest that commercial insurers should consider lung cancer screening of high-risk individuals to be high-value coverage and provide it as a benefit to people who are at least fifty years old and have a smoking history of thirty pack-years or more. We also believe that payers and patients should demand screening from high-quality, low-cost providers, thus helping set an example of efficient system innovation.

  6. 77 FR 42914 - Federal Employees Health Benefits Program and Federal Employees Dental and Vision Insurance...

    Science.gov (United States)

    2012-07-20

    ... Federal Flexible Benefits Plan: Pre-Tax Payment of Health Benefits Premiums AGENCY: Office of Personnel... this proposed rule; and (4) update the Federal Flexible Benefits Plan: Pre-Tax Payment of Health...--FEDERAL FLEXIBLE BENEFITS PLAN: PRE-TAX PAYMENTS OF HEALTH BENEFITS PREMIUMS PROGRAM 8. The authority...

  7. Impacts of a new insurance benefit with capitated provider payment on healthcare utilization, expenditure and quality of medication prescribing in China

    NARCIS (Netherlands)

    Sun, Jing; Zhang, Xiaotian; Zhang, Zou; Wagner, Anita K.; Ross-Degnan, Dennis; Hogerzeil, Hans V.

    ObjectivesTo assess a new Chinese insurance benefit with capitated provider payment for common diseases in outpatients. MethodsLongitudinal health insurance claims data, health administrative data and primary care facility data were used to assess trajectories in outpatient visits, inpatient

  8. Managing Mandated Educational Change

    Science.gov (United States)

    Clement, Jennifer

    2014-01-01

    This paper explores teachers' perspectives on the management of mandated educational change in order to understand how it may be managed more effectively. A case study of teachers' responses to the introduction of a quality teaching initiative in two New South Wales schools found that while some teachers described the strong negative impact of…

  9. Jobs without benefits: the health insurance crisis faced by small businesses and their workers.

    Science.gov (United States)

    Robertson, Ruth; Stremikis, Kristof; Collins, Sara R; Doty, Michelle M; Davis, Karen

    2012-11-01

    The share of U.S. workers in small firms who were offered, eligible for, and covered by health insurance through their jobs has declined over the past decade. Less than half of workers in companies with fewer than 50 employees were both offered and eligible for health insurance through their jobs in 2010, down from 58 percent in 2003. In contrast, about 90 percent of workers in companies with 100 or more employees were offered and eligible for their employer's health plans in both 2003 and 2010. Workers in the smallest firms--and those with the lowest wages--continue to be less likely to get coverage from their employers and more likely to be uninsured than workers in larger firms or with higher wages. The Affordable Care Act includes new subsidies that will lower the cost of health insurance for small businesses and workers who must purchase coverage on their own.

  10. Structure of the physical therapy benefit in a typical Blue Cross Blue Shield preferred provider organization plan available in the individual insurance market in 2011.

    Science.gov (United States)

    Sandstrom, Robert W; Lehman, Jedd; Hahn, Lee; Ballard, Andrew

    2013-10-01

    The Affordable Care Act of 2010 establishes American Health Benefit Exchanges. The benefit design of insurance plans in state health insurance exchanges will be based on the structure of existing small-employer-sponsored plans. The purpose of this study was to describe the structure of the physical therapy benefit in a typical Blue Cross Blue Shield (BCBS) preferred provider organization (PPO) health insurance plan available in the individual insurance market in 2011. A cross-sectional survey design was used. The physical therapy benefit within 39 BCBS PPO plans in 2011 was studied for a standard consumer with a standard budget. First, whether physical therapy was a benefit in the plan was determined. If so, then the structure of the benefit was described in terms of whether the physical therapy benefit was a stand-alone benefit or part of a combined-discipline benefit and whether a visit or financial limit was placed on the physical therapy benefit. Physical therapy was included in all BCBS plans that were studied. Ninety-three percent of plans combined physical therapy with other disciplines. Two thirds of plans placed a limit on the number of visits covered. The results of the study are limited to 1 standard consumer, 1 association of insurance companies, 1 form of insurance (a PPO), and 1 PPO plan in each of the 39 states that were studied. Physical therapy is a covered benefit in a typical BCBS PPO health insurance plan. Physical therapy most often is combined with other therapy disciplines, and the number of covered visits is limited in two thirds of plans.

  11. When can insurers offer products that dominate delayed old-age pension benefit claiming?

    NARCIS (Netherlands)

    Sanders, L.; De Waegenaere, A.M.B.; Nijman, T.E.

    2013-01-01

    It is common practice for public pension schemes to offer individuals the option to delay benefit claiming until after the normal retirement age, and increase the annual benefit level as a result. Existing literature shows that for non-liquidity constrained individuals, delaying benefit claiming for

  12. The potential and peril of health insurance tobacco surcharge programs: evidence from Georgia's State Employees' Health Benefit Plan.

    Science.gov (United States)

    Liber, Alex C; Hockenberry, Jason M; Gaydos, Laura M; Lipscomb, Joseph

    2014-06-01

    A rapidly growing number of U.S. employers are charging health insurance surcharges for tobacco use to their employees. Despite their potential to price-discriminate, little systematic empirical evidence of the impacts of these tobacco surcharges has been published. We attempted to assess the impact of a health insurance surcharge for tobacco use on cessation among enrollees in Georgia's State Health Benefit Plan (GSHBP). We identified a group of enrollees in GSHBP who began paying the tobacco surcharge at the program's inception in July 2005. We examined the proportion of these enrollees who certified themselves and their family members as tobacco-free and no longer paid the surcharge through April 2011, and we defined this as implied cessation. We compared this proportion to a national expected annual 2.6% cessation rate. We also compared our observation group to a comparison group to assess surcharge avoidance. By April 2011, 45% of enrollees who paid a tobacco surcharge starting in July 2005 had certified themselves as tobacco-free. This proportion exceeded the expected cessation based on 3 times the national rate (p health insurance surcharges in changing behavior, are tempered by the important limitation that enrollees' certification of quitting was self-reported and not subject to additional, clinical verification.

  13. User experience with a health insurance coverage and benefit-package access: implications for policy implementation towards expansion in Nigeria.

    Science.gov (United States)

    Mohammed, Shafiu; Aji, Budi; Bermejo, Justo Lorenzo; Souares, Aurelia; Dong, Hengjin; Sauerborn, Rainer

    2016-04-01

    Developing countries are devising strategies and mechanisms to expand coverage and benefit-package access for their citizens through national health insurance schemes (NHIS). In Nigeria, the scheme aims to provide affordable healthcare services to insured-persons and their dependants. However, inclusion of dependants is restricted to four biological children and a spouse per user. This study assesses the progress of implementation of the NHIS in Nigeria, relating to coverage and benefit-package access, and examines individual factors associated with the implementation, according to users' perspectives. A retrospective, cross-sectional survey was done between October 2010 and March 2011 in Kaduna state and 796 users were randomly interviewed. Questions regarding coverage of immediate-family members and access to benefit-package for treatment were analysed. Indicators of coverage and benefit-package access were each further aggregated and assessed by unit-weighted composite. The additive-ordinary least square regression model was used to identify user factors that may influence coverage and benefit-package access. With respect to coverage, immediate-dependants were included for 62.3% of the users, and 49.6 rated this inclusion 'good' (49.6%). In contrast, 60.2% supported the abolishment of the policy restriction for non-inclusion of enrolees' additional children and spouses. With respect to benefit-package access, 82.7% of users had received full treatments, and 77.6% of them rated this as 'good'. Also, 14.4% of users had been refused treatments because they could not afford them. The coverage of immediate-dependants was associated with age, sex, educational status, children and enrolment duration. The benefit-package access was associated with types of providers, marital status and duration of enrolment. This study revealed that coverage of family members was relatively poor, while benefit-package access was more adequate. Non-inclusion of family members could

  14. The impact of unemployment insurance benefits on the probability of migration of the unemployed.

    Science.gov (United States)

    Gose, E; Paul, C

    1990-08-01

    "By ignoring individual unemployment compensation benefits and conditions of job termination, past migration research has concluded that personal unemployment doubles the likelihood of interstate labor-force migration. Findings from the present study indicate that aggregating the unemployed, without adjusting for these two factors, overstates the probability of migration for the involuntarily unemployed benefit recipient and understates the likelihood of migration for the voluntarily unemployed benefit recipient. The results suggest that federal discretionary unemployment-compensation programs, which are implemented during recessionary periods, likely serve to retard out-migration of those who are involuntarily unemployed." Data are from a 1982 sample of unemployed U.S. workers. excerpt

  15. The Identification of Incentive Effects of Benefit Exhaustion in Unemployment Insurance Systems

    DEFF Research Database (Denmark)

    Pico Geerdsen, Lars

    The paper examines the different assumptions which have been applied in the literature in order to identify the motivation effect of benefits exhaustion. The different assumptions are tested on a common data set.......The paper examines the different assumptions which have been applied in the literature in order to identify the motivation effect of benefits exhaustion. The different assumptions are tested on a common data set....

  16. Residential High-Speed Internet Among Those Likely to Benefit From an Online Health Insurance Marketplace.

    Science.gov (United States)

    Boudreaux, Michel H; Gonzales, Gilbert; Blewett, Lynn; Fried, Brett; Karaca-Mandic, Pinar

    2016-01-01

    Using data from the 2013 American Community Survey, we found that 24.3 million people (about 1 in 4) who were either eligible for Medicaid/Children's Health Insurance Program (CHIP) or appeared likely to shop for Qualified Health Plan (QHP) lacked residential high-speed Internet. Specifically, 28.6% or 18.9 million people eligible for Medicaid/CHIP and 17.1% or 5.5 million people who appeared likely to shop for a QHP did not have high-speed Internet in the home. For both the Medicaid/CHIP eligible and those likely to shop for a QHP, the proportion of people living in households without Internet varied substantially by race, geography, and other socio-demographic characteristics. © The Author(s) 2016.

  17. The Benefit Implications of Recent Trends in Flexible Staffing Arrangements. Staff Working Paper.

    Science.gov (United States)

    Houseman, Susan N.

    Workers in flexible staffing arrangementsincluding temporary agency, direct-hire temporary, on-call, and contract workersare much less likely than regular, direct-hire employees to be covered by laws mandating or regulating workplace benefits. They are also much less likely to receive pension, health insurance, and other benefits on the job.…

  18. [High and low use of insurance benefits. A comparison of 2 Norwegian municipalities--Båtsfjord in Finnmark and Vik in Sogn and Fjordane].

    Science.gov (United States)

    Grünfeld, B; Noreik, K

    1991-04-10

    Health insurance benefits and social welfare support has been investigated in two municipalities in Norway, Båtsfjord in the northernmost part of the country and Vik, in the county of Sogn and Fjordane in the western region. Båtsfjord is mainly a fishing community and 30% of the inhabitants aged 16-66 were receiving health insurance benefits, as compared to 8% in Vik, where the main sources of income are agriculture, industry and tourism. More than half of the insurance benefits contributions were permanent pensions. In addition 12% of the population in Båtsfjord and 1% in Vik received social welfare benefits. Most of the recipients of these benefits were younger than 35 years. The authors discuss the main reasons for these differences in public economic support among residents of the two municipalities. Factors such as level of education, conditions on the labour market and attitudes among the population and health personnel concerning public economic assistance through the health insurance system seem to be conducive to the steadily higher consumption of public welfare benefits.

  19. Mental Health Insurance Parity and Provider Wages.

    Science.gov (United States)

    Golberstein, Ezra; Busch, Susan H

    2017-06-01

    Policymakers frequently mandate that employers or insurers provide insurance benefits deemed to be critical to individuals' well-being. However, in the presence of private market imperfections, mandates that increase demand for a service can lead to price increases for that service, without necessarily affecting the quantity being supplied. We test this idea empirically by looking at mental health parity mandates. This study evaluated whether implementation of parity laws was associated with changes in mental health provider wages. Quasi-experimental analysis of average wages by state and year for six mental health care-related occupations were considered: Clinical, Counseling, and School Psychologists; Substance Abuse and Behavioral Disorder Counselors; Marriage and Family Therapists; Mental Health Counselors; Mental Health and Substance Abuse Social Workers; and Psychiatrists. Data from 1999-2013 were used to estimate the association between the implementation of state mental health parity laws and the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act and average mental health provider wages. Mental health parity laws were associated with a significant increase in mental health care provider wages controlling for changes in mental health provider wages in states not exposed to parity (3.5 percent [95% CI: 0.3%, 6.6%]; pwages. Health insurance benefit expansions may lead to increased prices for health services when the private market that supplies the service is imperfect or constrained. In the context of mental health parity, this work suggests that part of the value of expanding insurance benefits for mental health coverage was captured by providers. Given historically low wage levels of mental health providers, this increase may be a first step in bringing mental health provider wages in line with parallel health professions, potentially reducing turnover rates and improving treatment quality.

  20. Connecting Capital and Catastrophe in a Modeled World - How re/insurance and public science interact to manage risk for societal benefit

    Science.gov (United States)

    Douglas, R.

    2010-12-01

    a common philosophy on the need for openness and transparency on modeling methodologies and results. The opportunities for future research and collaboration are significant. The re/insurance sector provides a fertile environment for developing refined research avenues on natural hazards and their social and economic impact. Meanwhile the financial aspects of insurance modelling enable possibilities for improving the scientific analysis from hazard, to risk and ultimately financial loss. This often assists in highlighting the importance and impact of research to funding agencies. Meanwhile re/insurer benefit from the knowledge, resources and rigour of public science. This invited talk with unpack these themes and provide case studies and perspectives of how the re/insurance sector and geophysical science communities can build upon this growing relationship for mutual benefit.

  1. Economic Effects of Legislations and Policies to Expand Mental Health and Substance Abuse Benefits in Health Insurance Plans: A Community Guide Systematic Review

    Science.gov (United States)

    Jacob, Verughese; Qu, Shuli; Chattopadhyay, Sajal; Sipe, Theresa Ann; Knopf, John A.; Goetzel, Ron Z.; Finnie, Ramona; Thota, Anilkrishna B.

    2015-01-01

    Background Health insurance plans have historically limited the benefits for mental health and substance abuse (MH/SA) services compared to benefits for physical health services. In recent years, legislative and policy initiatives in the U.S. have been taken to expand MH/SA health insurance benefits and achieve parity with physical health benefits. The relevance of these legislations for international audiences is also explored, particularly for the European context. Aims of the Study This paper reviews the evidence of costs and economic benefits of legislative or policy interventions to expand MH/SA health insurance benefits in the U.S. The objectives are to assess the economic value of the interventions by comparing societal cost to societal benefits, and to determine impact on costs to insurance plans resulting from expansion of these benefits. Methods The search for economic evidence covered literature published from January 1950 to March 2011 and included evaluations of federal and state laws or rules that expanded MH/SA benefits as well as voluntary actions by large employers. Two economists screened and abstracted the economic evidence of MH/SA benefits legislation based on standard economic and actuarial concepts and methods. Results The economic review included 12 studies: eleven provided evidence on cost impact to health plans, and one estimated the effect on suicides. There was insufficient evidence to determine if the intervention was cost-effective or cost-saving. However, the evidence indicates that MH/SA benefits expansion did not lead to any substantial increase in costs to insurance plans, measured as a percentage of insurance premiums. Discussion and Limitations This review is unable to determine the overall economic value of policies that expand MH/SA insurance benefits due to lack of cost-effectiveness and cost-benefit studies, predominantly due to the lack of evaluations of morbidity and mortality outcomes. This may be remedied in time when

  2. Legislations and policies to expand mental health and substance abuse benefits in health insurance plans: a community guide systematic economic review.

    Science.gov (United States)

    Jacob, Verughese; Qu, Shuli; Chattopadhyay, Sajal; Sipe, Theresa Ann; Knopf, John A; Goetzel, Ron Z; Finnie, Ramona; Thota, Anilkrishna B

    2015-03-01

    Health insurance plans have historically limited the benefits for mental health and substance abuse (MH/SA) services compared to benefits for physical health services. In recent years, legislative and policy initiatives in the U.S. have been taken to expand MH/SA health insurance benefits and achieve parity with physical health benefits. The relevance of these legislations for international audiences is also explored, particularly for the European context. This paper reviews the evidence of costs and economic benefits of legislative or policy interventions to expand MH/SA health insurance benefits in the U.S. The objectives are to assess the economic value of the interventions by comparing societal cost to societal benefits, and to determine impact on costs to insurance plans resulting from expansion of these benefits. The search for economic evidence covered literature published from January 1950 to March 2011 and included evaluations of federal and state laws or rules that expanded MH/SA benefits as well as voluntary actions by large employers. Two economists screened and abstracted the economic evidence of MH/SA benefits legislation based on standard economic and actuarial concepts and methods. The economic review included 12 studies: eleven provided evidence on cost impact to health plans, and one estimated the effect on suicides. There was insufficient evidence to determine if the intervention was cost-effective or cost-saving. However, the evidence indicates that MH/SA benefits expansion did not lead to any substantial increase in costs to insurance plans, measured as a percentage of insurance premiums. This review is unable to determine the overall economic value of policies that expanded MH/SA insurance benefits due to lack of cost-effectiveness and cost-benefit studies, predominantly due to the lack of evaluations of morbidity and mortality outcomes. This may be remedied in time when long-term MH/SA patient-level data becomes available to researchers. A

  3. Publication Of Administrative Circulars: No. 4 (Rev. 4) – Unemployment Insurance Scheme No. 30 (Rev. 2) – Financial Benefits on Taking Up Appointment and on Termination of Contract

    CERN Multimedia

    HR Department

    2008-01-01

    Administrative Circular No. 4 (Rev. 4) – Unemployment insurance scheme Administrative Circular No. 4 (Rev. 4) – "Unemployment insurance scheme", approved following discussion in the Standing Concertation Committee meetings of 28 August 2007 and 27 February 2008, is now available on the intranet site of the Human Resources Department. It cancels and replaces Administrative Circular No. 4 (Rev. 3) – "Unemployment insurance" of October 1993. Copies will shortly be available in Departmental secretariats. Human Resources Department Tel. 78003 Administrative Circular No. 30 (Rev. 2) – Financial benefits on taking up appointment and termination of contract Administrative Circular No. 30 (Rev. 2) – "Financial benefits on taking up appointment and termination of contract", approved following discussion in the Standing Concertation Committee meetings of 28 August 2007 and 27 February 2008, is now available on the intranet site of the Human Resources De...

  4. Publication Of Administrative Circulars: No. 4 (Rev. 4) – Unemployment Insurance Scheme No. 30 (Rev. 2) – Financial Benefits on Taking Up Appointment and on Termination of Contract

    CERN Document Server

    HR Department

    2008-01-01

    Administrative Circular No. 4 (Rev. 4) – Unemployment insurance scheme Administrative Circular No. 4 (Rev. 4) – "Unemployment insurance scheme", approved following discussion at the Standing Concertation Committee meetings of 28 August 2007 and 27 February 2008, is now available on the intranet site of the Human Resources Department. It cancels and replaces Administrative Circular No. 4 (Rev. 3) – "Unemployment insurance" of October 1993. Copies will shortly be available in Departmental secretariats. Human Resources Department Tel. 78003 Administrative Circular No. 30 (Rev. 2) – Financial benefits on taking up appointment and termination of contract Administrative Circular No. 30 (Rev. 2) – "Financial benefits on taking up appointment and termination of contract", approved following discussion at the Standing Concertation Committee meetings of 28 August 2007 and 27 February 2008, is now available on the intranet site of the Human Resources De...

  5. Child Abuse and Mandated Reporting

    Science.gov (United States)

    Woika, Shirley; Bowersox, Carissa

    2013-01-01

    Teachers and teachers-in-training are mandated reporters; they are legally required to report any suspected child abuse or neglect. This article describes: (1) How to file a report; (2) How prevalent child abuse is; (3) What abuse is; (4) What it means to be a mandated reporter; (5) When the report should be made; and (6) What to do if abuse is…

  6. Community preferences for a social health insurance benefit package: an exploratory study among the uninsured in Vietnam.

    Science.gov (United States)

    Nguyen, Hoa Thi; Luu, Tinh Viet; Leppert, Gerald; De Allegri, Manuela

    2017-01-01

    Understanding public preferences in terms of health benefit packages (HBPs) remains limited, yet gathering community insights is an important endeavour when developing people-centred health systems and moving towards universal health coverage. Our study aimed to address this gap in knowledge by eliciting community preferences for the social health insurance benefit package among the uninsured in Vietnam. We adopted a mixed methods approach that included a ranking exercise followed by focus group discussions. We collected quantitative and qualitative data from 174 uninsured people in Bac Giang, a province in northern Vietnam. Study participants were purposively selected from 12 communities and assembled in 14 group sessions that entailed three stages: participants first selected and ranked benefit items individually, then in groups and finally they engaged in a discussion regarding their decisions. The majority of respondents (both as individuals and as groups) preferred an HBP that covers both curative and preventive care, with a strong preference for the inclusion of high-cost care, resulting from rare and costly events (inpatient care), as well as frequent and less costly events (drugs, tests and outpatient care). The process of group discussion highlighted how individual choices could be modified in the context of group negotiation. The shift in preferences was motivated by the wish to protect low-income people from catastrophic expenditure while maximising community access to vital yet costly healthcare services. Future research, interventions and policies can built on this initial exploration of preferences to explore how stakeholders can engage communities and support greater public involvement in the development of HBPs in Vietnam and other low-income and middle-income countries.

  7. Social Security Rulings on Federal Old-Age, Survivors, Disability, Health Insurance, Supplemental Security Income, and Black Lung Benefits. Cumulative Bulletin 1976.

    Science.gov (United States)

    Social Security Administration (DHEW), Washington, DC.

    The purpose of this publication is to make available to the public official rulings relating to the Federal old-age, survivors, disability, health insurance, supplemental security income, and miners' benefit programs. The rulings contain precedential case decisions, statements of policy and interpretations of the law and regulations. Included is a…

  8. The Failure of Mandated Disclosures

    Directory of Open Access Journals (Sweden)

    Omri Ben-Shahar

    2017-06-01

    Full Text Available Objective to elaborate the conceptual theoreticallegal provisions and scientific recommendations for the substantiating the inefficiency of mandated disclosure. Methods general dialectic method of cognition as well as the general scientific and specific legal methods of research based on it. Results the article explores the spectacular prevalence and failure of the single most common technique for protecting personal autonomy in modern society mandated disclosure. The article has four parts 1 a comprehensive summary of the recurring use of mandated disclosures in many forms and circumstances in the areas of consumer and borrower protection patient informed consent contract formation and constitutional rights 2 a survey of the empirical literature documenting the failure of the mandated disclosure regime in informing people and in improving their decisions 3 an account of the multitude of reasons mandated disclosures fail focusing on the political dynamics underlying the enactments of these mandates the incentives of disclosers to carry them out and most importantly on the ability of disclosees to use them and 4 an argument that mandated disclosure not only fails to achieve its stated goal but also leads to unintended consequences that often harm the very people it intends to serve. Scientific novelty the article elaborates and introduces into academic sphere the substantiation of the efficiency of mandated disclosure proves the failure of the mandated disclosure regime in informing people and in improving their decisions and reveals the unintended consequences that often harm the very people it intends to serve. Practical significance the provisions ad conclusions of the article can be used in scientific lawmaking and lawenforcement activities and in the educational process of institutions of higher education.

  9. The Failure of Mandated Disclosure

    Directory of Open Access Journals (Sweden)

    Omri Ben-Shahar

    2017-12-01

    Full Text Available Objective to elaborate the conceptual theoreticallegal provisions and scientific recommendations for the substantiating the inefficiency of mandated disclosure. Methods general dialectic method of cognition as well as the general scientific and specific legal methods of research based on it. Results the article explores the spectacular prevalence and failure of the single most common technique for protecting personal autonomy in modern society mandated disclosure. The article has four parts 1 a comprehensive summary of the recurring use of mandated disclosures in many forms and circumstances in the areas of consumer and borrower protection patient informed consent contract formation and constitutional rights 2 a survey of the empirical literature documenting the failure of the mandated disclosure regime in informing people and in improving their decisions 3 an account of the multitude of reasons mandated disclosures fail focusing on the political dynamics underlying the enactments of these mandates the incentives of disclosers to carry them out and most importantly on the ability of disclosees to use them and 4 an argument that mandated disclosure not only fails to achieve its stated goal but also leads to unintended consequences that often harm the very people it intends to serve. Scientific novelty the article elaborates and introduces into academic sphere the substantiation of the efficiency of mandated disclosure proves the failure of the mandated disclosure regime in informing people and in improving their decisions and reveals the unintended consequences that often harm the very people it intends to serve. Practical significance the provisions ad conclusions of the article can be used in scientific lawmaking and lawenforcement activities and in the educational process of institutions of higher education.

  10. Disability Income Insurance

    OpenAIRE

    Hayhoe, Celia Ray; Smith, Mike, CPF

    2009-01-01

    The purpose of disability income insurance is to partially replace your income if you are unable to work because of sickness or an accident. This guide reviews the types of disability insurance, important terms and concepts and employer provided benefits.

  11. Federal Employees Health Benefits Program and Federal Employees Dental and Vision Insurance Program: eligibility for Pathway Programs participants. Interim final rule with request for comments.

    Science.gov (United States)

    2014-01-06

    The U.S. Office of Personnel Management (OPM) is issuing an interim final regulation to update the Federal Employees Health Benefits Program (FEHBP) and the Federal Employees Dental and Vision Insurance Program (FEDVIP) regulations to reflect updated election opportunities for participants in the Pathways Programs. The Pathways Programs were created by Executive Order (E.O.) 13562, signed by the President on December 27, 2010, and are designed to enable the Federal Government to compete effectively for students and recent graduates by improving its recruitment efforts through internships and similar programs with Federal agencies. This interim final rule furthers these recruitment and retention efforts by providing health insurance, as well as dental and vision benefits, to eligible program participants and their families.

  12. INSURANCE INTERMEDIARIES

    Directory of Open Access Journals (Sweden)

    Andreea Stoican

    2013-11-01

    Full Text Available The actual Civil code regulates for the first time in the Romanian legislation the intermediation contract, until its entering into force existing multiple situations that lent themselves to this legal operation, but did not benefit of such particular legal rules. Yet, the case law has shown that the situations that arise in the activity of the legal or natural persons are much more complex, this leading, in time, to the reglementation of such particular rules. Such a case is that found in the matter of insurance contracts, the position of the insurance intermediaries being regulated especially by Law no. 32/2000, according to which they represent the natural or legal persons authorized in the conditions of the above mentioned legal document, that perform intermediation activities in the insurance field, in exchange of a remuneration, as well as the intermediaries from the EU member states that perform such an activity on the Romanian territory, in accordance with the freedom in performing services. Therefore, the present paper aims to analyze the conclusion of such insurance contracts and to underline the particular position of the insurance brokers, having the following structure: 1 Introduction; 2 The reglementation of the intermediation contract/brokerage agreement in the Romanian Law; 3 The importance of the intermediaries in the insurance contracts; 4 The conclusion of the insurance contracts; 5 Conclusions.

  13. Impacts of health insurance benefit design on percutaneous coronary intervention use and inpatient costs among patients with acute myocardial infarction in Shanghai, China.

    Science.gov (United States)

    Yuan, Suwei; Liu, Yan; Li, Na; Zhang, Yunting; Zhang, Zhe; Tao, Jingjing; Shi, Lizheng; Quan, Hude; Lu, Mingshan; Ma, Jin

    2014-03-01

    Currently, the most popular hospital payment method in China is fee-for-service (FFS) with a global budget cap. As of December 2009, a policy change means that heart stents are covered by public health insurance, whereas previously they were not. This policy change provides us an opportunity to study how a change in insurance benefit affected the quantity and quality of hospital services. The new policy introduced incentives for both patients and providers: it encourages patient demand for percutaneous coronary intervention (PCI) services and stent use (moral hazard effect), and discourages hospital supply due to the financial pressures of the global cap (provider gaming effect). If the provider's gaming effect dominates the moral hazard effect, actual utilisation and costs might go down, and vice versa. Our hypothesis is that patients in the higher reimbursement groups will have fewer PCIs and lower inpatient costs. We aimed to examine the impact of health insurance benefit design on PCI and stent use, and on inpatient costs and out-of-pocket expenses for patients with acute myocardial infarction (AMI) in Shanghai. We included 720 patients with AMI (467 before the benefit change and 253 after) from a large teaching tertiary hospital in Shanghai. Data were collected via review of hospital medical charts, and from the hospital billing database. Patient information collected included demographic characteristics, medical history and procedure information. All patients were categorised into four groups according to their actual reimbursement ratio: high (90-100 %), moderate (80-90 %), low (0-80 %) and none (self-paid patients). Multiple regression and difference-in-difference (DID) models were used to investigate the impacts of the health insurance benefit design on PCI and stent use, and on total hospital costs and patients' out-of-pocket expenses. After the change in insurance benefit policy, compared with the self-paid group, PCI rates for the moderate and low

  14. Low-level waste injury: liability, insurance, and indemnification

    International Nuclear Information System (INIS)

    Merz, J.F.

    1986-01-01

    It would be worth developing compatible policies to address the issues involving third-party liabilities which remain unanswered before the different states and interstate compact agreements implementing the Low Level Radioactive Waste Policy Act develop a range of approaches. A plan that draws resources from a number of states would have economic and technological benefits, and could help ensure public confidence in the management of low level radioactive wastes. Interstate cooperation and coordination to produce such a plan would benefit from a Congressional mandate. An appendix arranged alphabetically by state illustrates the range of immunity/waiver, insurance, and limits that already exist

  15. Consequences of a Liquid Mandate

    DEFF Research Database (Denmark)

    Sörbom, Adrienne; Garsten, Christina

    This paper describes and answers the question how the WEF creates a strong position for itself in the global arena, without a formal and institutional mandate. Theoretically the paper builds and adds to emerging body of literature regarding partial organization, as framed by Ahrne and Brunsson (2...

  16. Medicaid and Children's Health Insurance Programs: essential health benefits in alternative benefit plans, eligibility notices, fair hearing and appeal processes, and premiums and cost sharing; exchanges: eligibility and enrollment. Final rule.

    Science.gov (United States)

    2013-07-15

    This final rule implements provisions of the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively referred to as the Affordable Care Act. This final rule finalizes new Medicaid eligibility provisions; finalizes changes related to electronic Medicaid and the Children's Health Insurance Program (CHIP) eligibility notices and delegation of appeals; modernizes and streamlines existing Medicaid eligibility rules; revises CHIP rules relating to the substitution of coverage to improve the coordination of CHIP coverage with other coverage; and amends requirements for benchmark and benchmark-equivalent benefit packages consistent with sections 1937 of the Social Security Act (which we refer to as ``alternative benefit plans'') to ensure that these benefit packages include essential health benefits and meet certain other minimum standards. This rule also implements specific provisions including those related to authorized representatives, notices, and verification of eligibility for qualifying coverage in an eligible employer-sponsored plan for Affordable Insurance Exchanges. This rule also updates and simplifies the complex Medicaid premium and cost sharing requirements, to promote the most effective use of services, and to assist states in identifying cost sharing flexibilities. It includes transition policies for 2014 as applicable.

  17. Can broader diffusion of value-based insurance design increase benefits from US health care without increasing costs? Evidence from a computer simulation model.

    Directory of Open Access Journals (Sweden)

    R Scott Braithwaite

    2010-02-01

    Full Text Available BACKGROUND: Evidence suggests that cost sharing (i.e.,copayments and deductibles decreases health expenditures but also reduces essential care. Value-based insurance design (VBID has been proposed to encourage essential care while controlling health expenditures. Our objective was to estimate the impact of broader diffusion of VBID on US health care benefits and costs. METHODS AND FINDINGS: We used a published computer simulation of costs and life expectancy gains from US health care to estimate the impact of broader diffusion of VBID. Two scenarios were analyzed: (1 applying VBID solely to pharmacy benefits and (2 applying VBID to both pharmacy benefits and other health care services (e.g., devices. We assumed that cost sharing would be eliminated for high-value services ($300,000 per life-year. All costs are provided in 2003 US dollars. Our simulation estimated that approximately 60% of health expenditures in the US are spent on low-value services, 20% are spent on intermediate-value services, and 20% are spent on high-value services. Correspondingly, the vast majority (80% of health expenditures would have cost sharing that is impacted by VBID. With prevailing patterns of cost sharing, health care conferred 4.70 life-years at a per-capita annual expenditure of US$5,688. Broader diffusion of VBID to pharmaceuticals increased the benefit conferred by health care by 0.03 to 0.05 additional life-years, without increasing costs and without increasing out-of-pocket payments. Broader diffusion of VBID to other health care services could increase the benefit conferred by health care by 0.24 to 0.44 additional life-years, also without increasing costs and without increasing overall out-of-pocket payments. Among those without health insurance, using cost saving from VBID to subsidize insurance coverage would increase the benefit conferred by health care by 1.21 life-years, a 31% increase. CONCLUSION: Broader diffusion of VBID may amplify benefits from

  18. Can broader diffusion of value-based insurance design increase benefits from US health care without increasing costs? Evidence from a computer simulation model.

    Science.gov (United States)

    Braithwaite, R Scott; Omokaro, Cynthia; Justice, Amy C; Nucifora, Kimberly; Roberts, Mark S

    2010-02-16

    Evidence suggests that cost sharing (i.e.,copayments and deductibles) decreases health expenditures but also reduces essential care. Value-based insurance design (VBID) has been proposed to encourage essential care while controlling health expenditures. Our objective was to estimate the impact of broader diffusion of VBID on US health care benefits and costs. We used a published computer simulation of costs and life expectancy gains from US health care to estimate the impact of broader diffusion of VBID. Two scenarios were analyzed: (1) applying VBID solely to pharmacy benefits and (2) applying VBID to both pharmacy benefits and other health care services (e.g., devices). We assumed that cost sharing would be eliminated for high-value services (value services ($100,000-$300,000 per life-year or unknown), and would be increased for low-value services (>$300,000 per life-year). All costs are provided in 2003 US dollars. Our simulation estimated that approximately 60% of health expenditures in the US are spent on low-value services, 20% are spent on intermediate-value services, and 20% are spent on high-value services. Correspondingly, the vast majority (80%) of health expenditures would have cost sharing that is impacted by VBID. With prevailing patterns of cost sharing, health care conferred 4.70 life-years at a per-capita annual expenditure of US$5,688. Broader diffusion of VBID to pharmaceuticals increased the benefit conferred by health care by 0.03 to 0.05 additional life-years, without increasing costs and without increasing out-of-pocket payments. Broader diffusion of VBID to other health care services could increase the benefit conferred by health care by 0.24 to 0.44 additional life-years, also without increasing costs and without increasing overall out-of-pocket payments. Among those without health insurance, using cost saving from VBID to subsidize insurance coverage would increase the benefit conferred by health care by 1.21 life-years, a 31% increase

  19. A utility theory approach for insurance pricing

    Directory of Open Access Journals (Sweden)

    Mohsen Gharakhani

    2015-11-01

    Full Text Available Providing insurance contract with “deductible” is beneficial for both insurer and insured. In this paper, we provide a utility modeling approach to handle insurance pricing and evaluate the tradeoff between discount benefit and deductible level. We analyze four different pricing problems of no insurance, full insurance coverage, insurance with β% deductible and insurance with D-dollar deductible based on a given utility function. A numerical example is also used to illustrate some interesting results.

  20. 78 FR 71476 - Health Insurance Providers Fee

    Science.gov (United States)

    2013-11-29

    .... The final regulations clarify that these benefits constitute health insurance when they are offered by... insurance. Limited Scope Dental and Vision Benefits The proposed regulations defined health insurance to... revising the definition of health insurance to exclude limited scope dental and vision benefits (sometimes...

  1. The impact of the healthcare system in Barbados (provision of health insurance and the benefit service scheme) on the use of herbal remedies by Christian churchgoers.

    Science.gov (United States)

    Cohall, D H; Scantlebury-Manning, T; Cadogan-McLean, C; Lallement, A; Willis-O'Connor, S

    2012-06-01

    To determine the impact of health insurance and the government's Benefit Service Scheme, a system that provides free drugs to treat mostly chronic illnesses to persons aged 16 to 65 years, on the use of herbal remedies by Christian churchgoers in Barbados. The eleven parishes of Barbados were sampled over a six-week period using a survey instrument developed and tested over a four-week period prior to administration. Persons were asked to participate and after written informed consent, they were interviewed by the research team. The data were analysed by the use of IBM SPSS version 19. The data were all nominal, so descriptive statistics including counts, the frequencies, odds ratios and percentages were calculated. More than half of the participants (59.2%) were female, a little less than a third (29.9%) were male, and one tenth of the participants (10.9%) did not indicate their gender The majority of the participants were between the ages of 41 and 70 years, with the age range of 51-60 years comprising 26.1% of the sample interviewed. Almost all of the participants were born in Barbados (92.5%). Approximately 33% of the respondents indicated that they used herbal remedies to treat various ailments including chronic conditions. The odds ratio of persons using herbal remedies and having health insurance to persons not using herbal remedies and having health insurance is 1.01 (95% CI 0.621, 1.632). There was an increase in the numbers of respondents using herbal remedies as age increased. This trend continued until the age group 71-80 years which showed a reduction in the use of herbal remedies, 32.6% of respondents compared with 38.3% of respondents in the 61-70-year category. The data demonstrated that only a third of the study population is using herbal remedies for ailments. Health insurance was not an indicator neither did it influence the use of herbal remedies by respondents. The use of herbal remedies may not be associated with affluence. The reduction in

  2. Outcomes of Kidney Transplantations Under the Philippine Health Insurance Corporation's Type Z Benefit Package at the National Kidney and Transplant Institute, Philippines.

    Science.gov (United States)

    Pamugas, G E P; Arakama, M-H I; Danguilan, R A; Ledesma, D

    2016-04-01

    Under the Universal Health Care Program of the Department of Health, the Philippine Health Insurance Corporation (PHIC) launched the Case Type Z benefit package for kidney transplantation, providing the largest amount (USD $13,300.00) for any single medical procedure. The objective of this study was to describe under the PHIC Case Type Z Benefit Package for kidney transplantation at the National Kidney and Transplant Institute and kidney transplantation outcomes under this package. Included in the benefit were standard risk recipients between 10 and 70 years of age with at least 1 human leukocyte antigen (HLA) DR match with the donor, panel-reactive antibody (PRA) less than 20%, and absence of donor-specific antibody (DSA). Previous transplantations, malignancy, hepatitis B and C, human immunodeficiency virus (HIV) positivity, cytomegalovirus (CMV) R-/D+, congestive heart failure, and liver cirrhosis were exclusion criteria. Patients were evaluated by a medical social worker according to their family's financial status. Since June 2012, a total of 261 patients have received the benefit, with 44 under service, 37 with fixed co-pay and 180 with variable co-pay. Of the living donor kidney transplants, 98% had immediate graft function, with 2.3% (6/261) acute rejection rates at 1 year. The total cost of hospitalization was within the benefit for living donor kidney transplants (less than USD 8000.00) but exceeded it in all cases of deceased donor kidney transplants. The successful use of and excellent outcomes under the Case Type Z benefit demonstrated how collaboration among government agencies, health care providers, and pharmaceutical companies could result in a program that improved the access to health care for Filipino patients with end-stage renal disease. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Assessing the impact of macroeconomic variables on pension benefits in Ghana: A case of Social Security and National Insurance Trust

    Directory of Open Access Journals (Sweden)

    Grace Ofori-Abebrese

    2017-10-01

    Full Text Available Background: One of the most pressing phases for all economic agents is post-retirement standard of living. Irrespective of the higher returns on pension contribution and varied pension reforms, there are possible factors that can render these pension benefits inadequate, which can affect the longevity of retirees. Studies conducted in other countries have concluded that inflation deteriorates the value of pension benefits. Aim: This study, thus, sought to assess the impact of some major economic indicators in the Ghanaian environment on pension benefits. Setting: This study was carried out in Ghana by obtaining quarterly data frequencies on pension benefits and economic indicators spanning the period 2000Q1 to 2014Q4. Method: The Auto-regressive Distributed Lag Model was utilised to examine the long run and short run dynamics of some major economic indicators and pension benefits. Results: The empirical evidence indicated that inflation deteriorates total pension benefits. Increasing monetary policy rate and depreciation of the domestic currency should be an issue to contend with only in the short run rather than in the long run. The study also found the prominence of the implementation of the National Pension Reform in 2008. Conclusion: The study concluded that if policy makers target the reduction in the monetary policy rate and the appreciation of the domestic currency in an effort to stabilise the value of total pension benefits in the long run, it would not be effective in the long run because of their insignificant nature. Policy makers should rather target inflation as the prime tool for stabilising the standard of living of retirees in the long run.

  4. Insuring against health shocks: Health insurance and household choices.

    Science.gov (United States)

    Liu, Kai

    2016-03-01

    This paper provides empirical evidence on the role of public health insurance in mitigating adverse outcomes associated with health shocks. Exploiting the rollout of a universal health insurance program in rural China, I find that total household income and consumption are fully insured against health shocks even without access to health insurance. Household labor supply is an important insurance mechanism against health shocks. Access to health insurance helps households to maintain investment in children's human capital during negative health shocks, which suggests that one benefit of health insurance could arise from reducing the use of costly smoothing mechanisms. Copyright © 2016 Elsevier B.V. All rights reserved.

  5. The Defense Base Act (DBA): The Federally Mandated Workers’ Compensation System for Overseas Government Contractors

    Science.gov (United States)

    2010-06-02

    savings since adopting single-source models for their DBA insurance in which contractors for each agency are required to purchase insurance from a single...set up a legally licensed insurance company, known generally as a captive insurer , to whom actuarially determined premiums are paid but ownership of...the cap that will not be replaced by DBA disability benefits. Because of this, KBR is essentially paying insurance on payroll that does not need to

  6. Health insurance basic actuarial models

    CERN Document Server

    Pitacco, Ermanno

    2014-01-01

    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 int...

  7. The Effect of Disability Insurance on Health Investment: Evidence from the Veterans Benefits Administration's Disability Compensation Program

    Science.gov (United States)

    Singleton, Perry

    2009-01-01

    I examine whether individuals respond to monetary incentives to detect latent medical conditions. The effect is identified by a policy that deemed diabetes associated with herbicide exposure a compensable disability under the Veterans Benefits Administration's Disability Compensation program. Since a diagnosis is a requisite for benefit…

  8. Health Insurance: Understanding Your Health Plan's Rules

    Science.gov (United States)

    ... to know what your insurance company is paying…Health Insurance: Understanding What It CoversRead Article >>Insurance & BillsHealth Insurance: Understanding What It CoversYour insurance policy lists a package of medical benefits such as tests, drugs, and treatment services. These ...

  9. The influence of gender and product design on farmers' preferences for weather-indexed crop insurance.

    Science.gov (United States)

    Akter, Sonia; Krupnik, Timothy J; Rossi, Frederick; Khanam, Fahmida

    2016-05-01

    Theoretically, weather-index insurance is an effective risk reduction option for small-scale farmers in low income countries. Renewed policy and donor emphasis on bridging gender gaps in development also emphasizes the potential social safety net benefits that weather-index insurance could bring to women farmers who are disproportionately vulnerable to climate change risk and have low adaptive capacity. To date, no quantitative studies have experimentally explored weather-index insurance preferences through a gender lens, and little information exists regarding gender-specific preferences for (and constraints to) smallholder investment in agricultural weather-index insurance. This study responds to this gap, and advances the understanding of preference heterogeneity for weather-index insurance by analysing data collected from 433 male and female farmers living on a climate change vulnerable coastal island in Bangladesh, where an increasing number of farmers are adopting maize as a potentially remunerative, but high-risk cash crop. We implemented a choice experiment designed to investigate farmers' valuations for, and trade-offs among, the key attributes of a hypothetical maize crop weather-index insurance program that offered different options for bundling insurance with financial saving mechanisms. Our results reveal significant insurance aversion among female farmers, irrespective of the attributes of the insurance scheme. Heterogeneity in insurance choices could however not be explained by differences in men's and women's risk and time preferences, or agency in making agriculturally related decisions. Rather, gendered differences in farmers' level of trust in insurance institutions and financial literacy were the key factors driving the heterogeneous preferences observed between men and women. Efforts to fulfill gender equity mandates in climate-smart agricultural development programs that rely on weather-index insurance as a risk-abatement tool are therefore

  10. Social health insurance

    CERN Document Server

    International Labour Office. Geneva

    1997-01-01

    This manual provides an overview of social health insurance schemes and looks at the development of health care policies and feasibility issues. It also examines the design of health insurance schemes, health care benefits, financing and costs and considers the operational and strategic information requirements.

  11. Social Security and Medicare Benefits

    Data.gov (United States)

    Social Security Administration — Cash benefits and rehabilitation benefits paid in each year from the Old-Age and Survivors Insurance, and Disability Insurance Trust Funds, and benefits paid from...

  12. HEALTH INSURANCE

    CERN Multimedia

    2000-01-01

    The CERN-AUSTRIA Agreement, which implemented CERN's health insurance scheme, expired on 31 December 1999.In accordance with CERN's rules, a call for tenders for the management of the health insurance scheme was issued and the contract was once again awarded to AUSTRIA. In June 1999, the Finance Committee thus authorised the Management to conclude a new contract with AUSTRIA, which came into force on 1st January 2000.Continuity is thus assured on favourable conditions and the transition from one contract to the other will entail no substantial changes in the system for those insured at CERN except for a few minor and purely formal amendmentsWHAT REMAINS UNCHANGEDThe list of benefits, i.e. the 'cover' provided by the system, is not changed;Neither is the reimbursement procedure.AUSTRIA's office at CERN and its opening hours as well as its city headquarters remain the same. The envelopes containing requests for reimbursement have had to be sent (since the end of 1998) to :Rue des Eaux-Vives 94Case postale 64021...

  13. Impact of out-of-pocket spending caps on financial burden of those with group health insurance.

    Science.gov (United States)

    Riggs, Kevin R; Buttorff, Christine; Alexander, G Caleb

    2015-05-01

    The Affordable Care Act (ACA) mandates that all private health insurance include out-of-pocket spending caps. Insurance purchased through the ACA's Health Insurance Marketplace may qualify for income-based caps, whereas group insurance will not have income-based caps. Little is known about how out-of-pocket caps impact individuals' health care financial burden. We aimed to estimate what proportion of non-elderly individuals with group insurance will benefit from out-of-pocket caps, and the effect that various cap levels would have on their financial burden. We applied the expected uniform spending caps, hypothetical reduced uniform spending caps (reduced by one-third), and hypothetical income-based spending caps (similar to the caps on Health Insurance Marketplace plans) to nationally representative data from the Medical Expenditure Panel Survey (MEPS). Participants were non-elderly individuals (aged health insurance in the 2011 and 2012 MEPS surveys (n =26,666). (1) The percentage of individuals with reduced family out-of-pocket spending as a result of the various caps; and (2) the percentage of individuals experiencing health care services financial burden (family out-of-pocket spending on health care, not including premiums, greater than 10% of total family income) under each scenario. With the uniform caps, 1.2% of individuals had lower out-of-pocket spending, compared with 3.8% with reduced uniform caps and 2.1% with income-based caps. Uniform caps led to a small reduction in percentage of individuals experiencing financial burden (from 3.3% to 3.1%), with a modestly larger reduction as a result of reduced uniform caps (2.9%) and income-based caps (2.8%). Mandated uniform out-of-pocket caps for those with group insurance will benefit very few individuals, and will not result in substantial reductions in financial burden.

  14. The Failure of Mandated Disclosures, part 3

    Directory of Open Access Journals (Sweden)

    Omri Ben-Shahar

    2017-09-01

    Full Text Available Objective to elaborate the conceptual theoreticallegal provisions and scientific recommendations for the substantiating the inefficiency of mandated disclosure. Methods general dialectic method of cognition as well as the general scientific and specific legal methods of research based on it. Results the article explores the spectacular prevalence and failure of the single most common technique for protecting personal autonomy in modern society mandated disclosure. The article has four parts 1 a comprehensive summary of the recurring use of mandated disclosures in many forms and circumstances in the areas of consumer and borrower protection patient informed consent contract formation and constitutional rights 2 a survey of the empirical literature documenting the failure of the mandated disclosure regime in informing people and in improving their decisions 3 an account of the multitude of reasons mandated disclosures fail focusing on the political dynamics underlying the enactments of these mandates the incentives of disclosers to carry them out and most importantly on the ability of disclosees to use them and 4 an argument that mandated disclosure not only fails to achieve its stated goal but also leads to unintended consequences that often harm the very people it intends to serve. Scientific novelty the article elaborates and introduces into academic sphere the substantiation of the efficiency of mandated disclosure proves the failure of the mandated disclosure regime in informing people and in improving their decisions and reveals the unintended consequences that often harm the very people it intends to serve. Practical significance the provisions ad conclusions of the article can be used in scientific lawmaking and lawenforcement activities and in the educational process of institutions of higher education.

  15. Medicaid and Children's Health Insurance Programs; Mental Health Parity and Addiction Equity Act of 2008; the Application of Mental Health Parity Requirements to Coverage Offered by Medicaid Managed Care Organizations, the Children's Health Insurance Program (CHIP), and Alternative Benefit Plans. Final rule.

    Science.gov (United States)

    2016-03-30

    This final rule will address the application of certain requirements set forth in the Public Health Service Act, as amended by the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008, to coverage offered by Medicaid managed care organizations, Medicaid Alternative Benefit Plans, and Children’s Health Insurance Programs.

  16. Cost-Benefit Performance of Robotic Surgery Compared with Video-Assisted Thoracoscopic Surgery under the Japanese National Health Insurance System.

    Science.gov (United States)

    Kajiwara, Naohiro; Patrick Barron, James; Kato, Yasufumi; Kakihana, Masatoshi; Ohira, Tatsuo; Kawate, Norihiko; Ikeda, Norihiko

    2015-01-01

    Medical economics have significant impact on the entire country. The explosion in surgical techniques has been accompanied by questions regarding actual improvements in outcome and cost-effectiveness, such as the da Vinci(®) Surgical System (dVS) compared with conventional video-assisted thoracic surgery (VATS). To establish a medical fee system for robot-assisted thoracic surgery (RATS), which is a system not yet firmly established in Japan. This study examines the cost benefit performance (CBP) based on medical fees compared with VATS and RATS under the Japanese National Health Insurance System (JNHIS) introduced in 2012. The projected (but as yet undecided) price in the JNHIS would be insufficient if institutions have less than even 200 dVS cases per year. Only institutions which perform more than 300 dVS operations per year would obtain a positive CBP with the projected JNHIS reimbursement. Thus, under the present conditions, it is necessary to perform at least 300 dVS operations per year in each institution with a dVS system to avoid financial deficit with current robotic surgical management. This may hopefully encourage a downward price revision of the dVS equipment by the manufacture which would result in a decrease in the cost per procedure.

  17. Insuring the uninsured: potential impact of Health Care Reform Act of 2010 on trauma centers.

    Science.gov (United States)

    Shafi, Shahid; Ogola, Gerald; Fleming, Neil; Rayan, Nadine; Kudyakov, Rustam; Barnes, Sunni A; Ballard, David J

    2012-11-01

    Viability of trauma centers is threatened by cost of care provided to patients without health insurance. The health care reform of 2010 is likely to benefit trauma centers by mandating universal health insurance by 2014. However, the financial benefit of this mandate will depend on the reimbursement provided. The study hypothesis was that compensation for the care of uninsured trauma patients at Medicare or Medicaid rates will lead to continuing losses for trauma centers. Financial data for first hospitalization were obtained from an urban Level I trauma center for 3 years (n = 6,630; 2006-2008) and linked with clinical information. Patients were grouped into five payments categories: commercial (29%), Medicaid (8%), Medicare (20%), workers' compensation (6%), and uninsured (37%). Prediction models for costs and payments were developed for each category using multiple regression models, adjusting for patient demographics, injury characteristics, complications, and survival. These models were used to predict payments that could be expected if uninsured patients were covered by different insurance types. Results are reported as net margin per patient (payments minus total costs) for each insurance type, with 95% confidence intervals, discounted to 2008 dollar values. Patients were typical for an urban trauma center (median age of 43 years, 66% men, 82% blunt, 5% mortality, and median length of stay 4 days). Overall, the trauma center lost $5,655 per patient, totaling $37.5 million over 3 years. These losses were encountered for patients without insurance ($14,343), Medicare ($4,838), and Medicaid ($15,740). Patients with commercial insurance were profitable ($5,295) as were those with workers' compensation ($6,860). Payments for the care of the uninsured at Medicare/Medicaid levels would lead to continued losses at $2,267 to $4,143 per patient. The health care reforms of 2010 would lead to continued losses for trauma centers if uninsured are covered with Medicare

  18. Optimal social insurance with linear income taxation

    DEFF Research Database (Denmark)

    Bovenberg, Lans; Sørensen, Peter Birch

    2009-01-01

    We study optimal social insurance aimed at insuring disability risk in the presence of linear income taxation. Optimal disability insurance benefits rise with previous earnings. Optimal insurance is incomplete even though disability risks are exogenous and verifiable so that moral hazard in disab...... in disability insurance is absent. Imperfect insurance is optimal because it encourages workers to insure themselves against disability by working and saving more, thereby alleviating the distortionary impact of the redistributive income tax on labor supply and savings.......We study optimal social insurance aimed at insuring disability risk in the presence of linear income taxation. Optimal disability insurance benefits rise with previous earnings. Optimal insurance is incomplete even though disability risks are exogenous and verifiable so that moral hazard...

  19. Unemployment Insurance and Inequality

    DEFF Research Database (Denmark)

    Larsen, Birthe; Waisman, Gisela

    This paper examines the impact of higher unemployment insurance on the fraction of the work force paying into an unemployment insurance fond, wage differences and therefore inquality and education letting worker initial wealth being important for the decisions and implied values. As usually higher...... educated workers receive a lower fraction of their wages as unemployment insurance, we consider how the impact on labour market performance and wage differences and thereby inequality differ dependent on whether educated or uneducated workers receive higher benefits. The model can help shed light...... on the the puzzle why only some workers, for given educational level, pay into an unemployment insurance fond, the lower wealth mobility than income mobility as well as the relative compressed wage structure in countries with generous social assistance as well as unemployment insurance for low income workers...

  20. [Remunerations, benefits and labor incentives perceived by health care workers in Peru: an analysis comparing the Ministry of Health and the Social Insurance, 2009].

    Science.gov (United States)

    Pardo, Karim; Andia, Marcelino; Rodriguez, Amado; Pérez, Walter; Moscoso, Betsy

    2011-06-01

    To describe the main characteristics of the general salaries situation and the incentive policies of health care workers of Peru, comparing them by their origin institution and type of contract. A mixed design study was done including both quantitative and qualitative components during 2008 and 2009 with both professional and technical personnel of the Ministry of Health (MINSA) and the Social Insurance (EsSalud) in Peru. The salary structure was primarily evaluated considering incentives, bonuses and other remunerations according to position, type of contract and work place. Remuneration and bonus policies at the national level are determined by the responsibilities and amount of time served. The type of contract is determined by the programs of the public system (DL 276) and the private system (DL 728), also by the Special Program of Contract Services Administration (CAS) and exclusively in MINSA contracting is determined by local health administration Committees (CLAS). The salary structure differs between both types of institutions, especially with respect to incentives and benefits. An special economic incentive for assistance (AETA) is unique to MINSA, but the proportion of assistance varies by region. The professionals of MINSA have lower salaries than those of EsSalud, in all types of contracts. A professional contracted through CAS generally has a lower salary than staff peers in MINSA, though this situation is reversed in EsSalud. The lowest salaries are found in contracts made through CLAS. The structure and salary amounts differ between MINSA and EsSalud, just as they differ by existing contracting types.

  1. Vaccines as Epidemic Insurance.

    Science.gov (United States)

    Pauly, Mark V

    2017-10-27

    This paper explores the relationship between the research for and development of vaccines against global pandemics and insurance. It shows that development in advance of pandemics of a portfolio of effective and government-approved vaccines does have some insurance properties: it requires incurring costs that are certain (the costs of discovering, developing, and testing vaccines) in return for protection against large losses (if a pandemic treatable with one of the vaccines occurs) but also with the possibility of no benefit (from a vaccine against a disease that never reaches the pandemic stage). It then argues that insurance against the latter event might usefully be offered to organizations developing vaccines, and explores the benefits of insurance payments to or on behalf of countries who suffer from unpredictable pandemics. These ideas are then related to recent government, industry, and philanthropic efforts to develop better policies to make vaccines against pandemics available on a timely basis.

  2. Vaccines as Epidemic Insurance

    Directory of Open Access Journals (Sweden)

    Mark V. Pauly

    2017-10-01

    Full Text Available This paper explores the relationship between the research for and development of vaccines against global pandemics and insurance. It shows that development in advance of pandemics of a portfolio of effective and government-approved vaccines does have some insurance properties: it requires incurring costs that are certain (the costs of discovering, developing, and testing vaccines in return for protection against large losses (if a pandemic treatable with one of the vaccines occurs but also with the possibility of no benefit (from a vaccine against a disease that never reaches the pandemic stage. It then argues that insurance against the latter event might usefully be offered to organizations developing vaccines, and explores the benefits of insurance payments to or on behalf of countries who suffer from unpredictable pandemics. These ideas are then related to recent government, industry, and philanthropic efforts to develop better policies to make vaccines against pandemics available on a timely basis.

  3. Knowledge and attitude towards dental insurance and utilization of dental services among insured and uninsured patients: A cross-sectional study

    Directory of Open Access Journals (Sweden)

    Radhika Maniyar

    2018-01-01

    Conclusion: Knowledge regarding dental insurance was poor in both groups, while the insured group showed a more positive attitude toward benefits of dental insurance. Utilization of dental services was seen more among insured group.

  4. THE IMPACT OF COOPERATION BETWEEN INSURERS AND BANKS ON THE DEVELOPMENT OF THE INSURANCE SYSTEM

    OpenAIRE

    Nataliya Prikazyuk; Ganna Oliynik

    2017-01-01

    The article highlights how the cooperation of insurance companies and banks affects the insurance system. Defined the concept of bancassurance, provided a brief description of the main bancassurance models in the context of their impact on the insurance system. Defined the main benefits and risks that accompany cooperation of insurance companies and banks within different models of association. It is noted that despite the generally accepted benefits of cooperation between insurers and banks,...

  5. 20 CFR 617.58 - Unemployment insurance.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Unemployment insurance. 617.58 Section 617.58 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR TRADE ADJUSTMENT ASSISTANCE... Unemployment insurance. Unemployment insurance payable to an adversely affected worker shall not be denied or...

  6. Change of Subsidiary Mandates in Emerging Markets

    DEFF Research Database (Denmark)

    Hansen, Michael W.; Petersen, Bent; Wad, Peter

    2011-01-01

    fails to conceptualize how the specificities of emerging market business environments affect subsidiary mandate evolution. The paper develops a theoretical model for business environment change influence on subsidiary mandates, and demonstrates how the model can capture much of recent years dramatic......In recent years, the activities of Danish MNCs in India have expanded dramatically. Previously dormant subsidiaries have been transformed into integral components in the global strategies of Danish MNCs, either as crucial cash cows catering to the rapidly growing Indian markets, or as platforms...

  7. Health Insurance

    Science.gov (United States)

    Health insurance helps protect you from high medical care costs. It is a contract between you and your ... Many people in the United States get a health insurance policy through their employers. In most cases, the ...

  8. Procedures and Criteria for the regulation of innovative non-medicinal technologies into the benefit catalogue of solidly financed health care insurances

    Directory of Open Access Journals (Sweden)

    Hagen, Anja

    2007-01-01

    Full Text Available Because great interest in an efficient range of effective medicinal innovations and achievements has arisen, many countries have introduced procedures to regulate the adoption of innovative non-medicinal technologies into the benefit catalogue of solidly financed health care insurances. With this as a background, this report will describe procedures for the adoption of innovative non-medicinal technologies by solidly financed health care insurances in Germany, England, Australia and Switzerland. This report was commissioned by the German Agency for Health Technology Assessment at the German Institute for Medical Documentation and Information.In order to find the relevant literature and information, systematic literature research, a hand search and a written survey were carried out. All the selected documents (chosen according to defined criteria for inclusion and exclusion were qualitatively evaluated, summarized and presented on a chart using a framework developed for this purpose. All the countries in this report require that some innovative non-medicinal technologies undergo evaluation by a central governing body. This evaluation is a prerequisite for adoption into the benefit catalogue. The process of evaluation can differ (e. g. the people and institutions concerned, the division of the synthesis of evidence and overall evaluation, processing the evidence. Similarities do exist, such as the size and composition of the governing bodies or the overreaching criteria according to which institutions must make their recommendations. This is how all the countries examined in this report determine how the benefits and effectiveness of the innovations, as well as their cost-effectiveness, can be chosen as criteria for the evaluation. Furthermore, there are many criteria which differ from country to country (social and ethical aspects, possible effects on the health system, etc. and which are also relevant to an evaluation. The preferred types of

  9. Insurance crisis

    International Nuclear Information System (INIS)

    Williams, P.L.

    1996-01-01

    The article discusses the effects of financing and technology advances on the availability of insurance for independent power producers operating gas turbines. Combined cycle units which require new materials and processes make it difficult to assess risk. Insurers are denying coverage, or raising prices and deductibles. Many lenders, however, are requiring insurance prior to financing. Some solutions proposed include information sharing by industry participants and insurers and increased risk acceptance by plant owners/operators

  10. Probabilistic Insurance

    NARCIS (Netherlands)

    Wakker, P.P.; Thaler, R.H.; Tversky, A.

    1997-01-01

    Probabilistic insurance is an insurance policy involving a small probability that the consumer will not be reimbursed. Survey data suggest that people dislike probabilistic insurance and demand more than a 20% reduction in premium to compensate for a 1% default risk. These observations cannot be

  11. Probabilistic Insurance

    NARCIS (Netherlands)

    P.P. Wakker (Peter); R.H. Thaler (Richard); A. Tversky (Amos)

    1997-01-01

    textabstractProbabilistic insurance is an insurance policy involving a small probability that the consumer will not be reimbursed. Survey data suggest that people dislike probabilistic insurance and demand more than a 20% reduction in the premium to compensate for a 1% default risk. While these

  12. Mandated Preparation Program Redesign: Kentucky Case

    Science.gov (United States)

    Browne-Ferrigno, Tricia

    2013-01-01

    This case study presents a chronicle of events spanning a decade in Kentucky that led to state policy changes for principal preparation and details the response to those mandated changes by professors at the University of Kentucky. Professors' collaborative efforts resulted in a new teacher leadership program and redesigned principal certification…

  13. Changes in out-of-pocket costs for hormonal IUDs after implementation of the Affordable Care Act: an analysis of insurance benefit inquiries.

    Science.gov (United States)

    Bearak, Jonathan M; Finer, Lawrence B; Jerman, Jenna; Kavanaugh, Megan L

    2016-02-01

    The Affordable Care Act (ACA) requires that privately insured women can obtain contraceptive services and supplies without cost sharing. This may substantially affect women who prefer an intrauterine device (IUD), a long-acting reversible contraceptive, because of high upfront costs that they would otherwise face. However, imperfect enforcement of and exceptions to this provision could limit its effect. We analyzed administrative data for 417,221 women whose physicians queried their insurance plans from January 2012 to March 2014 to determine whether each woman had insurance coverage for a hormonal IUD and the extent of that coverage. In January 2012, 58% of women would have incurred out-of-pocket costs for an IUD, compared to only 13% of women in March 2014. Differentials by age and region virtually dissolved over the period studied, which suggests that the ACA reduced inequality among insured women. Our findings suggest that the cost of hormonal IUDs fell to US$0 for most insured women following the implementation of the ACA. Financial barriers to one of the most effective methods of contraception fell substantially following the ACA. If more women interested in this method can access it, this may contribute to a decline in unintended pregnancies in the United States. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  14. Insurance payment process for HANDI 2000 business management system

    Energy Technology Data Exchange (ETDEWEB)

    Wilson, D.

    1998-08-24

    The Pensions and Savings group handles three types of payment into and out of Fluor Daniel Hanford related to insurance benefits: Premium payment to insurance company; Application of employee insurance withholding against insurance costs; Remittance of insurance claims, and administrative fees. General approach in making and recording the remittance is by forwarding payment information to Accounts Payable Master.

  15. Can Broader Diffusion of Value-Based Insurance Design Increase Benefits from US Health Care without Increasing Costs? Evidence from a Computer Simulation Model

    OpenAIRE

    Scott Braithwaite, R.; Omokaro, Cynthia; Justice, Amy C.; Nucifora, Kimberly; Roberts, Mark S.

    2010-01-01

    Editors' Summary Background More money is spent per person on health care in the US than in any other country. US health care expenditure accounts for 16.2% of the gross domestic product and this figure is rising. Indeed, the increase in health care costs is outstripping the economy's growth rate. Consequently, US policy makers and providers of health insurance?health care in the US is largely provided by the private sector and is paid for through private health insurance or through governmen...

  16. Deductibles in health insurance

    Science.gov (United States)

    Dimitriyadis, I.; Öney, Ü. N.

    2009-11-01

    This study is an extension to a simulation study that has been developed to determine ruin probabilities in health insurance. The study concentrates on inpatient and outpatient benefits for customers of varying age bands. Loss distributions are modelled through the Allianz tool pack for different classes of insureds. Premiums at different levels of deductibles are derived in the simulation and ruin probabilities are computed assuming a linear loading on the premium. The increase in the probability of ruin at high levels of the deductible clearly shows the insufficiency of proportional loading in deductible premiums. The PH-transform pricing rule developed by Wang is analyzed as an alternative pricing rule. A simple case, where an insured is assumed to be an exponential utility decision maker while the insurer's pricing rule is a PH-transform is also treated.

  17. The Swedish national dental insurance and dental health care policy

    DEFF Research Database (Denmark)

    Moore, Rod

    1981-01-01

    Sweden initiated a dental health care insurance in 1973. The health insurance is outlined, current problems and political issues are described. The benefits and limitations are described.......Sweden initiated a dental health care insurance in 1973. The health insurance is outlined, current problems and political issues are described. The benefits and limitations are described....

  18. Mitigation Index Insurance for Developing Countries: Insure the Loss or Insure the Signal?

    OpenAIRE

    Li, Yiting; Miranda, Mario J.

    2015-01-01

    Conventional agricultural index insurance indemnifies based on the observed value of a specified variable, such as rainfall, that is correlated with agricultural production losses. Typically, indemnities are paid to the policyholder after the losses have been experienced. This paper explores alternate timing for index insurance payouts. In particular, we explore the potential benefits of what we call “mitigation index insurance” in which the payouts of the insurance contract arrive before los...

  19. A RANGELAND GRASSHOPPER INSURANCE PROGRAM

    OpenAIRE

    Skold, Melvin D.; Davis, Robert M.

    1995-01-01

    The incidence of benefits and costs from controlling rangeland grasshoppers on public grazing lands poses problems of economic efficiency and distributional equity. Public grasshopper control programs operate like public disaster assistance. However, grasshopper infestations are an insurable risk. This article proposes a rangeland grasshopper insurance program which reduces the economic inefficiencies and distributional inequities of the existing program.

  20. Nuclear insurance

    International Nuclear Information System (INIS)

    Anon.

    1992-01-01

    The yearbook contains among others the figures of the nuclear insurance line. According to these these the DKVG (German nuclear power plant insurance association) has 102 member insurance companies all registered in the Federal Republic of Germany. By using reinsurance capacities of the other pools at present property insurance amounts to 1.5 billion DM and liability insurance to 200 million DM. In 1991 the damage charges on account of DKV amounted to 3.1 (1990 : 4.3) million DM. From these 0.6 million DM are apportioned to payments and 2.5 million DM to reserves. One large damage would cost a maximum gross sum of 2.2 billion DM property and liability insurance; on account of DKVG 750 million DM. (orig./HSCH) [de

  1. On the road again: traffic fatalities and auto insurance minimums

    Directory of Open Access Journals (Sweden)

    Pavel A. Yakovlev

    2018-03-01

    Full Text Available Prior research on policy-induced moral hazard effects in the auto insurance market has focused on the impact of compulsory insurance, no-fault liability, and tort liability laws on traffic fatalities. In contrast, this paper examines the moral hazard effect of a previously overlooked policy variable: minimum auto insurance coverage. We hypothesize that state-mandated auto insurance minimums may “over-insure” some drivers, lowering their incentives to drive carefully. Using a longitudinal panel of American states from 1982 to 2006, we find that policy-induced increases in auto insurance minimums are associated with higher traffic fatality rates, ceteris paribus.

  2. Probabilistic insurance

    OpenAIRE

    Wakker, P.P.; Thaler, R.H.; Tversky, A.

    1997-01-01

    textabstractProbabilistic insurance is an insurance policy involving a small probability that the consumer will not be reimbursed. Survey data suggest that people dislike probabilistic insurance and demand more than a 20% reduction in the premium to compensate for a 1% default risk. While these preferences are intuitively appealing they are difficult to reconcile with expected utility theory. Under highly plausible assumptions about the utility function, willingness to pay for probabilistic i...

  3. Social insurance for health service.

    Science.gov (United States)

    Roemer, M I

    1997-06-01

    Implementation of social insurance for financing health services has yielded different patterns depending on a country's economic level and its government's political ideology. By the late 19th century, thousands of small sickness funds operated in Europe, and in 1883 Germany's Chancellor Bismarck led the enactment of a law mandating enrollment by low-income workers. Other countries followed, with France completing Western European coverage in 1928. The Russian Revolution in 1917 led to a National Health Service covering everyone from general revenues by 1937. New Zealand legislated universal population coverage in 1939. After World War II, Scandinavian countries extended coverage to everyone and Britain introduced its National Health Service covering everyone with comprehensive care and financed by general revenues in 1948. Outside of Europe Japan adopted health insurance in 1922, covering everyone in 1946. Chile was the first developing country to enact statutory health insurance in 1924 for industrial workers, with extension to all low-income people with its "Servicio Nacional de Salud" in 1952. India covered 3.5 percent of its large population with the Employees' State Insurance Corporation in 1948, and China after its 1949 revolution developed four types of health insurance for designated groups of workers and dependents. Sub-Saharan African countries took limited health insurance actions in the late 1960s and 1970s. By 1980, some 85 countries had enacted social security programs to finance or deliver health services or both.

  4. Using payroll deduction to shelter individual health insurance from income tax.

    Science.gov (United States)

    Hall, Mark A; Hager, Christie L; Orentlicher, David

    2011-02-01

    To assess the impact of state laws requiring or encouraging employers to establish "section 125" cafeteria plans that shelter employees' premium contributions from tax. Available descriptive statistics, 65 key-informant interviews, and relevant documents in study states and nationally, 2008-2009. Case studies were conducted in Indiana, Massachusetts, and Missouri--three states adopting laws in 2007. Descriptive quantitative information came from insurers, regulators, and surveys of employers. In each state, 15-17 semistructured but open-ended interviews were conducted with insurance agents, insurers, government officials, and third-party administration firms, and 29 informed sources were interviewed from a national perspective or other states. Key informants were selected based on their known or reported experience, in a "snowball" fashion until saturation was reached. Interview notes were coded for systematic analysis. Finally, relevant rulings, brochures, instructions, marketing materials, and other documents were collected and analyzed. Despite the potential for substantial cost savings, use of section 125 plans to purchase individual insurance remained low in these states after 1 or 2 years. Absent a mandate, few employers were strongly motivated to offer these plans in order to retain an adequate workforce, and uncertainty about federal legality deterred doing so. For smaller employers, benefits to owners did not outweigh administrative complexities. Nevertheless, few downsides were found to states mandating or encouraging these plans. In particular, there is little evidence that many employers dropped group coverage as a result. Section 125 plans remain a limited tool for states to reduce the inequitable tax treatment of individually purchased insurance, but a complete remedy requires reform of federal tax law. © Health Research and Educational Trust.

  5. Systematic co-operation between employer, occupational health service and social insurance office: a 6-year follow-up of vocational rehabilitation for people on sick-leave, including economic benefits.

    Science.gov (United States)

    Kärrholm, Jenny; Ekholm, Karolina; Ekholm, Jan; Bergroth, Alf; Ekholm, Kristina Schüldt

    2008-08-01

    To evaluate the effects of systematic co-operation among municipal employees on the number of sick-leave days per month and the type of benefit granted by the Social Insurance Office. A further aim was to evaluate the economic consequences for society. A 6-year follow-up study with a matched-pairs design. Days on sick-leave were calculated for each subject one year before the intervention started and yearly for the following 6-year period. Statistical mixed-model analysis was used. The economic benefit of the intervention was estimated as the increased production stemming from fewer days on sick-leave. Sixty-four employees on long-term sick-leave were individually matched with controls from another Social Insurance Office in a county with a socioeconomic structure similar to that of the study group. The study group had 5.7 fewer days on sick-leave per month and person over the 6-year period (p=0.003). The estimated average economic benefit of the intervention was euro36,600 per person over the 6-year period. In conclusion, those who received systematic co-operation in vocational rehabilitation had fewer days on sick-leave than their "treatment-as-usual" peers. This effect persisted over 6 years, generating substantial net economic gains for society.

  6. Congressional Statistics: Disability Insurance for December 2014

    Data.gov (United States)

    Social Security Administration — While Social Security is best known for providing retirement benefits, the program also provides Disability Insurance (DI) protection to workers and their families...

  7. Women Saw Large Decrease In Out-Of-Pocket Spending For Contraceptives After ACA Mandate Removed Cost Sharing.

    Science.gov (United States)

    Becker, Nora V; Polsky, Daniel

    2015-07-01

    The Affordable Care Act mandates that private health insurance plans cover prescription contraceptives with no consumer cost sharing. The positive financial impact of this new provision on consumers who purchase contraceptives could be substantial, but it has not yet been estimated. Using a large administrative claims data set from a national insurer, we estimated out-of-pocket spending before and after the mandate. We found that mean and median per prescription out-of-pocket expenses have decreased for almost all reversible contraceptive methods on the market. The average percentages of out-of-pocket spending for oral contraceptive pill prescriptions and intrauterine device insertions by women using those methods both dropped by 20 percentage points after implementation of the ACA mandate. We estimated average out-of-pocket savings per contraceptive user to be $248 for the intrauterine device and $255 annually for the oral contraceptive pill. Our results suggest that the mandate has led to large reductions in total out-of-pocket spending on contraceptives and that these price changes are likely to be salient for women with private health insurance. Project HOPE—The People-to-People Health Foundation, Inc.

  8. Group Life Insurance

    CERN Multimedia

    2013-01-01

    The CERN Administration would like to remind you that staff members and fellows have the possibility to take out a life insurance contract on favourable terms through a Group Life Insurance.   This insurance is provided by the company Helvetia and is available to you on a voluntary basis. The premium, which varies depending on the age and gender of the person insured, is calculated on the basis of the amount of the death benefit chosen by the staff member/fellow and can be purchased in slices of 10,000 CHF.    The contract normally ends at the retirement age (65/67 years) or when the staff member/fellow leaves the Organization. The premium is deducted monthly from the payroll.   Upon retirement, the staff member can opt to maintain his membership under certain conditions.   More information about Group Life Insurance can be found at: Regulations (in French) Table of premiums The Pension Fund Benefit Service &...

  9. School Insurance.

    Science.gov (United States)

    1964

    The importance of insurance in the school budget is the theme of this comprehensive bulletin on the practices and policies for Texas school districts. Also considered is the development of desirable school board policies in purchasing insurance and operating the program. Areas of discussion are: risks to be covered, amount of coverage, values,…

  10. Forest insurance

    Science.gov (United States)

    Ellis T. Williams

    1949-01-01

    Standing timber is one of the few important kinds of property that are not generally covered by insurance. Studies made by the Forest Service and other agencies have indicated that the risks involved in the insurance of timber are not unduly great, provided they can be properly distributed. Such studies, however, have thus far failed to induce any notable development...

  11. Cost-Benefit Performance Simulation of Robot-Assisted Thoracic Surgery As Required for Financial Viability under the 2016 Revised Reimbursement Paradigm of the Japanese National Health Insurance System.

    Science.gov (United States)

    Kajiwara, Naohiro; Kato, Yasufumi; Hagiwara, Masaru; Kakihana, Masatoshi; Ohira, Tatsuo; Kawate, Norihiko; Ikeda, Norihiko

    2018-04-20

    To discuss the cost-benefit performance (CBP) and establish a medical fee system for robotic-assisted thoracic surgery (RATS) under the Japanese National Health Insurance System (JNHIS), which is a system not yet firmly established. All management steps for RATS are identical, such as preoperative and postoperative management. This study examines the CBP based on medical fees of RATS under the JNHIS introduced in 2016. Robotic-assisted laparoscopic prostatectomy (RALP) and robotic-assisted partial nephrectomy (RAPN) now receive insurance reimbursement under the category of use of support devices for endoscopic surgery ($5420 and $3485, respectively). If the same standard amount were to be applied to RATS, institutions would need to perform at least 150 or 300 procedures thoracic operation per year to show a positive CBP ($317 per procedure as same of RALP and $130 per procedure as same of RAPN, respectively). Robotic surgery in some areas receives insurance reimbursement for its "supportive" use for endoscopic surgery as for RALP and RAPN. However, at present, it is necessary to perform da Vinci Surgical System Si (dVSi) surgery at least 150-300 times in a year in a given institution to prevent a deficit in income.

  12. An Assessment of the Unfunded Mandates Reform Act in 1997

    National Research Council Canada - National Science Library

    Gullo, Theresa

    1998-01-01

    .... At the same time, some Members of Congress and other observers question whether UMRA's definition of intergovernmental mandates is adequate and whether the legislative procedures that apply to private-sector mandates should be bolstered.

  13. The Ontario Energy Board's proposed new mandate

    International Nuclear Information System (INIS)

    Laughren, F.

    1998-01-01

    The Ontario Energy Board's proposed new mandate was reviewed. The role of the Board will be to regulate the monopoly delivery components of the electricity and natural gas industry and to smooth the transition to competition. The Board will monitor market performance and will encourage electricity and natural gas monopoly services to be compatible where possible. The Board will also assist local restructuring efforts when called upon do so and ensure that the marketplace operates efficiently and effectively. Gas marketers' licensing is scheduled to begin in early 1999. Licenses will also apply to the electric industry. The objectives of the proposed licensing, the regulatory requirements and the proposed regulatory approach are described

  14. 10 CFR 490.302 - Vehicle acquisition mandate schedule.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 3 2010-01-01 2010-01-01 false Vehicle acquisition mandate schedule. 490.302 Section 490... Alternative Fuel Provider Vehicle Acquisition Mandate § 490.302 Vehicle acquisition mandate schedule. (a) Except as provided in section 490.304 of this part, of the light duty motor vehicles newly acquired by a...

  15. Estimating Nitrogen Load Resulting from Biofuel Mandates

    Science.gov (United States)

    Alshawaf, Mohammad; Douglas, Ellen; Ricciardi, Karen

    2016-01-01

    The Energy Policy Act of 2005 and the Energy Independence and Security Act (EISA) of 2007 were enacted to reduce the U.S. dependency on foreign oil by increasing the use of biofuels. The increased demand for biofuels from corn and soybeans could result in an increase of nitrogen flux if not managed properly. The objectives of this study are to estimate nitrogen flux from energy crop production and to identify the catchment areas with high nitrogen flux. The results show that biofuel production can result in an increase of nitrogen flux to the northern Gulf of Mexico from 270 to 1742 thousand metric tons. Using all cellulosic (hay) ethanol or biodiesel to meet the 2022 mandate is expected to reduce nitrogen flux; however, it requires approximately 25% more land when compared to other scenarios. Producing ethanol from switchgrass rather than hay results in three-times more nitrogen flux, but requires 43% less land. Using corn ethanol for 2022 mandates is expected to have double the nitrogen flux when compared to the EISA-specified 2022 scenario; however, it will require less land area. Shifting the U.S. energy supply from foreign oil to the Midwest cannot occur without economic and environmental impacts, which could potentially lead to more eutrophication and hypoxia. PMID:27171101

  16. Ethical dilemma of mandated contraception in pharmaceutical research at catholic medical institutions.

    Science.gov (United States)

    Casey, Murray Joseph; O'Brien, Richard; Rendell, Marc; Salzman, Todd

    2012-01-01

    The Catholic Church proscribes methods of birth control other than sexual abstinence. Although the U.S. Food and Drug Administration (FDA) recognizes abstinence as an acceptable method of birth control in research studies, some pharmaceutical companies mandate the use of artificial contraceptive techniques to avoid pregnancy as a condition for participation in their studies. These requirements are unacceptable at Catholic health care institutions, leading to conflicts among institutional review boards, clinical investigators, and sponsors. Subjects may feel coerced by such mandates to adopt contraceptive techniques inconsistent with their personal situation and beliefs; women committed to celibacy or who engage exclusively in non-heterosexual activities are negatively impacted. We propose principles to insure informed consent to safeguard the rights of research subjects at Catholic institutions while mitigating this ethical conflict. At the same time, our proposal respects the interests of pharmaceutical research agencies and Catholic moral precepts, and fully abides by regulatory guidance.

  17. The effect of state dependent mandate laws on the labor supply decisions of young adults.

    Science.gov (United States)

    Depew, Briggs

    2015-01-01

    Prior to the Affordable Care Act, the majority of states in the U.S. had already implemented state laws that extended the age that young adults could enroll as dependents on their parent's employer-based health insurance plans. Because of the fundamental link between health insurance and employment in the U.S., such policies may effect the labor supply decisions of young adults. Although the interaction between labor supply and health insurance has been extensively studied for other subpopulations, little is known about the role of health insurance in the labor supply decisions of young adults. I use the variation from the implementation and changes in state policies that expanded dependent health insurance coverage to examine how young adults adjusted their labor supply when they were able to be covered as a dependent on their parent's plan. I find that these state mandates led to a decrease in labor supply on the intensive margin. Copyright © 2014 Elsevier B.V. All rights reserved.

  18. Insurance dictionary

    International Nuclear Information System (INIS)

    Mueller-Lutz, H.L.

    1984-01-01

    Special technical terms used in the world of insurance can hardly be found in general dictionaries. This is a gap which the 'Insurance dictionary' now presented is designed to fill. In view of its supplementary function, the number of terms covered is limited to 1200. To make this dictionary especially convenient for ready reference, only the most commonly used translations are given for each key word in any of the four languages. This dictionary is subdivided into four parts, each containing the translation of the selected terms in the three other languages. To further facilitate the use of the booklet, paper of different colours was used for the printing of the German, English, French and Greek sections. The present volume was developed from a Swedish insurance dictionary (Fickordbok Foersaekring), published in 1967, which - with Swedish as the key language- offers English, French and German translations of the basic insurance terms. (orig./HP) [de

  19. The French biofuels mandates under cost uncertainty - an assessment based on robust optimization

    International Nuclear Information System (INIS)

    Lorne, Daphne; Tchung-Ming, Stephane

    2012-01-01

    This paper investigates the impact of primary energy and technology cost uncertainty on the achievement of renewable and especially biofuel policies - mandates and norms - in France by 2030. A robust optimization technique that allows to deal with uncertainty sets of high dimensionality is implemented in a TIMES-based long-term planning model of the French energy transport and electricity sectors. The energy system costs and potential benefits (GHG emissions abatements, diversification) of the French renewable mandates are assessed within this framework. The results of this systemic analysis highlight how setting norms and mandates allows to reduce the variability of CO 2 emissions reductions and supply mix diversification when the costs of technological progress and prices are uncertain. Beyond that, we discuss the usefulness of robust optimization in complement of other techniques to integrate uncertainty in large-scale energy models. (authors)

  20. 29 CFR 1625.10 - Costs and benefits under employee benefit plans.

    Science.gov (United States)

    2010-07-01

    ..., the “benefit package” approach may not be used to reduce health insurance benefits by more than is..., even though the older worker may thereby receive a lesser amount of benefits or insurance coverage... of group term life insurance coverage for older workers, on the basis of age. However, a benefit-by...

  1. University Benefits Survey. Part 1 (All Benefits Excluding Pensions).

    Science.gov (United States)

    University of Western Ontario, London.

    Results of a 1983 survey of benefits, excluding pensions, for 17 Ontario, Canada, universities are presented. Information is provided on the following areas: whether the university self-administers insurance plans, communication of benefits, proposed changes in benefits, provision of life and dismemberment insurance, maternity leave policy,…

  2. The Impact of the Affordable Care Act's Dependent Coverage Mandate on Use of Dental Treatments and Preventive Services.

    Science.gov (United States)

    Shane, Dan M; Wehby, George L

    2017-09-01

    Oral health problems are the leading chronic conditions among children and younger adults. Lack of dental coverage is thought to be an important barrier to care but little empirical evidence exists on the causal effect of private dental coverage on use of dental services. We explore the relationship between dental coverage and dental services utilization with an analysis of a natural experiment of increasing private dental coverage stemming from the Affordable Care Act's (ACA)-dependent coverage mandate. To evaluate whether increased private dental insurance due to the spillover effect of the ACA-dependent coverage health insurance mandate affected utilization of dental services among a group of affected young adults. 2006-2013 Medical Expenditure Panel Surveys. We used a difference-in-difference regression approach comparing changes in dental care utilization for 25-year olds affected by the policy to unaffected 27-year olds. We evaluate effects on dental treatments and preventive services RESULTS:: Compared to 27-year olds, 25-year olds were 8 percentage points more likely to have private dental coverage in the 3 years following the mandate. We do not find compelling evidence that young adults increased their use of preventive dental services in response to gaining insurance. We do find a nearly 5 percentage point increase in the likelihood of dental treatments among 25-year olds following the mandate, an effect that appears concentrated among women. Increases in private dental coverage due to the ACA's-dependent coverage mandate do not appear to be driving significant changes in overall preventive dental services utilization but there is evidence of an increase in restorative care.

  3. The Normative Foundations of (Social) Insurance

    DEFF Research Database (Denmark)

    Landes, Xavier

    Insurance mechanisms are prevalent in industrialized societies, in both public and private sectors. Insurance is offered for various risks ranging from fire to accident. They also constitute the core of the modern welfare state (public health insurance, unemployment benefits and public pensions......). The analysis of (public) insurance has however remained marginal in political theory because insurance is often perceived as a simple tool for pursuing equality, i.e. a tool without any moral significance proper. This text proposes an alternative view by drawing a continuum between insurance as a technology......, which is the common interpretation in economics, and insurance as a social practice, which characterizes social theory. The goal is to underline how the technology of insurance alters social practices by, for instance, promoting equal standing or transforming the paradigm of individual responsibility...

  4. Nuclear insurance

    International Nuclear Information System (INIS)

    Anon.

    1993-01-01

    The German Nuclear Power Plant Insurance (DKVG) Association was able to increase its net capacity in property insurance to 637 million marks in 1993 (1992: 589 million). The reinsurance capacity of the other pools included, the total amount covered now amounts to 2 billion marks in property incurance and 200 million marks in liability incurance. As in the year before the pool can reckon with a stable gross premium yield around 175 million marks. The revival of the US dollar has played a decisive role in this development. In 1993 in the domestic market, the DKVG offered policies for 22 types of property risk and 43 types to third-party risk, operating with a gross target premium of 65 million marks and 16 million marks, respectively. The DKVG also participated in 540 foreign insurance contracts. (orig./HSCH) [de

  5. Inflation Insurance

    OpenAIRE

    Zvi Bodie

    1989-01-01

    A contract to insure $1 against inflation is equivalent to a European call option on the consumer price index. When there is no deductible this call option is equivalent to a forward contract on the CPI. Its price is the difference between the prices of a zero coupon real bond and a zero coupon nominal bond, both free of default risk. Provided that the risk-free real rate of interest is positive, the price of such an inflation insurance policy first rises and then falls with time to maturity....

  6. How do health insurer market concentration and bargaining power with hospitals affect health insurance premiums?

    Science.gov (United States)

    Trish, Erin E; Herring, Bradley J

    2015-07-01

    The US health insurance industry is highly concentrated, and health insurance premiums are high and rising rapidly. Policymakers have focused on the possible link between the two, leading to ACA provisions to increase insurer competition. However, while market power may enable insurers to include higher profit margins in their premiums, it may also result in stronger bargaining leverage with hospitals to negotiate lower payment rates to partially offset these higher premiums. We empirically examine the relationship between employer-sponsored fully-insured health insurance premiums and the level of concentration in local insurer and hospital markets using the nationally-representative 2006-2011 KFF/HRET Employer Health Benefits Survey. We exploit a unique feature of employer-sponsored insurance, in which self-insured employers purchase only administrative services from managed care organizations, to disentangle these different effects on insurer concentration by constructing one concentration measure representing fully-insured plans' transactions with employers and the other concentration measure representing insurers' bargaining with hospitals. As expected, we find that premiums are indeed higher for plans sold in markets with higher levels of concentration relevant to insurer transactions with employers, lower for plans in markets with higher levels of insurer concentration relevant to insurer bargaining with hospitals, and higher for plans in markets with higher levels of hospital market concentration. Copyright © 2015 Elsevier B.V. All rights reserved.

  7. Charged-particle beam: a safety mandate

    International Nuclear Information System (INIS)

    Young, K.C.

    1983-01-01

    The Advanced Test Accelerator (ATA) is a recent development in the field of charged particle beam research at Lawrence Livermore National Laboratory. With this experimental apparatus, researchers will characterize intense pulses of electron beams propagated through air. Inherent with the ATA concept was the potential for exposure to hazards, such as high radiation levels and hostile breathing atmospheres. The need for a comprehensive safety program was mandated; a formal system safety program was implemented during the project's conceptual phase. A project staff position was created for a safety analyst who would act as a liaison between the project staff and the safety department. Additionally, the safety analyst would be responsible for compiling various hazards analyses reports, which formed the basis of th project's Safety Analysis Report. Recommendations for safety features from the hazards analysis reports were incorporated as necessary at appropriate phases in project development rather than adding features afterwards. The safety program established for the ATA project faciliated in controlling losses and in achieving a low-level of acceptable risk

  8. The Protos mandate a scientific novel

    CERN Document Server

    Kanas, Nick

    2014-01-01

    In the 25th Century, the effects of overpopulation and global warming on Earth have led to the formation of human colonies on the Moon, Mars and elsewhere in the Solar System, yet the limited number of viable places forces humanity to look to the stars. A crash program has been developed to send Protos 1, a giant multigenerational starship, to a newly discovered Earth-like planet orbiting a nearby star. The plan is for awake crewmembers to run the ship, and for people in suspended animation to be roused before planetfall to use their skills in exploration and colony formation. To fulfill the goals of the mission and ensure that the in-flight population does not deplete the limited resources, the Protos Mandate is set up to govern a tightly controlled social system for the duration of the journey, which will take several generations.  But problems threaten to sabotage the mission during its launch and transit, and what finally awaits the crewmembers shocks them in an unpredictable way.  This novel chronicl...

  9. 42 CFR 409.60 - Benefit periods.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Benefit periods. 409.60 Section 409.60 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM HOSPITAL INSURANCE BENEFITS Scope of Hospital Insurance Benefits § 409.60 Benefit periods. (a) When benefit...

  10. Multi-objective regulations on transportation fuels: Comparing renewable fuel mandates and emission standards

    International Nuclear Information System (INIS)

    Rajagopal, D.; Plevin, R.; Hochman, G.; Zilberman, D.

    2015-01-01

    We compare two types of fuel market regulations — a renewable fuel mandate and a fuel emission standard — that could be employed to simultaneously achieve multiple outcomes such as reduction in fuel prices, fuel imports and greenhouse gas (GHG) emissions. We compare these two types of regulations in a global context taking into account heterogeneity in carbon content of both fossil fuels and renewable fuels. We find that although neither the ethanol mandate nor the emission standard is certain to reduce emissions relative to a business-as-usual baseline, at any given level of biofuel consumption in the policy region, a mandate, relative to an emission standard, results in higher GHG emissions, smaller expenditure on fuel imports, lower price of ethanol-blended gasoline and higher domestic fuel market surplus. This result holds over a wide range of values of model parameters. We also discuss the implications of this result to a regulation such as the US Renewable Fuel Standard given recent developments within the US such as increase in shale and tight oil production and large increase in average vehicle fuel economy of the automotive fleet. - Highlights: • Biofuel mandates and fuel GHG emission standards are analyzed from a multiple criteria perspective • An emission-standard always results in lower global emissions while requiring less biofuel relative to a biofuel mandate • An emission-standard results in higher fuel price in the home region relative to a biofuel mandate • Emission standards lead to more shuffling of both fossil fuels and biofuels between home and abroad • The relative impact of the policies on fuel imports depends on the relative cost-effectiveness of domestic & imported biofuel • Recent developments oil production and fuel economy increase the net benefits of an LCFS approach relative to RFS

  11. Competing values in serving older and vulnerable adults: adult protective services, mandated reporting, and domestic violence programs.

    Science.gov (United States)

    Cramer, Elizabeth P; Brady, Shane R

    2013-01-01

    State mandatory reporting statutes may directly or indirectly list domestic violence programs as among those that are mandated reporters of cases of suspected abuse, neglect, or exploitation of older individuals and those with disabilities. Domestic violence programs, however, may not consider themselves to be mandated reporters, because the responsibility of reporting abuse may be contrary to their programmatic philosophy. In the Commonwealth of Virginia, the potential conflict between domestic violence programs and Adult Protective Services about the issue of mandated reporting has created tension between these organizations as each entity continues interpreting the issues and policies of mandated reporting through its own lens. The authors draw out some of the reasons for the conflict as well as make recommendations for improving relationships between the two organizations, which will ultimately benefit vulnerable adults who are experiencing abuse.

  12. Federal Employees Health Benefits and Federal Employees Dental and Vision Insurance Programs' Coverage Exception for Children of Same-Sex Domestic Partners. Interim final rule.

    Science.gov (United States)

    2016-12-02

    This action amends the rule to create a regulatory exception that allows children of same-sex domestic partners living overseas to maintain their Federal Employees Health Benefits (FEHB) and Federal Employees Dental and Vision Program (FEDVIP) coverage until September 30, 2018. Due to a recent Supreme Court decision, as of January 1, 2016, coverage of children of same-sex domestic partners under the FEHB Program and FEDVIP will generally only be allowed if the couple is married, as discussed in Benefits Administration Letter (BAL) 15-207 dated October 5, 2015. OPM recognizes there are additional requirements placed on overseas federal employees that may not apply to other civilian employees with duty stations in the United States making it difficult to travel to the United States to marry same-sex partners.

  13. Reporting transparency: making the ethical mandate explicit.

    Science.gov (United States)

    Nicholls, Stuart G; Langan, Sinéad M; Benchimol, Eric I; Moher, David

    2016-03-16

    Improving the transparency and quality of reporting in biomedical research is considered ethically important; yet, this is often based on practical reasons such as the facilitation of peer review. Surprisingly, there has been little explicit discussion regarding the ethical obligations that underpin reporting guidelines. In this commentary, we suggest a number of ethical drivers for the improved reporting of research. These ethical drivers relate to researcher integrity as well as to the benefits derived from improved reporting such as the fair use of resources, minimizing risk of harms, and maximizing benefits. Despite their undoubted benefit to reporting completeness, questions remain regarding the extent to which reporting guidelines can influence processes beyond publication, including researcher integrity or the uptake of scientific research findings into policy or practice. Thus, we consider investigation on the effects of reporting guidelines an important step in providing evidence of their benefits.

  14. Does hemopericardium after chest trauma mandate sternotomy?

    Science.gov (United States)

    Thorson, Chad M; Namias, Nicholas; Van Haren, Robert M; Guarch, Gerardo A; Ginzburg, Enrique; Salerno, Tomas A; Schulman, Carl I; Livingstone, Alan S; Proctor, Kenneth G

    2012-06-01

    Recently, three patients with hemopericardium after severe chest trauma were successfully managed nonoperatively at our institution. This prompted the question whether these were rare or common events. Therefore, we reviewed our experience with similar injuries to test the hypothesis that trauma-induced hemopericardium mandates sternotomy. Records were retrospectively reviewed for all patients at a Level I trauma center (December 1996 to November 2011) who sustained chest trauma with pericardial window (PCW, n = 377) and/or median sternotomy (n = 110). Fifty-five (15%) patients with positive PCW proceeded to sternotomy. Penetrating injury was the dominant mechanism (n = 49, 89%). Nineteen (35%) were hypotensive on arrival or during initial resuscitation. Most received surgeon-performed focused cardiac ultrasound examinations (n = 43, 78%) with positive results (n = 25, 58%). Ventricular injuries were most common, with equivalent numbers occurring on the right (n = 16, 29%) and left (n = 15, 27%). Six (11%) with positive PCW had isolated pericardial lacerations, but 21 (38%) had no repairable cardiac or great vessel injury. Those with therapeutic versus nontherapeutic sternotomies were similar with respect to age, mechanisms of injury, injury severity scores, presenting laboratory values, resuscitation fluids, and vital signs. Multiple logistic regression revealed that penetrating trauma (odds ratio: 13.3) and hemodynamic instability (odds ratio: 7.8) were independent predictors of therapeutic sternotomy. Hemopericardium per se may be overly sensitive for diagnosing cardiac or great vessel injuries after chest trauma. Some stable blunt or penetrating trauma patients without continuing intrapericardial bleeding had nontherapeutic sternotomies, suggesting that this intervention could be avoided in selected cases. Therapeutic study, level III. Copyright © 2012 by Lippincott Williams & Wilkins.

  15. Development of the Health Insurance Literacy Measure (HILM): Conceptualizing and Measuring Consumer Ability to Choose and Use Private Health Insurance

    OpenAIRE

    Paez, Kathryn A.; Mallery, Coretta J.; Noel, HarmoniJoie; Pugliese, Christopher; McSorley, Veronica E.; Lucado, Jennifer L.; Ganachari, Deepa

    2014-01-01

    Understanding health insurance is central to affording and accessing health care in the United States. Efforts to support consumers in making wise purchasing decisions and using health insurance to their advantage would benefit from the development of a valid and reliable measure to assess health insurance literacy. This article reports on the development of the Health Insurance Literacy Measure (HILM), a self-assessment measure of consumers' ability to select and use private health insurance...

  16. Crop insurance: Risks and models of insurance

    Directory of Open Access Journals (Sweden)

    Čolović Vladimir

    2014-01-01

    Full Text Available The issue of crop protection is very important because of a variety of risks that could cause difficult consequences. One type of risk protection is insurance. The author in the paper states various models of insurance in some EU countries and the systems of subsidizing of insurance premiums by state. The author also gives a picture of crop insurance in the U.S., noting that in this country pays great attention to this matter. As for crop insurance in Serbia, it is not at a high level. The main problem with crop insurance is not only the risks but also the way of protection through insurance. The basic question that arises not only in the EU is the question is who will insure and protect crops. There are three possibilities: insurance companies under state control, insurance companies that are public-private partnerships or private insurance companies on a purely commercial basis.

  17. The Mandate System for the Belgian Public Prosecution

    Directory of Open Access Journals (Sweden)

    Bruno BROUCKER

    2009-12-01

    Full Text Available The law of 22 December 1998 introduced the mandate system for the heads of the Public Prosecution offices, which were appointed permanent before that. Theoretically, such a system needs to enhance, within the organization, effectiveness, efficiency, responsabilisation, and goal-orientation. However, the mandate system within the Belgian Public Prosecution was introduced prematurely, for dubious reasons and in a precipitate manner. In the current situation, the position of the mandate holder is uncertain, with a bounded autonomy and a low wage increase. Moreover, it remains impossible to intervene in the policy of appointed heads of office (during their mandate, the efficiency and effectiveness is only increased in some prosecution offices and a contract containing actual management responsibilities is absent. In sum: there is a large gap between the theoretical principles of mandate systems and the way it is introduced in the Belgian Public Prosecution.

  18. HEALTH INSURANCE

    CERN Multimedia

    Division HR

    2000-01-01

    Change of name for AUSTRIA As of October 1, the AUSTRIA Assurances S.A. company will change its name to: UNIQA Assurances S.A. It inherits the same name as its parent Austrian company, which adopted it towards the end of 1999. This change has no effect on the contract which binds it to CERN for the administration of our Health Insurance Scheme. New insurance cards will be sent to you by UNIQA and the printed forms and envelopes will gradually be updated with the new name. Postal and phone addresses remain unaffected by the change. You should address your postal mail to: UNIQA Assurances rue des Eaux Vives 94 case postale 6402 1211 Genève 6 You may telephone your usual contact persons at the same numbers as before and send e-mails to the UNIQA office at CERN at: UNIQA.Assurances@cern.ch

  19. Export insurance

    International Nuclear Information System (INIS)

    1981-01-01

    These notes are intended as a general guide for the use of members of the Canadian Nuclear Association who are, or may become, involved in supplying goods or services or contracting/ erecting as part of a contract to supply a nuclear facility to an overseas country. They give information to the type of insurances needed and available, the parties normally responsible for providing the coverages, the intent and operation of the various policies, general methods of charging premiums, and main exclusions

  20. Quantifying the Impact of Autism Coverage on Private Insurance Premiums

    Science.gov (United States)

    Bouder, James N.; Spielman, Stuart; Mandell, David S.

    2009-01-01

    Many states are considering legislation requiring private insurance companies to pay for autism-related services. Arguments against mandates include that they will result in higher premiums. Using Pennsylvania legislation as an example, which proposed covering services up to $36,000 per year for individuals less than 21 years of age, this paper…

  1. Worker Sorting, Taxes and Health Insurance Coverage

    OpenAIRE

    Kevin Lang; Hong Kang

    2007-01-01

    We develop a model in which firms hire heterogeneous workers but must offer all workers insurance benefits under similar terms. In equilibrium, some firms offer free health insurance, some require an employee premium payment and some do not offer insurance. Making the employee contribution pre-tax lowers the cost to workers of a given employee premium and encourages more firms to charge. This increases the offer rate, lowers the take-up rate, increases (decreases) coverage among high (low) de...

  2. Ontario Universities Benefits Survey, 1990-91: Part I, Benefits Excluding Pensions.

    Science.gov (United States)

    Council of Ontario Universities, Toronto.

    The report details, in tabular form, non-pension benefits offered by each of 17 Ontario universities. These include: supplementary health insurance; long term disability; sick leave entitlement; sick leave-benefits continuance; long term disability-benefits continuance; life insurance; survivor benefit; dental plan; post-retirement benefits;…

  3. 38 CFR 9.14 - Accelerated Benefits.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Accelerated Benefits. 9...' GROUP LIFE INSURANCE AND VETERANS' GROUP LIFE INSURANCE § 9.14 Accelerated Benefits. (a) What is an Accelerated Benefit? An Accelerated Benefit is a payment of a portion of your Servicemembers' Group Life...

  4. 19 CFR 351.520 - Export insurance.

    Science.gov (United States)

    2010-04-01

    ... Duties INTERNATIONAL TRADE ADMINISTRATION, DEPARTMENT OF COMMERCE ANTIDUMPING AND COUNTERVAILING DUTIES Identification and Measurement of Countervailable Subsidies § 351.520 Export insurance. (a) Benefit—(1) In general. In the case of export insurance, a benefit exists if the premium rates charged are inadequate to...

  5. 29 CFR 5.29 - Specific fringe benefits.

    Science.gov (United States)

    2010-07-01

    ... benefits which the Congress considered to be common in the construction industry as a whole. These include... illness resulting from occupational activity, or insurance to provide any of the foregoing, unemployment benefits, life insurance, disability and sickness insurance, or accident insurance, vacation and holiday...

  6. Optimal Mandates and The Welfare Cost of Asymmetric Information: Evidence from The U.K. Annuity Market.

    Science.gov (United States)

    Einav, Liran; Finkelstein, Amy; Schrimpf, Paul

    2010-05-01

    Much of the extensive empirical literature on insurance markets has focused on whether adverse selection can be detected. Once detected, however, there has been little attempt to quantify its welfare cost, or to assess whether and what potential government interventions may reduce these costs. To do so, we develop a model of annuity contract choice and estimate it using data from the U.K. annuity market. The model allows for private information about mortality risk as well as heterogeneity in preferences over different contract options. We focus on the choice of length of guarantee among individuals who are required to buy annuities. The results suggest that asymmetric information along the guarantee margin reduces welfare relative to a first best symmetric information benchmark by about £127 million per year, or about 2 percent of annuitized wealth. We also find that by requiring that individuals choose the longest guarantee period allowed, mandates could achieve the first-best allocation. However, we estimate that other mandated guarantee lengths would have detrimental effects on welfare. Since determining the optimal mandate is empirically difficult, our findings suggest that achieving welfare gains through mandatory social insurance may be harder in practice than simple theory may suggest.

  7. Optimal Mandates and The Welfare Cost of Asymmetric Information: Evidence from The U.K. Annuity Market*

    Science.gov (United States)

    Einav, Liran; Finkelstein, Amy; Schrimpf, Paul

    2009-01-01

    Much of the extensive empirical literature on insurance markets has focused on whether adverse selection can be detected. Once detected, however, there has been little attempt to quantify its welfare cost, or to assess whether and what potential government interventions may reduce these costs. To do so, we develop a model of annuity contract choice and estimate it using data from the U.K. annuity market. The model allows for private information about mortality risk as well as heterogeneity in preferences over different contract options. We focus on the choice of length of guarantee among individuals who are required to buy annuities. The results suggest that asymmetric information along the guarantee margin reduces welfare relative to a first best symmetric information benchmark by about £127 million per year, or about 2 percent of annuitized wealth. We also find that by requiring that individuals choose the longest guarantee period allowed, mandates could achieve the first-best allocation. However, we estimate that other mandated guarantee lengths would have detrimental effects on welfare. Since determining the optimal mandate is empirically difficult, our findings suggest that achieving welfare gains through mandatory social insurance may be harder in practice than simple theory may suggest. PMID:20592943

  8. 77 FR 25788 - Request for Information Regarding Stop Loss Insurance

    Science.gov (United States)

    2012-05-01

    ... Health Plan Standards and Compliance Assistance, Employee Benefits Security Administration, Room N-5653... employee benefit plans to be insurance companies in order to regulate them under insurance laws.) \\6\\ As a... DEPARTMENT OF THE TREASURY Internal Revenue Service DEPARTMENT OF LABOR Employee Benefits Security...

  9. Social learning in a policy-mandated collaboration: Community wildfire protection planning in the eastern United States

    Science.gov (United States)

    Rachel F. Brummel; Kristen C. Nelson; Pamela J. Jakes; Daniel R. Williams

    2010-01-01

    Policies such as the US Healthy Forests Restoration Act (HFRA) mandate collaboration in planning to create benefits such as social learning and shared understanding among partners. However, some question the ability of top-down policy to foster successful local collaboration. Through in-depth interviews and document analysis, this paper investigates social learning and...

  10. INSURANCE MARKET. GENERAL CONSIDERATIONS OF INSURANCES IN ROMANIA

    Directory of Open Access Journals (Sweden)

    MARINEL NEDELUŢ

    2013-10-01

    Full Text Available Insurance is a contract made by a company or society, or by the state, to provide a guarantee for loss, damage, illness, death etc in return for regular payments. In other words it is a means by which one pays a relatively small known cost for protection against an uncertain and much larger cost. Still, this contract (insurance policy makes it possible for the insured to cover only losses that are measurable in terms of money and caused strictly by hazardous events, independent from own doing. If no such events should happen, the benefits won’t exist in a tangible, material form, but will take the shape of security against ruin. Since the insurance industry has developed more during the last decade due to the powerful players that have entered the market, the services provided by the insurance companies, and not only their products have evolved a lot in order to meet the requirements of the consumers, and to make them familiar with this type of investments. Therefore all the means of advertising became essential in this process of implementation and familiarization with this area of activity: mass-media advertising, insurance brokerage companies, the internet are all parts of this process.

  11. Entrepreneurial Moral Hazard in Income Insurance

    DEFF Research Database (Denmark)

    Ejrnæs, Mette; Hochguertel, Stefan

    We study risk behavior of Danish self-employed entrepreneurs, whose income risk may be driven by both exogenous factors and effort choice (moral hazard). Partial insurance is available through voluntary unemployment insurance (UI). Additional incentives to sign insurance contracts stem from a UI......-embedded, government-subsidized early retirement (ER) program, giving benefits that are unrelated to business risk. Indeed, we argue that the self-employeds' incentives to insure themselves stem from the ER plan rather than from the UI cover. We show how to use a policy reform to identify moral hazard in observed...

  12. The state of internal audit’s regulatory mandate

    Directory of Open Access Journals (Sweden)

    Christo Ackermann

    2016-08-01

    Full Text Available The importance of an effective internal audit function in South African municipalities have been recognised insofar as internal audit functions are legally mandated to exist within municipalities. This also means that legally, internal audit has certain mandates which must be fulfilled in order to add value to management and audit committees, and ultimately, to the board of directors. Even though internal audit is sanctioned by this important legal mandate, evidence shows that internal audit does not always fulfil this mandate. This state of affairs has prompted a detailed review of the relevant laws and regulations governing the work of internal audit in South African municipalities in order to determine the extent to which key stakeholders find the regulatory work of internal audit useful in discharging their (stakeholders’ oversight responsibilities. Questionnaires were administered to audit committees. The results summarise the extent to which internal audit’s work assists audit committees in their oversight responsibilities as this ultimately affects the ability of audit committees to fulfil these responsibilities to the board of directors. The results indicate that audit committees are greatly dependent on internal audit as a provider of assurance on a variety of legally mandated variables. The results of this study can be used as a measure of best practice of the legally mandated duties performed by internal audit. It can also be used by other researchers in comparative studies and by practitioners to benchmark their work in order to better serve audit committees and ultimately, the board of directors

  13. MNE R&D Subsidiary Mandates Evolution in Emerging Economies

    DEFF Research Database (Denmark)

    Schulzmann, David; Slepniov, Dmitrij

    2017-01-01

    The aim of this paper is to present the results of a systematic literature review (SLR) on the subject of Research and Development (R&D) subsidiary mandate evolution in emerging economies and to illustrate what triggers R&D mandate upgrade. The subject of R&D mandates is of crucial importance to ...... on subsidiary evolution in general and particularly in emerging markets. From a practical perspective, a better-integrated framework can provide guidance to businesses in emerging economies on how to start and successfully upgrade their R&D activities.......The aim of this paper is to present the results of a systematic literature review (SLR) on the subject of Research and Development (R&D) subsidiary mandate evolution in emerging economies and to illustrate what triggers R&D mandate upgrade. The subject of R&D mandates is of crucial importance...... to many multinational enterprises (MNEs) striving to utilize the potential of their foreign operations towards higher-value-added activities. While developed economies have long been a destination for R&D activities, emerging economies are increasingly recognized for their innovation potential. Previous...

  14. Role of American Nuclear Insurers in reducing occupational radiation exposure

    International Nuclear Information System (INIS)

    Forbes, J.L.

    1980-01-01

    Since 1957 the nuclear insurance pools have provided liability and property insurance for the nation's nuclear power generating stations as mandated by the Price-Anderson Act. Although the insurance was originally structured to give financial protection to the insured in the event of a major accident, the potential for third-party claims arising from routine occupational exposure is becoming a more realistic pathway for a loss to the pools. In order to give maximum protection to the pools' assets, the Liability Engineering Department of American Nuclear Insurers (ANI) performs periodic inspections of the power plants. By concentrating on programs and management areas, ANI inspections complement regulatory inspections so that all major areas of common interest are reviewed. This paper presents the nature, results, and findings of those periodic inspections particularly in the general area of plant radiation protection

  15. Unemployment Insurance Fund Insolvency and Debt in Michigan.

    Science.gov (United States)

    Blaustein, Saul J.

    Without changes in Michigan's unemployment insurance law, the state's unemployment insurance debt will probably reach $3.8 billion by the end of 1985. Currently, Michigan's employers pay unemployment insurance tax rates that vary from 1 to 9 percent, depending upon the amount of benefits charged against their accounts. Beginning with the federal…

  16. 29 CFR 1604.9 - Fringe benefits.

    Science.gov (United States)

    2010-07-01

    ..., accident, life insurance and retirement benefits; profit-sharing and bonus plans; leave; and other terms... maternity benefits while female employees receive no such benefits. (e) It shall not be a defense under...

  17. Congress, courts, and commerce: upholding the individual mandate to protect the public's health.

    Science.gov (United States)

    Hodge, James G; Brown, Erin C Fuse; Orenstein, Daniel G; O'Keefe, Sarah

    2011-01-01

    Among multiple legal challenges to the Patient Protection and Affordable Care Act (PPACA) is the premise that PPACA's "individual mandate" (requiring all individuals to obtain health insurance by 2014 or face civil penalties) is inviolate of Congress' interstate commerce powers because Congress lacks the power to regulate commercial "inactivity." Several courts initially considering this argument have rejected it, but federal district courts in Virginia and Florida have concurred, leading to numerous appeals and prospective review of the United States Supreme Court. Despite creative arguments, the dispositive constitutional question is not whether Congress' interstate commerce power extends to commercial inactivity. Rather, it is whether Congress may regulate individual decisions with significant economic ramifications in the interests of protecting and promoting the public's health. This article offers a counter-interpretation of the scope of Congress' interstate commerce power to regulate in furtherance of the public's health. © 2011 American Society of Law, Medicine & Ethics, Inc.

  18. Federal Deposit Insurance Corporation (FDIC) Insured Banks

    Data.gov (United States)

    Department of Homeland Security — The Summary of Deposits (SOD) is the annual survey of branch office deposits for all FDIC-insured institutions including insured U.S. branches of foreign banks. Data...

  19. Risk segmentation in Chilean social health insurance.

    Science.gov (United States)

    Hidalgo, Hector; Chipulu, Maxwell; Ojiako, Udechukwu

    2013-01-01

    The objective of this study is to identify how risk and social variables are likely to be impacted by an increase in private sector participation in health insurance provision. The study focuses on the Chilean health insurance industry, traditionally dominated by the public sector. Predictive risk modelling is conducted using a database containing over 250,000 health insurance policy records provided by the Superintendence of Health of Chile. Although perceived with suspicion in some circles, risk segmentation serves as a rational approach to risk management from a resource perspective. The variables that have considerable impact on insurance claims include the number of dependents, gender, wages and the duration a claimant has been a customer. As shown in the case study, to ensure that social benefits are realised, increased private sector participation in health insurance must be augmented by regulatory oversight and vigilance. As it is clear that a "community-rated" health insurance provision philosophy impacts on insurance firm's ability to charge "market" prices for insurance provision, the authors explore whether risk segmentation is a feasible means of predicting insurance claim behaviour in Chile's private health insurance industry.

  20. A Study of Contributing Factors in Islamic Motor Insurance

    Directory of Open Access Journals (Sweden)

    Wan Asri Wan Abdul Aziz

    2011-06-01

    Full Text Available This study examines the government servant‟s perception toward Islamic Motor Insurance named as takaful. The product based on syariah rules for general insurance provided by Insurance Company in Malaysia. This study emphasizes on four factors, which product knowledge, awareness, advertising and benefit of the product. The purpose of this study is to measure the level of perception of Islamic Motor insurance and to identify whether there is a relationship between the independent variables (four factors with the dependent variable (perception. The respondents are the government servants who are using Motor insurance. This research is carried out through the finding of multiple regression and Pearson correlation analysis where the relationship between knowledge, awareness, advertising and benefit of the product toward perception of Islamic Motor Insurance among government servants. From the findings, the respondents show very good perception toward Islamic Motor Insurance. The findings showed customers‟ perception levels are very positive towards Islamic Motor insurance

  1. Unemployment Insurance Query (UIQ)

    Data.gov (United States)

    Social Security Administration — The Unemployment Insurance Query (UIQ) provides State Unemployment Insurance agencies real-time online access to SSA data. This includes SSN verification and Title...

  2. Unemployment duration and unemployment insurance

    DEFF Research Database (Denmark)

    Røed, Knut; Jensen, Peter; Thoursie, Anna

    2008-01-01

    Based on pooled register data from Norway and Sweden, we find that differences in unemployment duration patterns reflect dissimilarities in unemployment insurance (UI) systems in a way that convincingly establishes the link between economic incentives and job search behaviour. Specifically, UI...... benefits are relatively more generous for low-income workers in Sweden than in Norway, leading to relatively longer unemployment spells for low-income workers in Sweden. Based on the between-countries variation in replacement ratios, we find that the elasticity of the outflow rate from insured unemployment...

  3. Korean immigrants don't buy health insurance: The influences of culture on self-employed Korean immigrants focusing on structure and functions of social networks.

    Science.gov (United States)

    Oh, Hyunsung; Jeong, Chung Hyeon

    2017-10-01

    Culture has been pinpointed as a culprit of disparities in health insurance coverage between Korean immigrants and other ethnic groups. This study explored specific mechanisms by which culture influences a decision to buy health insurance among self-employed Korean immigrants living in ethnic enclaves by focusing on the structure and functions of social networks. Between March and June 2015, we recruited 24 Korean immigrant adults (aged 18 or older) who identified as self-employed and being uninsured for substantial periods before 2014 in Southern California. Interviews were conducted in Korean, and Korean transcripts were translated into English by two bilingual interpreters. Using constant comparative analysis, we explored why participants didn't purchase health insurance after migrating to the United States and how their social networks influenced their decisions whether to purchase health insurance. Results indicate Korean immigrants sought health information from dense and homogeneous social networks whose members are mostly Korean immigrants embedded in similar social contexts. Social learning was frequently observed when people sought health care while uninsured. However, respondents often noted social ties do not provide helpful information about benefits, costs, and ways to use health insurance. "Koreans don't buy health insurance" was a dominant social norm reported by most respondents. Findings indicate that social learning and normative influence occur inside social networks and these mechanisms seemingly prevent purchasing of health insurance. In addition to the individual mandate in the Patient Protection and Affordable Care Act, more targeted approaches that consider the structure and functions of social networks could improve the public health of Korean immigrants. Copyright © 2017 Elsevier Ltd. All rights reserved.

  4. Print News Coverage of School-Based HPV Vaccine Mandate

    Science.gov (United States)

    Casciotti, Dana; Smith, Katherine C.; Andon, Lindsay; Vernick, Jon; Tsui, Amy; Klassen, Ann C.

    2015-01-01

    BACKGROUND In 2007, legislation was proposed in 24 states and the District of Columbia for school-based HPV vaccine mandates, and mandates were enacted in Texas, Virginia, and the District of Columbia. Media coverage of these events was extensive, and media messages both reflected and contributed to controversy surrounding these legislative activities. Messages communicated through the media are an important influence on adolescent and parent understanding of school-based vaccine mandates. METHODS We conducted structured text analysis of newspaper coverage, including quantitative analysis of 169 articles published in mandate jurisdictions from 2005-2009, and qualitative analysis of 63 articles from 2007. Our structured analysis identified topics, key stakeholders and sources, tone, and the presence of conflict. Qualitative thematic analysis identified key messages and issues. RESULTS Media coverage was often incomplete, providing little context about cervical cancer or screening. Skepticism and autonomy concerns were common. Messages reflected conflict and distrust of government activities, which could negatively impact this and other youth-focused public health initiatives. CONCLUSIONS If school health professionals are aware of the potential issues raised in media coverage of school-based health mandates, they will be more able to convey appropriate health education messages, and promote informed decision-making by parents and students. PMID:25099421

  5. THE IMPACT OF COOPERATION BETWEEN INSURERS AND BANKS ON THE DEVELOPMENT OF THE INSURANCE SYSTEM

    Directory of Open Access Journals (Sweden)

    Nataliya Prikazyuk

    2017-11-01

    Full Text Available The article highlights how the cooperation of insurance companies and banks affects the insurance system. Defined the concept of bancassurance, provided a brief description of the main bancassurance models in the context of their impact on the insurance system. Defined the main benefits and risks that accompany cooperation of insurance companies and banks within different models of association. It is noted that despite the generally accepted benefits of cooperation between insurers and banks, financial intermediaries’ unions often carry significant risks. Benefits from the cooperation of insurance companies and banks are disclosed with operational, marketing and financial aspects. The purpose of the article is to study the forms of cooperation between financial intermediaries and their impact on the insurance system. Methodology. The study is based on theoretical methods to study this problem. The theoretical and methodological basis of the study is works of scientists on the models of cooperation between insurers and banks. The dialectical method of cognition as well as such methods as logical generalization, structural and systematic analysis are used to study the methodological foundations of banks’ impact on the insurance companies and insurance system. Results. Banking activity has a significant impact on the insurance system. This impact is noticeable at the micro-level: insurers and banks can be clients of each other as well as they can sign cooperation agreements. A significant positive impact of the bancassurance on the activities of both financial institutions within the synergy that appears during their cooperation is highlighted in the article. Respectively, the insurance company and the bank are experiencing the benefits of cooperation along with savings on fixed, variable costs and obtaining additional profits; simplifying and optimization of the process of collecting and processing information; savings on advertising and

  6. Tax incentives and the demand for private health insurance.

    Science.gov (United States)

    Stavrunova, Olena; Yerokhin, Oleg

    2014-03-01

    We analyze the effect of an individual insurance mandate (Medicare Levy Surcharge) on the demand for private health insurance (PHI) in Australia. With administrative income tax return data, we show that the mandate has several distinct effects on taxpayers' behavior. First, despite the large tax penalty for not having PHI coverage relative to the cost of the cheapest eligible insurance policy, compliance with mandate is relatively low: the proportion of the population with PHI coverage increases by 6.5 percentage points (15.6%) at the income threshold where the tax penalty starts to apply. This effect is most pronounced for young taxpayers, while the middle aged seem to be least responsive to this specific tax incentive. Second, the discontinuous increase in the average tax rate at the income threshold created by the policy generates a strong incentive for tax avoidance which manifests itself through bunching in the taxable income distribution below the threshold. Finally, after imposing some plausible assumptions, we extrapolate the effect of the policy to other income levels and show that this policy has not had a significant impact on the overall demand for private health insurance in Australia. Copyright © 2014 Elsevier B.V. All rights reserved.

  7. Women's Health Insurance Coverage

    Science.gov (United States)

    ... Women's Health Policy Women’s Health Insurance Coverage Women’s Health Insurance Coverage Published: Oct 31, 2017 Facebook Twitter LinkedIn ... that many women continue to face. Sources of Health Insurance Coverage Employer-Sponsored Insurance: Approximately 57.9 million ...

  8. Alternative health insurance schemes

    DEFF Research Database (Denmark)

    Keiding, Hans; Hansen, Bodil O.

    2002-01-01

    In this paper, we present a simple model of health insurance with asymmetric information, where we compare two alternative ways of organizing the insurance market. Either as a competitive insurance market, where some risks remain uninsured, or as a compulsory scheme, where however, the level...... competitive insurance; this situation turns out to be at least as good as either of the alternatives...

  9. Health Insurance Basics

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español Health Insurance Basics KidsHealth / For Teens / Health Insurance Basics What's ... thought advanced calculus was confusing. What Exactly Is Health Insurance? Health insurance is a plan that people buy ...

  10. 26 CFR 1.411(d)-4 - Section 411(d)(6) protected benefits.

    Science.gov (United States)

    2010-04-01

    ...: (1) Ancillary life insurance protection; (2) Accident or health insurance benefits; (3) Social... availability of the optional form of benefit. Other aspects of an optional form of benefit may not be modified...

  11. Multinational Subsidiary Knowledge Protection - Do Mandates and Clusters Matter?

    DEFF Research Database (Denmark)

    Sofka, Wolfgang; Shehu, Edlira; de Faria, Pedro

    2014-01-01

    knowledge protection intensity. In addition, technological cluster regions in the host country can be expected to provide opportunities for knowledge sourcing and MNC subsidiaries may be willing to protect knowledge less intensively to participate in cluster networks. We test our hypotheses using a dataset...... of knowledge protection intensity of MNC subsidiaries. We argue that knowledge protection intensity is determined by MNC subsidiary mandates and by opportunities and risks originating from the host region. We hypothesize that not just competence-creating but also competence-exploiting mandates increase...... of 694 observations of 631 MNC subsidiaries in Germany and develop recommendations for research, managers and policy makers....

  12. Maternal employment, breastfeeding, and health: evidence from maternity leave mandates.

    Science.gov (United States)

    Baker, Michael; Milligan, Kevin

    2008-07-01

    Public health agencies around the world have renewed efforts to increase the incidence and duration of breastfeeding. Maternity leave mandates present an economic policy that could help achieve these goals. We study their efficacy, focusing on a significant increase in maternity leave mandates in Canada. We find very large increases in mothers' time away from work post-birth and in the attainment of critical breastfeeding duration thresholds. We also look for impacts of the reform on self-reported indicators of maternal and child health captured in our data. For most indicators we find no effect.

  13. Health Care Sharing Ministries and Their Exemption From the Individual Mandate of the Affordable Care Act.

    Science.gov (United States)

    Galarneau, Charlene

    2015-06-01

    The U.S. 2010 Patient Protection and Affordable Care Act (ACA) exempts members of health care sharing ministries (HCSMs) from the individual mandate to have minimum essential insurance coverage. Little is generally known about these religious organizations and even less critical attention has been brought to bear on them and their ACA exemption. Both deserve close scrutiny due to the exemption's less than clear legislative justification, their potential influence on the ACA's policy and ethical success, and their salience to current religious liberty debates surrounding the expansion of religious exemptions from ACA responsibilities for both individuals and corporations. Analyzing documents of the United States' three largest health care sharing ministries and related material, I examine these organizations and their ACA exemption with particular consideration of their ethical dimensions. Here a thick description of the nature and workings of health care sharing ministries precedes a similar account of the ACA exemption. From these empirical analyses, five ethical and policy concerns emerge: (1) the charity versus insurance status of these ministries; (2) the conflation of two ACA religious exemptions; (3) the tension between the values of religious liberty and of justice; (4) the potential undermining of ACA policy goals; and (5) the questionable compliance of health care sharing ministries with ACA exemption requirements.  An accurate and informed understanding of HCSMs is required for policymakers and others to justify the ACA exemption of health care sharing ministry members. A sufficient justification would address at least the five ethical and policy concerns raised here.

  14. The Reallocation of Compensation in Response to Health Insurance Premium Increases

    OpenAIRE

    Dana P. Goldman; Neeraj Sood; Arleen Leibowitz

    2003-01-01

    This paper examines how compensation packages change when health insurance premiums rise. We use data on employee choices within a single large firm with a flexible benefits plan; an increasingly common arrangement among medium and large firms. In these companies, employees explicitly choose how to allocate compensation between cash and various benefits such as retirement, medical insurance, life insurance, and dental benefits. We find that a $1 increase in the price of health insurance leads...

  15. School Superintendents' Perceptions of Schools Assisting Students in Obtaining Public Health Insurance

    Science.gov (United States)

    Rickard, Megan L.; Price, James H.; Telljohann, Susan K.; Dake, Joseph A.; Fink, Brian N.

    2011-01-01

    Background: Superintendents' perceptions regarding the effect of health insurance status on academics, the role schools should play in the process of obtaining health insurance, and the benefits/barriers to assisting students in enrolling in health insurance were surveyed. Superintendents' basic knowledge of health insurance, the link between…

  16. 20 CFR 404.212 - Computing your primary insurance amount from your average indexed monthly earnings.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Computing your primary insurance amount from... ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) Computing Primary Insurance Amounts Average-Indexed-Monthly-Earnings Method of Computing Primary Insurance Amounts § 404.212 Computing your...

  17. Financial Performance of Health Insurers: State-Run Versus Federal-Run Exchanges.

    Science.gov (United States)

    Hall, Mark A; McCue, Michael J; Palazzolo, Jennifer R

    2018-06-01

    Many insurers incurred financial losses in individual markets for health insurance during 2014, the first year of Affordable Care Act mandated changes. This analysis looks at key financial ratios of insurers to compare profitability in 2014 and 2013, identify factors driving financial performance, and contrast the financial performance of health insurers operating in state-run exchanges versus the federal exchange. Overall, the median loss of sampled insurers was -3.9%, no greater than their loss in 2013. Reduced administrative costs offset increases in medical losses. Insurers performed better in states with state-run exchanges than insurers in states using the federal exchange in 2014. Medical loss ratios are the underlying driver more than administrative costs in the difference in performance between states with federal versus state-run exchanges. Policy makers looking to improve the financial performance of the individual market should focus on features that differentiate the markets associated with state-run versus federal exchanges.

  18. A Review of Open Access Self-Archiving Mandate Policies

    Science.gov (United States)

    Xia, Jingfeng; Gilchrist, Sarah B.; Smith, Nathaniel X. P.; Kingery, Justin A.; Radecki, Jennifer R.; Wilhelm, Marcia L.; Harrison, Keith C.; Ashby, Michael L.; Mahn, Alyson J.

    2012-01-01

    This article reviews the history of open access (OA) policies and examines the current status of mandate policy implementations. It finds that hundreds of policies have been proposed and adopted at various organizational levels and many of them have shown a positive effect on the rate of repository content accumulation. However, it also detects…

  19. Keeping Children Safe: Afterschool Staff and Mandated Child Maltreatment Reporting

    Science.gov (United States)

    Gandarilla, Maria; O'Donnell, Julie

    2014-01-01

    With 8.4 million children in the U.S. spending an average of eight hours a week in afterschool programs, afterschool providers are an important part of the network of caring adults who can help to keep children safe. In addition, afterschool staff are "mandated reporters." Whether or not the laws specifically mention afterschool staff,…

  20. Education Policy Mediation: Principals' Work with Mandated Literacy Assessment

    Science.gov (United States)

    Comber, Barbara; Cormack, Phil

    2011-01-01

    Mandated literacy assessment is now a ubiquitous practice in many western educational systems. While educational researchers, principals, teachers and education unions continue to offer vociferous resistance in some nations, in others it is now commonplace in the educational landscape and built into the rhythms of the school year. This paper is…

  1. Wisconsin EE Mandates: The Bad News and the Good News.

    Science.gov (United States)

    Lane, Jennie; And Others

    1996-01-01

    Examines Wisconsin teachers' perceived competencies in, attitudes toward, and amount of class time devoted to teaching about the environment. Discusses the effects of Wisconsin environmental education mandates concerning preservice preparation in environmental education and K-12 environmental education curriculum plans. Identifies areas where the…

  2. Optimal Taxation and Social Insurance in a Lifetime Perspective

    DEFF Research Database (Denmark)

    Bovenberg, A. Lans; Sørensen, Peter Birch

    Advances in information technology have improved the administrative feasibility of redistribution based on lifetime earnings recorded at the time of retirement. We study optimal lifetime income taxation and social insurance in an economy in which redistributive taxation and social insurance serve......-transfer system does not provide full disability insurance. By offering imperfect insurance and structuring disability benefits so as to enable workers to insure against disability by working harder, social insurance is designed to offset the distortionary impact of the redistributive labor income tax on labor...... to insure (ex ante) against skill heterogeneity as well as disability risk. Optimal disability benefits rise with previous earnings so that public transfers depend not only on current earnings but also on earnings in the past. Hence, lifetime taxation rather than annual taxation is optimal. The optimal tax...

  3. 77 FR 16453 - Student Health Insurance Coverage

    Science.gov (United States)

    2012-03-21

    ... eliminating annual and lifetime dollar limits would result in dramatic premium hikes for student plans and.... Industry and university commenters noted that student health insurance coverage benefits typically... duplication of benefits and makes student plans more affordable. Industry commenters noted that student health...

  4. Insurer risk control and nuclear liability

    Energy Technology Data Exchange (ETDEWEB)

    DeMerchant, C. [Nuclear Insurance Association of Canada, Toronto, ON (Canada)

    2015-07-01

    We specialize in high quality insurance risk management, underwriting and inspections for Canadian nuclear exposures. We provide true risk transfer, secure insurance capacity and collaborate with the world's nuclear experts to create innovative domestic solutions for our clients and members. The benefit of our experience works for all stake holders: insured clients, members, multi-level government agencies and all Canadians. NIAC has a 55-year history of partnering with insurers around the globe to create reliable risk management for the nuclear industry. We offer Canadian risk solutions, thought leadership and expertise that provides security and confidence to our customers and members. NIAC leads in the areas of nuclear insurance law, good governance and claims administration to create a true Centre of Excellence.

  5. Insurer risk control and nuclear liability

    International Nuclear Information System (INIS)

    DeMerchant, C.

    2015-01-01

    We specialize in high quality insurance risk management, underwriting and inspections for Canadian nuclear exposures. We provide true risk transfer, secure insurance capacity and collaborate with the world's nuclear experts to create innovative domestic solutions for our clients and members. The benefit of our experience works for all stake holders: insured clients, members, multi-level government agencies and all Canadians. NIAC has a 55-year history of partnering with insurers around the globe to create reliable risk management for the nuclear industry. We offer Canadian risk solutions, thought leadership and expertise that provides security and confidence to our customers and members. NIAC leads in the areas of nuclear insurance law, good governance and claims administration to create a true Centre of Excellence.

  6. Insurance of nuclear risk

    International Nuclear Information System (INIS)

    Lacroix, M.

    1976-01-01

    Insurance for large nuclear installations covers mainly four types of risk: third party liability which in accordance with the nuclear conventions, is borne by a nuclear operator following an incident occurring in his installation or during transport of nuclear substances; material damage to the installation itself, which precisely is not covered by third party liability insurance; machinery breakdown, i.e. accidental damage or interruption of operation. Only the first category must be insured. In view of the magnitude of the risk, nuclear insurance resorts to co-insurance and reinsurance techniques which results in a special organisation of the nuclear insurance market, based on national nuclear insurance pools and on the Standing Committee on Atomic Risk of the European Insurance Committee. Conferences of the chairmen of nuclear insurance pools are convened regularly at a worldwide level. (NEA) [fr

  7. Pensions as Retirement Income Insurance.

    OpenAIRE

    Bodie, Zvi

    1990-01-01

    This paper develops the view that employer-sponsored pension plans are best understood as retirement income insurance for employees and from that perspective addresses a number of questions regarding the reasons for their existence, their design, and their funding and investment policies. The most important of these questions are: - Why do employers provide pension plans for their employees and why is participation usually mandatory? - Why is the defined benefit form of pension plan the domin...

  8. Employee Responses to Health Insurance Premium Increases

    OpenAIRE

    Goldman, Dana; Leibowitz, Arleen; Robalino, David

    2004-01-01

    Objective: To determine the sensitivity of employees’ health insurance decisions—including the decision to not choose health maintenance organization or fee-for-service coverage—during periods of rapidly escalating healthcare costs. Study Design: A retrospective cohort study of employee plan choices at a single large firm with a “cafeteria-style” benefits plan wherein employees paid all the additional cost of purchasing more generous insurance. Methods: We modeled the probabil...

  9. Individual savings accounts for social insurance

    DEFF Research Database (Denmark)

    Bovenberg, Lans; Hansen, Martin Ino; Sørensen, Peter Birch

    2008-01-01

    Using Danish data, we find that about three-fourths of the taxes levied to finance public transfers actually finance benefits that redistribute income over the life cycle of individual taxpayers rather than redistribute resources across people. This finding and similar results for other countries...... provide a rationale for financing part of social insurance via mandatory individual savings accounts. We discuss the advantages and disadvantages of mandatory individual savings accounts for social insurance and survey some recent alternative proposals for such accounts...

  10. 76 FR 24572 - Proposed Information Collection (Application for Ordinary Life Insurance) Activity: Comment Request

    Science.gov (United States)

    2011-05-02

    ... insurance. Modified Life insurance coverage is reduced automatically by one-half from its present face value... (Application for Ordinary Life Insurance) Activity: Comment Request AGENCY: Veterans Benefits Administration, Department of Veterans Affairs. ACTION: Notice. SUMMARY: The Veterans Benefits Administration (VBA...

  11. Systematic review of the effect of immunization mandates on uptake of routine childhood immunizations.

    Science.gov (United States)

    Lee, Cecilia; Robinson, Joan L

    2016-06-01

    The efficacy of immunization mandates for childcare or school entry is a long-standing controversy. The United States (US) adopted school entry immunization mandates in the 1800s, while most countries still do not have mandates. The objective of this systematic review was to analyze the evidence that immunization uptake increases with mandates. A search was conducted for studies that compared immunization uptake in a population prior to and after mandates, or in similar populations with one group having and the other not having mandates. Data were extracted and synthesized qualitatively due to the heterogeneity of study design. Eleven before-and-after studies and ten studies comparing uptake in similar populations with and without mandates were included. Studies were from the US (n = 18), France (n = 1) and Canada (n = 2). Eleven of the 21 studies looked at middle school mandates. All but two studies showed at least a trend towards increased uptake with mandates. Higher uptake was associated with a more long-standing mandate. Immunization mandates have generally led to increased short-term and long-term uptake in the group to whom the mandate applies. Many studies have centered around middle school mandates in the US and there is a paucity of studies of childcare mandates or of studies of mandates in other countries or in settings with relatively high baseline immunization uptake. Copyright © 2016 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

  12. Reforming insurance to support workers' rights to compensation.

    Science.gov (United States)

    McCluskey, Martha T

    2012-06-01

    The structure and regulation of the insurance system for financing workers' compensation affects the costs of workers' benefits. Using the example of Maine's insurance market restructuring in response to a crisis of the early 1990s, this commentary explores how changes in insurance regulation might better support the goals of workers' compensation. The commentary analyzes how insurance and its regulation should go beyond correct pricing of risks to questions of how to structure incentives for loss control to include workers' interests as well as the interests of employers and insurers. Copyright © 2012 Wiley Periodicals, Inc.

  13. Expanding Canada Pension Plan Retirement Benefits: Assessing Big CPP Proposals

    Directory of Open Access Journals (Sweden)

    Jonathan R. Kesselman

    2010-10-01

    Full Text Available Current and growing deficiencies in many workers’ ability to maintain their accustomed living standards in retirement have evoked varied proposals for reform of Canada’s retirement income system. This study focuses on proposals for expanding the retirement benefits of the Canada Pension Plan (CPP, and undertakes comparative analysis with proposals for reforms affecting workplace pensions and individual savings. It begins by reviewing key policy questions for the retirement income system and describing essential features of several proposals for CPP benefit expansion. It then uses these “Big CPP” proposals as a basis to assess the design issues for expanding CPP benefits and the implications for other components of the retirement income system. The paper assesses each of the major private and public savings vehicles based on multifaceted criteria for a well-performing retirement income system; a mandatory public scheme with defined benefits ranks most highly on almost all criteria other than individual flexibility. Additional behavioural and institutional factors also support the use of mandatory public pensions: myopia in savings, individual investment behaviour, scale economies and costs of fund management, adverse selection and annuitization costs, the Samaritan’s Dilemma, and labour market incentives. The study provides an overview analysis of key design issues for the expansion of CPP retirement benefits. Major issues include the desirable scale of expansion for both the percentage of insurable earnings and the insurable earnings ceiling; mandatory versus voluntary coverage and options; the allocation of investment return risk; and the phasing-in of higher premiums and benefits. The study then assesses the implications of CPP expansion for other components of the retirement income system: Old Age Security and the Guaranteed Income Supplement, workplace pensions, tax provisions for savings, and individual savings. A Big CPP fits

  14. Chinese nuclear insurance and Chinese nuclear insurance pool

    International Nuclear Information System (INIS)

    Gong Zhiqi

    2000-01-01

    Chinese Nuclear Insurance Started with Daya Bay Nuclear Power Station, PICC issued the insurance policy. Nuclear insurance cooperation between Chinese and international pool's organizations was set up in 1989. In 1996, the Chinese Nuclear Insurance Pool was prepared. The Chinese Nuclear Insurance Pool was approved by The Chinese Insurance Regulatory Committee in May of 1999. The principal aim is to centralize maximum the insurance capacity for nuclear insurance from local individual insurers and to strengthen the reinsurance relations with international insurance pools so as to provide the high quality insurance service for Chinese nuclear industry. The Member Company of Chinese Nuclear Pool and its roles are introduced in this article

  15. Understanding health insurance plans

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/patientinstructions/000879.htm Understanding health insurance plans To use the sharing features on this ... plan for you and your family. Types of Health Insurance Plans Depending on how you get your health ...

  16. 34 CFR 106.56 - Fringe benefits.

    Science.gov (United States)

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false Fringe benefits. 106.56 Section 106.56 Education... benefits. (a) Fringe benefits defined. For purposes of this part, fringe benefits means: Any medical, hospital, accident, life insurance or retirement benefit, service, policy or plan, any profit-sharing or...

  17. 24 CFR 266.602 - Mortgage insurance premium: Insured advances.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Mortgage insurance premium: Insured... Contract Rights and Obligations Mortgage Insurance Premiums § 266.602 Mortgage insurance premium: Insured.... On each anniversary of the initial closing, the HFA shall pay an interim mortgage insurance premium...

  18. Statewide Community College Employee Benefit Consortium.

    Science.gov (United States)

    Guy, Jerry T.

    Health insurance benefit programs in Texas community college districts fall into three groups. Comprising 25% of the districts, districts fall into three groups. Comprising 25% of the districts, the "help me now" group has experienced heavy group health insurance benefit utilization over the past few years and is unable to purchase required…

  19. Farmers Insures Success

    Science.gov (United States)

    Freifeld, Lorri

    2012-01-01

    Farmers Insurance claims the No. 2 spot on the Training Top 125 with a forward-thinking training strategy linked to its primary mission: FarmersFuture 2020. It's not surprising an insurance company would have an insurance policy for the future. But Farmers takes that strategy one step further, setting its sights on 2020 with a far-reaching plan to…

  20. Health Insurance Coverage: Early Release of Estimates from the National Health Interview Survey, January -- June 2013

    Science.gov (United States)

    ... from 2010 to 2013 were also evaluated using logistic regression analysis. State-specific health insurance estimates are ... coverage options; compare health insurance plans based on cost, benefits, and other important features; choose a plan; ...

  1. Evaluation of the League General Insurance Company child safety seat distribution program

    Science.gov (United States)

    1982-05-01

    This report presents an evaluation of the child safety seat distribution initiated by the League General Insurance Company in June 1979. The program provides child safety seats as a benefit under the company's auto insurance policies to policy-holder...

  2. Household perceptions and their implications for enrollment in the National Health Insurance Scheme in Ghana.

    NARCIS (Netherlands)

    Jehu-Appiah, C.; Aryeetey, G.C.; Agyepong, I.; Spaan, E.J.; Baltussen, R.M.

    2012-01-01

    OBJECTIVE: This paper identifies, ranks and compares perceptions of insured and uninsured households in Ghana on health care providers (quality of care, service delivery adequacy, staff attitudes), health insurance schemes (price, benefits and convenience) and community attributes (health 'beliefs

  3. Benefits for handicapped children

    CERN Multimedia

    2003-01-01

    The introduction of long-term care benefits within the CERN Health Insurance Scheme requires the coordination of the benefits foreseen for handicapped children. Measures were adopted by the Management following the recommendation made by the Standing Concertation Committee on 26 March 2003. A document clarifying these measures is available on the Web at the following address: http://humanresources.web.cern.ch/humanresources/external/soc/Social_affairs/social_affairs.asp Social Affairs Service 74201

  4. Risks and nuclear insurance

    International Nuclear Information System (INIS)

    Debaets, M.; Springett, G.D.; Luotonen, K.; Virole, J.

    1988-01-01

    When analysing the nuclear insurance market, three elements must be taken into account: the nuclear operator's liability is regulated by national laws and/or international Conventions, such operators pay large premiums to insure their nuclear installations against property damage and finally, the nuclear insurance market is made up of pools and is mainly a monopoly. This report describes the different types of insurance coverage, the system governing nuclear third party liability under the Paris Convention and the Brussels Supplementary Convention and several national laws in that field. The last part of the report deals with liability and insurance aspects of international transport of nuclear materials [fr

  5. Insurance concerns relative to onsite storage of low level radioactive waste

    International Nuclear Information System (INIS)

    Fox, P.R.

    1995-01-01

    ANI and MAELU are voluntary associations made up of approximately 80 stock ampersand 98 mutual insurance companies who insure nuclear risks on a syndicate or pooling basis. The purpose of the pools is to provide for the insurance needs of the nuclear industry in the United States as mandated by the Congress and the NRC. ANI and MAELU provide two types of insurance policies: (1) liability policies - In general, nuclear liability policies provide protection for third party bodily injury and off-site property damage resulting from the nuclear hazard. (2) property policies - The property policies insure against radioactive contamination as the primary peril, but also provide coverage of many conventional property insurance perils. These range from boiler and machinery type losses to fire, extended coverage and vandalism to earthquake and flood coverage

  6. Facilitating Consumer Learning in Insurance Markets

    DEFF Research Database (Denmark)

    Lagerlöf, Johan N. M.; Schottmüller, Christoph

    2018-01-01

    We model a monopoly insurance market where consumers can learn their accident risks at a cost c. We then ask: What are the welfare effects of a policy that reduces c? If c is sufficiently small (c consumer gathers information. For c ... and consumer benefit from a policy that reduces c further. For c > c*, marginally reducing c hurts the insurer and weakly benefits the consumer. Finally, a reduction in c that is “successful,” meaning that the consumer gathers information after the reduction but not before it, can hurt both parties....

  7. STUDY ON THE MAIN THEORETICAL ASPECTS RELATING TO THE PREMIUM TARIFFS IN THE PROPERTY INSURANCE

    Directory of Open Access Journals (Sweden)

    Vaduva Maria

    2012-03-01

    Full Text Available In the insurance market of goods, most of the first levied by the insurer is used for payment of damages due insured. The element mainly depending on which he fixes the level of share premium pricing is likely to size claims the insurer will pay insured. Part of the quota tariff intended for the first payment of damages is called net or share of first base. Adding to the addition cover expenditure on lodging and administering the fund insurance and financing of measures to prevent the damage, formation of the reserve fund and achieve the insurer has a specific benefit, get the first tariff or first gross.

  8. Public Insurance and Equality

    DEFF Research Database (Denmark)

    Landes, Xavier; Néron, Pierre-Yves

    2015-01-01

    Heath (among other political theorists) considers that the principle of efficiency provides a better normative explanation and justification of public insurance than the egalitarian account. According to this view, the fact that the state is involved in the provision of specific insurance (primarily......Public insurance is commonly assimilated with redistributive tools mobilized by the welfare state in the pursuit of an egalitarian ideal. This view contains some truth, since the result of insurance, at a given moment, is the redistribution of resources from the lucky to unlucky. However, Joseph...... surrounding public insurance as a redistributive tool, advancing the idea that public insurance may be a relational egalitarian tool. It then presents a number of relational arguments in favor of the involvement of the state in the provision of specific forms of insurance, arguments that have been overlooked...

  9. Social Insurance in Romania - Concern for Governors

    Directory of Open Access Journals (Sweden)

    Manuela Panaitescu

    2011-05-01

    Full Text Available Objectives: the comparative research of the public and private insurance systems is important as itprovides financial benefits to the individuals who have lost their income due to their old age, along with theirdecreased labour ability caused by disabilities, disease, motherhood, work related accidents orunemployment, and the resulting benefits are conditioned by the due contributions; Prior Work: this workcontinues previous research conducted for the PhD thesis called “Improving Management in the Public andPrivate Insurance Systems in the Market Economy”; Approach: the main methods that have been used insurveys and observation of the population’s behaviour; Results: in order to reduce the financial restraints thatthe public insurance system has to cope with, the concrete implementation of a social insurance system basedon the needs and value scales of the Romanian state is necessary; Implications: academics and researchersinterested in the Romanian social insurance system management and its long run effects on the population;Value: the insurance systems determins the quality of life for most of the population and strongly influencethe economy, especially the labour market and the capital market. This is why social security is a commonchallenge for all European countries.

  10. State insurance exchanges face challenges in offering standardized choices alongside innovative value-based insurance.

    Science.gov (United States)

    Corlette, Sabrina; Downs, David; Monahan, Christine H; Yondorf, Barbara

    2013-02-01

    Value-based insurance is a relatively new approach to health insurance in which financial barriers, such as copayments, are lowered for clinical services that are considered high value, while consumer cost sharing may be increased for services considered to be of uncertain value. Such plans are complex and do not easily fit into the simplified, consumer-friendly comparison tools that many state health insurance exchanges are formulating for use in 2014. Nevertheless some states and plans are attempting to strike the right balance between a streamlined health exchange shopping experience and innovative, albeit complex, benefit design that promotes value. For example, agencies administering exchanges in Vermont and Oregon are contemplating offering value-based insurance plans as an option in addition to a set of standardized plans. In the postreform environment, policy makers must find ways to present complex value-based insurance plans in a way that consumers and employers can more readily understand.

  11. IoT enabled Insurance Ecosystem - Possibilities Challenges and Risks

    OpenAIRE

    Manral, Jai

    2015-01-01

    Internet of Thing (IoT) is looking over to overhaul the business processes of many industries including insurance domain. The current line of business such as Property and Casualty, Health, and Life Insurance can avail tremendous benefits from the contextual and relevant data being generated from billions of connected devices; Smartphone's, wearable gadget and other electronic smart sensors. For P&C insurer's the biggest challenges is not the rapidly changing environment but tackling these ch...

  12. Health Care Analysis for the MCRMC Insurance Cost Model

    Science.gov (United States)

    2015-06-01

    incentive to reduce utilization  Subsidy to leave TRICARE and use other private health insurance  Increases in TRICARE premiums and co-pays  This...analysis develops the estimated cost of providing health care through a premium -based insurance model consistent with an employer-sponsored benefit...State  Income  Plan premium data  Contract cost data 22 May 2015 9 Agenda  Overview  Background  Data  Insurance Cost Estimate Methodology

  13. HEALTH INSURANCE: FIXED CONTRIBUTION AND REIMBURSEMENT MAXIMA

    CERN Document Server

    Human Resources Division

    2001-01-01

    Affected by the salary adjustments on 1 January 2001 and the evolution of the staff members and fellows population, the average reference salary, which is used as an index for fixed contributions and reimbursement maxima, has changed significantly. An adjustment of the amounts of the reimbursement maxima and the fixed contributions is therefore necessary, as from 1 January 2001. Reimbursement maxima The revised reimbursement maxima will appear on the leaflet summarizing the benefits for the year 2001, which will be sent out with the forthcoming issue of the CHIS Bull'. This leaflet will also be available from the divisional secretariats and from the UNIQA office at CERN. Fixed contributions The fixed contributions, applicable to some categories of voluntarily insured persons, are set as follows (amounts in CHF for monthly contributions) : voluntarily insured member of the personnel, with normal health insurance cover : 910.- (was 815.- in 2000) voluntarily insured member of the personnel, with reduced heal...

  14. HEALTH INSURANCE: CONTRIBUTIONS AND REIMBURSEMENT MAXIMAL

    CERN Document Server

    HR Division

    2000-01-01

    Affected by both the salary adjustment index on 1.1.2000 and the evolution of the staff members and fellows population, the average reference salary, which is used as an index for fixed contributions and reimbursement maximal, has changed significantly. An adjustment of the amounts of the reimbursement maximal and the fixed contributions is therefore necessary, as from 1 January 2000.Reimbursement maximalThe revised reimbursement maximal will appear on the leaflet summarising the benefits for the year 2000, which will soon be available from the divisional secretariats and from the AUSTRIA office at CERN.Fixed contributionsThe fixed contributions, applicable to some categories of voluntarily insured persons, are set as follows (amounts in CHF for monthly contributions):voluntarily insured member of the personnel, with complete coverage:815,- (was 803,- in 1999)voluntarily insured member of the personnel, with reduced coverage:407,- (was 402,- in 1999)voluntarily insured no longer dependent child:326,- (was 321...

  15. From Partnership Formation to Collaboration: Developing a State Mandated University-Multidistrict Partnership to Design a PK-12 Principal Preparation Program in a Rural Service Area

    Science.gov (United States)

    Carlson, Cameron B.

    2012-01-01

    Recent state policies demand universities restructure principal preparation programs. Mandates, though unfunded, provide an opportunity for universities to engage representative stakeholders who benefit from context specific instruction. This article demonstrates how professors in one research university used collected programmatic information and…

  16. Willingness to Pay for Complementary Health Care Insurance in Iran.

    Science.gov (United States)

    Nosratnejad, Shirin; Rashidian, Arash; Akbari Sari, Ali; Moradi, Najme

    2017-09-01

    Complementary health insurance is increasingly used to remedy the limitations and shortcomings of the basic health insurance benefit packages. Hence, it is essential to gather reliable information about the amount of Willingness to Pay (WTP) for health insurance. We assessed the WTP for health insurance in Iran in order to suggest an affordable complementary health insurance. The study sample consisted of 300 household heads all over provinces of Iran in 2013. The method applied was double bounded dichotomous choice and open-ended question approach of contingent valuation. The average WTP for complementary health insurance per person per month by double bounded dichotomous choice and open-ended question method respectively was 199000 and 115300 Rials (8 and 4.6 USD, respectively). Household's heads with higher levels of income and those who worked had more WTP for the health insurance. Besides, the WTP increased in direct proportion to the number of insured members of each household and in inverse proportion to the family size. The WTP value can be used as a premium in a society. As an important finding, the study indicated that the households were willing to pay higher premiums than currently collected for the complementary health insurance coverage in Iran. This offers the policy makers the opportunity to increase the premium and provide good benefits package for insured people of country then better risk pooling.

  17. Do coverage mandates affect direct-to-consumer advertising for pharmaceuticals? Evidence from parity laws.

    Science.gov (United States)

    Nathenson, Robert; Richards, Michael R

    2018-01-29

    Direct-to-consumer advertising (DTCA) for prescription drugs is a relatively unique feature of the US health care system and a source of tens of billions of dollars in annual spending. It has also garnered the attention of researchers and policymakers interested in its implications for firm and consumer behavior. However, few economic studies have explored the DTCA response to public policies, especially those mandating coverage of these products. We use detailed advertising expenditure data to assess if pharmaceutical firms increase their marketing efforts after the implementation of relevant state and federal health insurance laws. We focus on mental health parity statutes and related drug therapies-a potentially ripe setting for inducing stronger consumer demand. We find no clear indication that firms expect greater value from DTCA after these regulatory changes. DTCA appears driven by other considerations (e.g., product debut); however, it remains a possibility that firms respond to these laws through other, unobserved channels (e.g., provider detailing).

  18. HEALTH INSURANCE RULES OF THE CERN HEALTH INSURANCE SCHEME

    CERN Multimedia

    Division HR

    2000-01-01

    A new document which groups together the general principles, the contributions, benefits, reimbursement procedures and other information making up the Rules of the CERN Health Insurance Scheme has been established. It was approved by the Director-General on 7th July 2000 and is being distributed to all contributing members of the Scheme. It has been dispatched by internal mail to members of the personnel and by postal mail to pensioners. These Rules will enter into force on 1st September 2000. Please make sure that you have received your copy. Should this not be the case, an additional copy may be obtained by telephoning 78003

  19. Health Insurance Rules of the CERN Health Insurance scheme

    CERN Multimedia

    Division HR

    2000-01-01

    A new document which groups together the general principles, the contributions, benefits, reimbursement procedures and other information making up the Rules of the CERN Health Insurance Scheme has been established. It was approved by the Director-General on 7th July 2000 and is being distributed to all contributing members of the Scheme. It has been dispatched by internal mail to members of the personnel and by postal mail to pensioners. These Rules will enter into force on 1st September 2000. Please make sure that you have received your copy. Should this not be the case, an additional copy may be obtained by telephoning 78003.

  20. Social Security Disability Insurance: Essential Protection when Work Incapacity Strikes

    Science.gov (United States)

    Reno, Virginia P.; Ekman, Lisa D.

    2012-01-01

    Social Security Disability Insurance (SSDI) is an essential lifeline for millions of Americans. Without it, many families would be in deep financial distress. SSDI is insurance that workers pay for through premiums deducted from their pay. In return, workers gain the right to monthly benefits if a disabling condition ends their capacity to earn a…

  1. 26 CFR 20.2042-1 - Proceeds of life insurance.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 14 2010-04-01 2010-04-01 false Proceeds of life insurance. 20.2042-1 Section 20.2042-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) ESTATE... speaking, the term has reference to the right of the insured or his estate to the economic benefits of the...

  2. The emerging market for supplemental long term care insurance in Germany in the context of the 2013 Pflege-Bahr reform.

    Science.gov (United States)

    Nadash, Pamela; Cuellar, Alison Evans

    2017-06-01

    The growing cost of long term care is burdening many countries' health and social care systems, causing them to encourage individuals and families to protect themselves against the financial risk posed by long term care needs. Germany's public long-term care insurance program, which mandates coverage for most Germans, is well-known, but fewer are aware of Germany's growing voluntary, supplemental private long-term care insurance market. This paper discusses German policymakers' 2013 effort to expand it by subsidizing the purchase of qualified policies. We provide data on market expansions and the extent to which policy goals are being achieved, finding that public subsidies for purchasing supplemental policies boosted the market, although the effect of this stimulus diminished over time. Meanwhile, sales growth in the unsubsidized market appears to have slowed, despite design features that create incentives for lower-risk individuals to seek better deals there. Thus, although subsidies for cheap, low-benefit policies seem to have achieved the goal of market expansion, the overall impact and long-term sustainability of these products is unclear; conclusions about its impact are further muddied by significant expansions to Germany's core program. The German example reinforces the examples of the US and France private long term care insurance markets, to show how such products flourish best when supplementing a public program. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  3. Nuclear insurance fire risk

    International Nuclear Information System (INIS)

    Dressler, E.G.

    2001-01-01

    Nuclear facilities operate under the constant risk that radioactive materials could be accidentally released off-site and cause injuries to people or damages to the property of others. Management of this nuclear risk, therefore, is very important to nuclear operators, financial stakeholders and the general public. Operators of these facilities normally retain a portion of this risk and transfer the remainder to others through an insurance mechanism. Since the nuclear loss exposure could be very high, insurers usually assess their risk first-hand by sending insurance engineers to conduct a nuclear insurance inspection. Because a serious fire can greatly increase the probability of an off-site release of radiation, fire safety should be included in the nuclear insurance inspection. This paper reviews essential elements of a facility's fire safety program as a key factor in underwriting nuclear third-party liability insurance. (author)

  4. Vaccinating health care workers against influenza: the ethical and legal rationale for a mandate.

    Science.gov (United States)

    Ottenberg, Abigale L; Wu, Joel T; Poland, Gregory A; Jacobson, Robert M; Koenig, Barbara A; Tilburt, Jon C

    2011-02-01

    Despite improvements in clinician education, symptom awareness, and respiratory precautions, influenza vaccination rates for health care workers have remained unacceptably low for more than three decades, adversely affecting patient safety. When public health is jeopardized, and a safe, low-cost, and effective method to achieve patient safety exists, health care organizations and public health authorities have a responsibility to take action and change the status quo. Mandatory influenza vaccination for health care workers is supported not only by scientific data but also by ethical principles and legal precedent. The recent influenza pandemic provides an opportunity for policymakers to reconsider the benefits of mandating influenza vaccination for health care workers, including building public trust, enhancing patient safety, and strengthening the health care workforce.

  5. Main Determinants of Supplementary Health Insurance Demand: (Case of Iran)

    Science.gov (United States)

    Motlagh, Soraya Nouraei; Gorji, Hassan Abolghasem; Mahdavi, Ghadir; Ghaderi, Hossein

    2015-01-01

    Introduction: In the majority of developing countries, the volume of medical insurance services, provided by social insurance organizations is inadequate. Thus, supplementary medical insurance is proposed as a means to address inadequacy of medical insurance. Accordingly, in this article, we attempted to provide the context for expansion of this important branch of insurance through identification of essential factors affecting demand for supplementary medical insurance. Method: In this study, two methods were used to identify essential factors affecting choice of supplementary medical insurance including Classification and Regression Trees (CART) and Bayesian logit. To this end, Excel® software was used to refine data and R® software for estimation. The present study was conducted during 2012, covering all provinces in Iran. Sample size included 18,541 urban households, selected by Statistical Center of Iran using 3-stage cluster sampling approach. In this study, all data required were collected from the Statistical Center of Iran. Results: In 2012, an overall 8.04% of the Iranian population benefited from supplementary medical insurance. Demand for supplementary insurance is a concave function of age of the household head, and peaks in middle-age when savings and income are highest. The present study results showed greater likelihood of demand for supplementary medical insurance in households with better economic status, higher educated heads, female heads, and smaller households with greater expected medical expenses, and household income is the most important factor affecting demand for supplementary medical insurance. Conclusion: Since demand for supplementary medical insurance is hugely influenced by households’ economic status, policy-makers in the health sector should devise measures to improve households’ economic or financial access to supplementary insurance services, by identifying households in the lower economic deciles, and increasing their

  6. Nonlife Insurance Pricing:

    Science.gov (United States)

    Darooneh, Amir H.

    We consider the insurance company as a physical system which is immersed in its environment (the financial market). The insurer company interacts with the market by exchanging the money through the payments for loss claims and receiving the premium. Here, in the equilibrium state, we obtain the premium by using the canonical ensemble theory, and compare it with the Esscher principle, the well-known formula in actuary for premium calculation. We simulate the case of car insurance for quantitative comparison.

  7. Nudges or mandates? The ethics of mandatory flu vaccination.

    Science.gov (United States)

    Dubov, Alex; Phung, Connie

    2015-05-21

    According to the CDC report for the 2012-2013 influenza season, there was a modest increase in the vaccination coverage rate among healthcare workers from 67% in 2011-2012, to 72% in 2012-2013 to the current 75% coverage. This is still far from reaching the US National Healthy People 2020 goal of 90% hospitals vaccination rates. The reported increase in coverage is attributed to the growing number of healthcare facilities with vaccination requirements with average rates of 96.5%. However, a few other public health interventions stir so much controversy and debate as vaccination mandates. The opposition stems from the belief that a mandatory flu shot policy violates an individual right to refuse unwanted treatment. This article outlines the historic push to achieve higher vaccination rates among healthcare professionals and a number of ethical issues arising from attempts to implement vaccination mandates. It then turns to a review of cognitive biases relevant in the context of decisions about influenza vaccination (omission bias, ambiguity aversion, present bias etc.) The article suggests that a successful strategy for policy-makers and others hoping to increase vaccination rates is to design a "choice architecture" that influences behavior of healthcare professionals without foreclosing other options. Nudges incentivize vaccinations and help better align vaccination intentions with near-term actions. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. Buying greenhouse insurance

    International Nuclear Information System (INIS)

    Manne, A.S.; Richels, R.G.

    1992-01-01

    A growing concern that the increasing accumulation of greenhouse gases will lead to undesirable changes in global climate has resulted in proposals, both in the United States and internationally, to set physical targets for reducing greenhouse gas emissions. But what will these proposals cost? This book outlines a way to think about greenhouse-effect decisions under uncertainty. It describes an insightful model for determining the economic costs of limiting CO 2 emissions produced by burning fossil fuels and provides a solid analytical base for rethinking public policy on the far-reaching issue of global warming. It presents region-by-region estimates of the costs that would underlie an international agreement. Using a computer model known as Global 2100, they analyze the economic impacts of limiting CO 2 emissions under alternative supply and conservation scenarios. The results clearly indicate that a reduction in emissions is not the sole policy response to potential climate change. Following a summary of the greenhouse effect, its likely causes, and possible consequences, this book takes up issues that concern the public at large. They provide an overview of Global 2100, look at how the U.S. energy sector is likely to evolve under business-as-usual conditions and under carbon constraints, and describe the concept of greenhouse insurance. They consider possible global agreements, including an estimate of benefits that might result from trading in an international market in emission rights. They conclude with a technical description directed toward modeling specialists

  9. Catastrophic risks and insurance

    International Nuclear Information System (INIS)

    Deprimoz, J.

    1988-01-01

    This short communication deals with compensation for nuclear damage and compensation for environmental pollution through industrial activities and compress both systems and their insurance coverage [fr

  10. Prescriptions and Insurance Plans

    Science.gov (United States)

    ... contributed by: familydoctor.org editorial staff Categories: Healthcare Management, Insurance & Bills, Your Health ResourcesTags: brand name, co-pay, drug, formulary, generic, isurance, medicine, ...

  11. Uninsured vs. insured population

    DEFF Research Database (Denmark)

    Andersen, Z. J.; Lin, Chyongchiou J; Chang, Chung-Chou H

    2003-01-01

    analyzed. Approximately 74 percent of uninsured Americans are nonelderly Americans. Among the nonelderly Americans, about 17 percent are uninsured. Our findings show that insurance status varies significantly by region, age, race, gender, marital status, income, education, employment status, and health......This study identified the underlying demographic and socioeconomic factors associated with insurance status among nonelderly Americans (age 19-64), as well as compared health care utilization between insured and uninsured. Data from the Community Tracking Study 1996-1997 Household Survey were...... status. Also, the insured nonelderly Americans were found to have better access to health care than the uninsured nonelderly....

  12. 36 CFR 1211.525 - Fringe benefits.

    Science.gov (United States)

    2010-07-01

    ... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Fringe benefits. 1211.525... Prohibited § 1211.525 Fringe benefits. (a) “Fringe benefits” defined. For purposes of these Title IX regulations, fringe benefits means: Any medical, hospital, accident, life insurance, or retirement benefit...

  13. 18 CFR 1317.525 - Fringe benefits.

    Science.gov (United States)

    2010-04-01

    ... 18 Conservation of Power and Water Resources 2 2010-04-01 2010-04-01 false Fringe benefits. 1317... benefits. (a) “Fringe benefits” defined. For purposes of these Title IX regulations, fringe benefits means: Any medical, hospital, accident, life insurance, or retirement benefit, service, policy or plan, any...

  14. 45 CFR 148.220 - Excepted benefits.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Excepted benefits. 148.220 Section 148.220 Public... FOR THE INDIVIDUAL HEALTH INSURANCE MARKET Preemption; Excepted Benefits § 148.220 Excepted benefits... provision of the benefits described in paragraphs (a) and (b) of this section (or any combination of the...

  15. 13 CFR 113.525 - Fringe benefits.

    Science.gov (United States)

    2010-01-01

    ... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Fringe benefits. 113.525 Section... benefits. (a) “Fringe benefits” defined. For purposes of these Title IX regulations, fringe benefits means: Any medical, hospital, accident, life insurance, or retirement benefit, service, policy or plan, any...

  16. 32 CFR 196.525 - Fringe benefits.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 2 2010-07-01 2010-07-01 false Fringe benefits. 196.525 Section 196.525... Prohibited § 196.525 Fringe benefits. (a) “Fringe benefits” defined. For purposes of these Title IX regulations, fringe benefits means: Any medical, hospital, accident, life insurance, or retirement benefit...

  17. 38 CFR 23.525 - Fringe benefits.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Fringe benefits. 23.525... benefits. (a) “Fringe benefits” defined. For purposes of these Title IX regulations, fringe benefits means: Any medical, hospital, accident, life insurance, or retirement benefit, service, policy or plan, any...

  18. 10 CFR 5.525 - Fringe benefits.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 1 2010-01-01 2010-01-01 false Fringe benefits. 5.525 Section 5.525 Energy NUCLEAR... Activities Prohibited § 5.525 Fringe benefits. (a) “Fringe benefits” defined. For purposes of these Title IX regulations, fringe benefits means: Any medical, hospital, accident, life insurance, or retirement benefit...

  19. 45 CFR 2555.525 - Fringe benefits.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Fringe benefits. 2555.525 Section 2555.525 Public... benefits. (a) “Fringe benefits” defined. For purposes of these Title IX regulations, fringe benefits means: Any medical, hospital, accident, life insurance, or retirement benefit, service, policy or plan, any...

  20. 29 CFR 36.525 - Fringe benefits.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true Fringe benefits. 36.525 Section 36.525 Labor Office of the... Activities Prohibited § 36.525 Fringe benefits. (a) “Fringe benefits” defined. For purposes of these Title IX regulations, fringe benefits means: Any medical, hospital, accident, life insurance, or retirement benefit...

  1. 20 CFR 404.1805 - Paying benefits.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Paying benefits. 404.1805 Section 404.1805 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) Payment Procedures § 404.1805 Paying benefits. (a) As soon as possible after we have made a determination...

  2. 45 CFR 618.525 - Fringe benefits.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 3 2010-10-01 2010-10-01 false Fringe benefits. 618.525 Section 618.525 Public... benefits. (a) “Fringe benefits” defined. For purposes of these Title IX regulations, fringe benefits means: Any medical, hospital, accident, life insurance, or retirement benefit, service, policy or plan, any...

  3. 24 CFR 3.525 - Fringe benefits.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Fringe benefits. 3.525 Section 3... benefits. (a) “Fringe benefits” defined. For purposes of these Title IX regulations, fringe benefits means: Any medical, hospital, accident, life insurance, or retirement benefit, service, policy or plan, any...

  4. Consumer preferences in social health insurance.

    Science.gov (United States)

    Kerssens, Jan J; Groenewegen, Peter P

    2005-03-01

    Allowing consumers greater choice of health plans is believed to be the key to high quality and low costs in social health insurance. This study investigates consumer preferences (361 persons, response rate 43%) for hypothetical health plans which differed in 12 characteristics (premium, deductibles, no-claim discount, extension of insurance and financial services, red tape involved, medical help-desk, choice of family physicians and hospitals, dental benefits, physical therapy benefits, benefits for prescription drugs and homeopathy). In 90% the health plan with the most attractive characteristics was preferred, indicating a predominantly rational kind of choice. The most decisive characteristics for preference were: complete dental benefits, followed by zero deductibles, and free choice of hospitals.

  5. 12 CFR 745.9-2 - Retirement and other employee benefit plan accounts.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Retirement and other employee benefit plan... Coverage § 745.9-2 Retirement and other employee benefit plan accounts. (a) Pass-through share insurance. Any shares of an employee benefit plan in an insured credit union shall be insured on a “pass-through...

  6. 12 CFR 330.14 - Retirement and other employee benefit plan accounts.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Retirement and other employee benefit plan... STATEMENTS OF GENERAL POLICY DEPOSIT INSURANCE COVERAGE § 330.14 Retirement and other employee benefit plan accounts. (a) “Pass-through” insurance. Any deposits of an employee benefit plan in an insured depository...

  7. The Impact of Unemployment Insurance Extensions On Disability Insurance Application and Allowance Rates

    OpenAIRE

    Matthew S. Rutledge

    2013-01-01

    Both unemployment insurance (UI) extensions and the availability of disability benefits have disincentive effects on job search. But UI extensions can reduce the efficiency cost of disability benefits if UI recipients delay disability application until they exhaust their unemployment benefits. This paper, the first to focus on the effect of UI extensions on disability applications, investigates whether UI eligibility, extension, and exhaustion affect the timing of disability applications and ...

  8. Fringe Benefits Provision by Rural Small Businesses

    OpenAIRE

    Jayachandran N. Variyam; David S. Kraybill

    1998-01-01

    We examine the relationship between employer size and the provision of fringe benefits in a large sample of rural businesses. A clear employer size-benefits relationship exists only in the case of health insurance, while other benefits are not strongly linked to employer size. The negative relationship between employer size and health insurance is weaker, though still existent, in businesses whose employees have relatively high skill levels. Single, independent establishments and sole proprie...

  9. The relationship between employer health insurance characteristics and the provision of employee assistance programs.

    Science.gov (United States)

    Zarkin, G A; Garfinkel, S A

    1994-01-01

    Workplace drug and alcohol abuse imposes substantial costs on employers. In response, employers have implemented a variety of programs to decrease substance abuse in the workplace, including drug testing, health and wellness programs, and employee assistance programs (EAPs). This paper focuses on the relationship between enterprises' organizational and health insurance characteristics and the firms' decisions to provide EAPs. Using data from the 1989 Survey of Health Insurance Plans (SHIP), sponsored by the Health Care Financing Administration (HCFA), we estimated the prevalence of EAPs by selected organizational and health insurance characteristics for those firms that offer health insurance to their workers. In addition, we estimated logistic models of the enterprises' decisions to provide EAPs as functions of the extent of state substance abuse and mental health insurance mandates, state-level demographic variables, and organizational and health insurance characteristics. Our results suggest that state mandates and demographic variables, as well as organizational and health insurance characteristics, are important explanatory variables of enterprises' decisions to provide EAPs.

  10. The Gendered Consequences of Unemployment Insurance Reforms

    Science.gov (United States)

    Mooi-Reci, Irma; Mills, Melinda

    2012-01-01

    This study examines whether a series of unemployment insurance benefit reforms that took place over a 20-year period in the Netherlands had a gendered effect on the duration of unemployment and labor market outcomes. Using longitudinal data from the Dutch Labor Supply Panel (OSA) over the period 1980-2000, and adopting a quasi-experimental design,…

  11. The Gendered Consequences of Unemployment Insurance Reforms

    NARCIS (Netherlands)

    Mooi-Reci, Irma; Mills, Melinda

    2012-01-01

    This study examines whether a series of unemployment insurance benefit reforms that took place over a 20-year period in the Netherlands had a gendered effect on the duration of unemployment and labor market outcomes. Using longitudinal data from the Dutch Labor Supply Panel (OSA) over the period

  12. Optimal unemployment insurance with monitoring and sanctions

    NARCIS (Netherlands)

    Boone, J.; Fredriksson, P.; Holmlund, B.; van Ours, J.C.

    2007-01-01

    This article analyses the design of optimal unemployment insurance in a search equilibrium framework where search effort among the unemployed is not perfectly observable. We examine to what extent the optimal policy involves monitoring of search effort and benefit sanctions if observed search is

  13. The gendered consequences of unemployment insurance reforms

    NARCIS (Netherlands)

    Mooi-Reci, I.; Mills, M.

    2012-01-01

    This study examines whether a series of unemployment insurance benefit reforms that took place over a 20-year period in the Netherlands had a gendered effect on the duration of unemployment and labor market outcomes. Using longitudinal data from the Dutch Labor Supply Panel (OSA) over the period

  14. The Match Quality Gains from Unemployment Insurance

    Science.gov (United States)

    Centeno, Mario

    2004-01-01

    The benefits of unemployment insurance (UI) by measuring its effect in match quality are assessed. The relationship between post-unemployment job tenure and measures of the state level UI generosity and the unemployment rate at the time of the job is analyzed, using NLSY data.

  15. The insurance of nuclear installations

    International Nuclear Information System (INIS)

    Francis, H.W.

    1977-01-01

    A brief account is given of the development of nuclear insurance. The subject is dealt with under the following headings: the need for nuclear insurance, nuclear insurance pools, international co-operation, nuclear installations which may be insured, international conventions relating to the liability of operators of nuclear installations, classes of nuclear insurance, nuclear reactor hazards and their assessment, future developments. (U.K.)

  16. Liquidity and Insurance for the Unemployed

    OpenAIRE

    Robert Shimer; Ivan Werning

    2008-01-01

    We study the optimal design of unemployment insurance for workers sampling job opportunities over time. We focus on the optimal timing of benefits and the desirability of allowing workers to freely access a riskless asset. When workers have constant absolute risk aversion preferences, it is optimal to use a very simple policy: a constant benefit during unemployment, a constant tax during employment that does not depend on the duration of the spell, and free access to savings using a riskless ...

  17. willingness to pay for voluntary health insurance in tanzania

    African Journals Online (AJOL)

    2011-02-02

    Feb 2, 2011 ... insurance scheme and to see how they respond to changes in the benefit package. We also examined ... population, with national coverage remaining low at around 13% in ..... on subsistence farming activities. While income ...

  18. 20 CFR 726.4 - Who must obtain insurance coverage.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Who must obtain insurance coverage. 726.4 Section 726.4 Employees' Benefits EMPLOYMENT STANDARDS ADMINISTRATION, DEPARTMENT OF LABOR FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969, AS AMENDED BLACK LUNG BENEFITS; REQUIREMENTS FOR COAL MINE OPERATOR...

  19. 20 CFR 726.201 - Insurance contracts-generally.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Insurance contracts-generally. 726.201 Section 726.201 Employees' Benefits EMPLOYMENT STANDARDS ADMINISTRATION, DEPARTMENT OF LABOR FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969, AS AMENDED BLACK LUNG BENEFITS; REQUIREMENTS FOR COAL MINE OPERATOR...

  20. 20 CFR 726.5 - Effective date of insurance coverage.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Effective date of insurance coverage. 726.5 Section 726.5 Employees' Benefits EMPLOYMENT STANDARDS ADMINISTRATION, DEPARTMENT OF LABOR FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969, AS AMENDED BLACK LUNG BENEFITS; REQUIREMENTS FOR COAL MINE OPERATOR...

  1. How the ACA's Health Insurance Expansions Have Affected Out-of-Pocket Cost-Sharing and Spending on Premiums.

    Science.gov (United States)

    Glied, Sherry; Solís-Román, Claudia; Parikh, Shivani

    2016-09-01

    One important benefit gained by the millions of Americans with health insurance through the Affordable Care Act (ACA) is protection from high out-of-pocket health spending. While Medicaid unambiguously reduces out-of-pocket premium and medical costs for low-income people, it is less certain that marketplace coverage and other types of insurance purchased to comply with the law's individual mandate also protect from high health spending. Goal: To compare out-of-pocket spending in 2014 to spending in 2013; assess how this spending changed in states where many people enrolled in the marketplaces relative to states where few people enrolled; and project the decline in the percentage of people paying high amounts out-of-pocket. Methods: Linear regression models were used to estimate whether people under age 65 spent above certain thresholds. Key findings and conclusions: The probability of incurring high out-of-pocket costs and premium expenses declined as marketplace enrollment increased. The percentage reductions were greatest among those with incomes between 250 percent and 399 percent of poverty, those who were eligible for premium subsidies, and those who previously were uninsured or had very limited nongroup coverage. These effects appear largely attributable to marketplace enrollment rather than to other ACA provisions or to economic trends.

  2. EXPERT SYSTEMS - DEVELOPMENT OF AGRICULTURAL INSURANCE TOOL

    Directory of Open Access Journals (Sweden)

    NAN Anca-Petruţa

    2013-07-01

    attempt to present the necessity and importance of implementing expert systems in agricultural insurance as a solution of development of the Romanian agricultural sector since insurance play an important role in the stimulation of investments in agriculture and in the stabilization of agricultural producers incomes. The results of the study, at a conceptual level, confirms the necessity of aplying expert systems in agricultural insurance because of the benefits which would be created (informing agricultural producers about the existence and importance of agricultural insurance, the development of the insurance market which would lead to the development of agriculture, creation of new insurance products adapted to the needs of the farmers.

  3. 17 CFR 270.6e-3(T) - Temporary exemptions for flexible premium variable life insurance separate accounts.

    Science.gov (United States)

    2010-04-01

    ... for issuance, increases in or additions of insurance benefits, transfer and redemption of flexible... deducted from amounts transferred to a flexible contract from another plan of insurance; (iii) Sections 27... guaranteed death benefit risks assumed by the life insurer under the flexible contracts (collectively, a...

  4. 20 CFR 422.510 - Applications and related forms used in the health insurance for the aged program.

    Science.gov (United States)

    2010-04-01

    ... health insurance for the aged program. 422.510 Section 422.510 Employees' Benefits SOCIAL SECURITY... forms used in the health insurance for the aged program. (a) Application forms. The following forms are prescribed for use in applying for entitlement to benefits under the health insurance for the aged program...

  5. Insuring against Health Shocks: Health Insurance and Household Choices

    OpenAIRE

    Liu, Kai

    2015-01-01

    This paper provides empirical evidence on the role of public health insurance in mitigating adverse outcomes associated with health shocks. Exploiting the rollout of a universal health insurance program in rural China, I find that total household income and consumption are fully insured against health shocks even without access to health insurance. Household labor supply is an important insurance mechanism against health shocks. Access to health insurance helps households to maintain investme...

  6. Nuclear energy and insurance

    International Nuclear Information System (INIS)

    Dow, J.C.

    1989-01-01

    It was the risk of contamination of ships from the Pacific atmospheric atomic bomb tests in the 1940's that seems first to have set insurers thinking that a limited amount of cover would be a practical possibility if not a commercially-attractive proposition. One Chapter of this book traces the early, hesitant steps towards the evolution of ''nuclear insurance'', as it is usually called; a term of convenience rather than exactitude because it seems to suggest an entirely new branch of insurance with a status of its own like that of Marine, Life or Motor insurance. Insurance in the field of nuclear energy is more correctly regarded as the application of the usual, well-established forms of cover to unusual kinds of industrial plant, materials and liabilities, characterised by the peculiar dangers of radioactivity which have no parallel among the common hazards of industry and commerce. It had, and still has, the feature that individual insurance underwriters are none too keen to look upon nuclear risks as a potential source of good business and profit. Only by joining together in Syndicates or Pools have the members of the national insurance markets been able to make proper provision for nuclear risks; only by close international collaboration among the national Pools have the insurers of the world been able to assemble adequate capacity - though still, even after thirty years, not sufficient to provide complete coverage for a large nuclear installation. (author)

  7. Insurance industry guide

    International Nuclear Information System (INIS)

    Anon.

    1992-01-01

    This is an insurance industry guide for the independent power industry. The directory includes the insurance company's name, address, telephone and FAX numbers and a description of the company's area of expertise, products and services, and limitations. The directory is international in scope. Some of the companies specialize in independent power projects

  8. Marketing in life insurance

    Directory of Open Access Journals (Sweden)

    Njegomir Vladimir

    2006-01-01

    Full Text Available Insurance industry has traditionally been oriented on sale of its products i.e. at the stage which from the aspect of marketing theory can be characterized as sales phase, phase which proceeds the marketing orientation. However, faced with numerous challenges of modern business environment such as globalization, deregulation and sophisticated information technology insurance companies must change their way of doing business. Competition is becoming fierce as insurance companies are faced with competition not only from insurance industry but also from other competitors, such as banks, that are in position to offer product substitutes for life insurance products. In this new environment information about customers and their education are becoming critical factors. Insurance companies must know their customers what influences their demand for life insurance, what is the amount of their income, what is inflation rate, their expenditures on other goods i.e. opportunity costs, etc. Those are factors that force insurance companies to concentrate more on present and potential buyers and their needs and force them to give their best to satisfy those needs in a way that will produce delighted customers.

  9. Performance of the life insurance industry under pressure: efficiency, competition and consolidation

    NARCIS (Netherlands)

    Bikker, J.A.

    2012-01-01

    A well-performing life insurance industry benefits consumers, producers and insurance firm stockholders alike. Unfavourable market conditions stress the need for life insurers to perform well in order to remain solvent. Using a unique supervisory data set, this paper investigates competition and

  10. 20 CFR 255.9 - Individual enrolled under supplementary medical insurance plan.

    Science.gov (United States)

    2010-04-01

    ... supplementary medical insurance premiums will be applied toward payment of such premiums, and the balance of the... medical insurance plan. 255.9 Section 255.9 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS... supplementary medical insurance plan. Where recovery of the overpayment is by setoff as provided for in § 255.6...

  11. Health insurance for "frontaliers"

    CERN Multimedia

    2013-01-01

    The French government has decided that, with effect from 1 June 2014, persons resident in France but working in Switzerland (hereinafter referred to as “frontaliers”) will no longer be entitled to opt for private French health insurance provision as their sole and principal health insurance.   The right of choice, which was granted by the Bilateral Agreement on the Free Movement of Persons between Switzerland and the European Union and which came into force on 1 June 2002, exempts “frontaliers” from the obligation to become a member of Switzerland’s compulsory health insurance scheme (LAMal) if they can prove that they have equivalent coverage in France, provided by either the French social security system (CMU) or a private French insurance provider. As the latter option of private health insurance as an alternative to membership of LAMal will be revoked under the new French legislation that will come into force on 1 June 2014, current “...

  12. Terrorism Risk Insurance: An Overview

    National Research Council Canada - National Science Library

    Webel, Baird

    2005-01-01

    .... Addressing this problem, Congress enacted the Terrorism Risk Insurance Act of 2002 (TRIA) to create a temporary program to share future insured terrorism losses with the property-casualty insurance industry and policyholders...

  13. Disposition of Insurance Allotment Payments

    National Research Council Canada - National Science Library

    Young, Shelton

    2001-01-01

    .... The request was prompted by action taken by the Florida Department of Insurance against two life insurance companies that had received large numbers of insurance allotments from Service members...

  14. Designing Health Information Technology Tools to Prevent Gaps in Public Health Insurance.

    Science.gov (United States)

    Hall, Jennifer D; Harding, Rose L; DeVoe, Jennifer E; Gold, Rachel; Angier, Heather; Sumic, Aleksandra; Nelson, Christine A; Likumahuwa-Ackman, Sonja; Cohen, Deborah J

    2017-06-23

    Changes in health insurance policies have increased coverage opportunities, but enrollees are required to annually reapply for benefits which, if not managed appropriately, can lead to insurance gaps. Electronic health records (EHRs) can automate processes for assisting patients with health insurance enrollment and re-enrollment. We describe community health centers' (CHC) workflow, documentation, and tracking needs for assisting families with insurance application processes, and the health information technology (IT) tool components that were developed to meet those needs. We conducted a qualitative study using semi-structured interviews and observation of clinic operations and insurance application assistance processes. Data were analyzed using a grounded theory approach. We diagramed workflows and shared information with a team of developers who built the EHR-based tools. Four steps to the insurance assistance workflow were common among CHCs: 1) Identifying patients for public health insurance application assistance; 2) Completing and submitting the public health insurance application when clinic staff met with patients to collect requisite information and helped them apply for benefits; 3) Tracking public health insurance approval to monitor for decisions; and 4) assisting with annual health insurance reapplication. We developed EHR-based tools to support clinical staff with each of these steps. CHCs are uniquely positioned to help patients and families with public health insurance applications. CHCs have invested in staff to assist patients with insurance applications and help prevent coverage gaps. To best assist patients and to foster efficiency, EHR based insurance tools need comprehensive, timely, and accurate health insurance information.

  15. Defined contribution health benefits.

    Science.gov (United States)

    Fronstin, P

    2001-03-01

    This Issue Brief discusses the emerging issue of "defined contribution" (DC) health benefits. The term "defined contribution" is used to describe a wide variety of approaches to the provision of health benefits, all of which have in common a shift in the responsibility for payment and selection of health care services from employers to employees. DC health benefits often are mentioned in the context of enabling employers to control their outlay for health benefits by avoiding increases in health care costs. DC health benefits may also shift responsibility for choosing a health plan and the associated risks of choosing a plan from employers to employees. There are three primary reasons why some employers currently are considering some sort of DC approach. First, they are once again looking for ways to keep their health care cost increases in line with overall inflation. Second, some employers are concerned that the public "backlash" against managed care will result in new legislation, regulations, and litigation that will further increase their health care costs if they do not distance themselves from health care decisions. Third, employers have modified not only most employee benefit plans, but labor market practices in general, by giving workers more choice, control, and flexibility. DC-type health benefits have existed as cafeteria plans since the 1980s. A cafeteria plan gives each employee the opportunity to determine the allocation of his or her total compensation (within employer-defined limits) among various employee benefits (primarily retirement or health). Most types of DC health benefits currently being discussed could be provided within the existing employment-based health insurance system, with or without the use of cafeteria plans. They could also allow employees to purchase health insurance directly from insurers, or they could drive new technologies and new forms of risk pooling through which health care services are provided and financed. DC health

  16. Insurance: Accounting, Regulation, Actuarial Science

    OpenAIRE

    Alain Tosetti; Thomas Behar; Michel Fromenteau; Stéphane Ménart

    2001-01-01

    We shall be examining the following topics: (i) basic frameworks for accounting and for statutory insurance rules; and (ii) actuarial principles of insurance; for both life and nonlife (i.e. casualty and property) insurance.Section 1 introduces insurance terminology, regarding what an operation must include in order to be an insurance operation (the legal, statistical, financial or economic aspects), and introduces the accounting and regulation frameworks and the two actuarial models of insur...

  17. Risk Management in Insurance Companies

    OpenAIRE

    Yang, Xufeng

    2006-01-01

    Insurance is the uncertain business in uncertain society. Today, insures face more complex and difficult risks. Efficient risk management mechanisms are essential for the insurers. The paper is set out initially to explore UK insurance companies risk management and risk disclosure by examining companies annual report after all the listed insurance companies are required to disclose risk information in their annual report, which seeks to reflect the recent development in UK insurance companies...

  18. Cancer insurance policies in Japan and the United States.

    Science.gov (United States)

    Bennett, C L; Weinberg, P D; Lieberman, J J

    1998-01-01

    Cancer care in the United States often results in financial hardship for patients and their families. Standard health insurance covers most medical costs, but nonmedical costs (such as lost wages, deductibles, copayments, and travel to and from caregivers) are paid out of pocket. Over the course of treatment, these costs can become substantial. Insurance companies have addressed the burden of these out-of-pocket costs by offering supplemental cancer insurance policies that, upon diagnosis of cancer, pay cash benefits for items that usually require out-of-pocket expenditures and are distinct from reimbursements made by traditional health insurance. Limitations associated with managed care have fostered increased consumer awareness and interest in the United States for cancer insurance and its ability to defray treatment expenditures that usually require out-of-pocket payments. Marketing campaigns are becoming more aggressive, and the number of cancer insurance policies sold has been steadily rising. While cancer insurance is only recently gaining popularity in the United States, it has been a successful product in Japan for over twenty years. In Japan, approximately one-quarter of the population own cancer insurance, and ten-year retention rates are estimated at 75%. As a result, individuals are afforded good access to nonmedical cancer services. Understanding the factors that led to the success of cancer insurance in Japan may assist policymakers in evaluating cancer insurance policies as they become more prevalent in the United States.

  19. Interdependence of life insurance service quality and premium

    Directory of Open Access Journals (Sweden)

    Dragan Benazić

    2006-12-01

    Full Text Available Insurance companies in Croatia feel the need to find new sources of competitive advantage on the Croatian life insurance market amid increasing competition and a poorly profiled offer of life insurance services. Lately, both marketing literature and practice seem to point to the shaping of a relationship between service quality and price as a possible solution to improving the position of insurance companies on the Croatian market. In providing life insurance services, the insurance companies should focus on the quality elements that offer certain benefits a client is willing to pay for. Changes in individual quality features have been evaluated differently by clients. Such differences in their evaluation of changes in the individual elements of service quality also reflect the willingness of clients to pay a suitable increase on their insurance premium. Improvements in the service quality features that are subjectively evaluated as important should lead to the client’s acceptance of a higher life insurance premium. The paper considers the interdependence between the quality of life insurance services and the premium from the aspect of the client’s willingness to pay a higher life insurance premium for a higher service quality.

  20. 20 CFR 404.338 - Widow's and widower's benefits amounts.

    Science.gov (United States)

    2010-04-01

    ... benefit may change as explained in § 404.304. (c) Your monthly benefit will be reduced if the insured person chooses to receive old-age benefits before reaching full retirement age. If so, your benefit will... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Widow's and widower's benefits amounts. 404...

  1. Romanian Insurance Market Facing Globalization Process

    Directory of Open Access Journals (Sweden)

    Dumitru G. Badea

    2008-09-01

    Full Text Available The Romanian insurance market has passed through a permanent process of growth which ended up in 2004 to exceed the threshold of 1 billion Euros, in the frame of a small awareness and confidence of the population towards insurance, even now after 15 years. The globalization process of the financial markets affected also the Romanian market even before Romania became member of the European Union. The globalization brought about benefits (especially under the form of increase in the quality of the services provided to clients but also disadvantages for local companies (significant costs in logistics and training in order to cope with the international groups.

  2. The Impact and Dilemma of Unfunded Mandates Confronting Local Government South Africa: A Comparative Analysis

    Directory of Open Access Journals (Sweden)

    M. Basdeo

    2012-09-01

    Full Text Available Local government has emerged from a prolonged transition to face a second generation of challenges, namely unfunded mandates. Compliance with the current financial management system is a constant challenge for local government. To complicate matters local government is challenged by the dilemma of unfunded mandates which are an extreme manifestation of the phenomenon of governing from the centre. National government through various strategies imposes national mandates on provincial and local government at the expense of the latter. The incidence of unfunded mandate reflects a power hierarchy. Unfunded mandates are generally a significant indicator of the relative weakness of national government because it is often local government occupying constitutionally and politically the weakest position in the hierarchy that is burdened with new responsibilities. In decentralised and federal government systems, provincial/state and local governments object to unfunded mandates because they shrink their policy space, limit their expenditure choices and ultimately local government’s accountability to their electorates. Further, these systems of governance establish a hierarchy of authority that creates  notions of self-rule by national government. Unfunded mandates reflect systemic weaknesses of decentralised or federal allocation of powers and functions. Although there are principled objections, unfunded mandates remain constitutional. Given the wide incidence of unfunded mandates the critical question arises as to how in a decentralised system, one level of government can impose mandates with cost implications on another. How is it constitutionally justifiable?

  3. Senior Benefits

    Science.gov (United States)

    Information Medicaid Public Health Centers Temporary "Cash" Assistance Senior Benefits Program GovDelivery Skip Navigation Links Health and Social Services > Public Assistance > Senior Benefits Page Content Senior Benefits Senior Benefits Logo Senior Benefits Fact Sheet - June, 2016 Reduction Information

  4. Insurability of Terrorism Risks

    International Nuclear Information System (INIS)

    Harbruecker, D.

    2006-01-01

    Until 2001 losses caused by terrorist attacks have been covered under fire policies worldwide with two exceptions: Spain and UK where major and multiple losses caused by ETA and IRA had led to specific insurance solutions. The September 11, 2001 attacks on the World Trade Centre have changed the world in many aspects. This includes the insurance industry, which was compelled to exclude terrorism from coverage and to offer special solutions for extra premium. Nuclear power plants have been repeatedly called targets for terrorists as their destruction could cause a large catastrophe and more victims than the September 2001 attacks. How does the insurance industry respond? (author)

  5. Pricing Externalities to Balance Public Risks and Benefits of Research.

    Science.gov (United States)

    Farquhar, Sebastian; Cotton-Barratt, Owen; Snyder-Beattie, Andrew

    How should scientific funders evaluate research with public health risks? Some risky work is valuable, but accepting too much risk may be ethically neglectful. Recent controversy over H5N1 influenza experiments has highlighted the difficulty of this problem. Advocates of the research claim the work is needed to understand pandemics, while opponents claim that accidents or misuse could release the very pandemic the work is meant to prevent. In an attempt to resolve the debate, the US government sponsored an independent evaluation that successfully produced a quantitative estimate of the risks involved, but only a qualitative estimate of the benefits. Given the difficulties of this "apples-to-oranges" risk-benefit analysis, what is the best way forward? Here we outline a general approach for balancing risks and benefits of research with public risks. Instead of directly comparing risks and benefits, our approach requires only an estimate of risk, which is then translated into a financial price. This estimate can be obtained either through a centrally commissioned risk assessment or by mandating liability insurance, which allows private markets to estimate the financial burden of risky research. The resulting price can then be included in the cost of the research, enabling funders to evaluate grants as usual-comparing the scientific merits of a project against its full cost to society. This approach has the advantage of aligning incentives by assigning costs to those responsible for risks. It also keeps scientific funding decisions in the hands of scientists, while involving the public on questions of values and risk experts on risk evaluation.

  6. Insurance Exchange Marketplace: Implications for Emergency Medicine Practice

    Directory of Open Access Journals (Sweden)

    David S. Rankey, MD, MPH

    2012-05-01

    Full Text Available The Patient Protection and Affordable Care Act of 2010 requires states to establish healthcareinsurance exchanges by 2014 to facilitate the purchase of qualified health plans. States are required toestablish exchanges for small businesses and individuals. A federally operated exchange will beestablished, and states failing to participate in any other exchanges will be mandated to join the federalexchange. Policymakers and health economists believe that exchanges will improve healthcare atlower cost by promoting competition among insurers and by reducing burdensome transaction costs.Consumers will no longer be isolated from monthly insurance premium costs. Exchanges will increasethe number of patients insured with more cost-conscious managed care and high-deductible plans.These insurance plan models have historically undervalued emergency medical services, while alsounderinsuring patients and limiting their healthcare system access to the emergency department. Thisparadoxically increases demand for emergency services while decreasing supply. The continualdevaluation of emergency medical services by insurance payers will result in inadequate distribution ofresources to emergency care, resulting in further emergency department closures, increases inemergency department crowding, and the demise of acute care services provided to families andcommunities.

  7. Optimum amount of an insurance sum in life insurance

    Directory of Open Access Journals (Sweden)

    Janez Balkovec

    2001-01-01

    Full Text Available Personal insurance represents one of the sources of personal social security as a category of personal property. How to get a proper life insurance is a frequently asked question. When insuring material objects (car, house..., the problem is usually not in the amount of the taken insurance. With life insurance (abstract goods, problems as such occur. In this paper, we wish to present a model that, according to the financial situation and the anticipated future, makes it possible to calculate the optimum insurance sum in life insurance.

  8. Group life insurance

    CERN Multimedia

    2013-01-01

    The CERN Administration wishes to inform staff members and fellows having taken out optional life insurance under the group contract signed by CERN that the following changes to the rules and regulations entered into force on 1 January 2013:   The maximum age for an active member has been extended from 65 to 67 years. The beneficiary clause now allows insured persons to designate one or more persons of their choice to be their beneficiary(-ies), either at the time of taking out the insurance or at a later date, in which case the membership/modification form must be updated accordingly. Beneficiaries must be clearly identified (name, first name, date of birth, address).   The membership/modification form is available on the FP website: http://fp.web.cern.ch/helvetia-life-insurance For further information, please contact: Valentina Clavel (Tel. 73904) Peggy Pithioud (Tel. 72736)

  9. M. Nuclear insurance

    International Nuclear Information System (INIS)

    1976-01-01

    Nuclear insurance and some of the features associated with it, such as the International Conventions and the operation of Atomic Risk Pools, are discussed both in general and with specific reference to the USA, Canada and the United Kingdom

  10. Building and Contents Insurance.

    Science.gov (United States)

    Freese, William C.

    Insurance coverage of school buildings and contents is becoming increasingly difficult to obtain, and increases of 50 percent or more in the premium are not uncommon. Methods of reducing premium increases are outlined in this speech. (MLF)

  11. HUD Insured Hospitals

    Data.gov (United States)

    Department of Housing and Urban Development — The Office of Healthcare Programs (OHP), previously known as the Office of Insured Health Care Facilities, is located within the Office of Housing and administers...

  12. OASDI Beneficiaries and Benefits by State, 2014

    Data.gov (United States)

    Social Security Administration — This annual map focuses on the Social Security beneficiary population receiving Old-Age, Survivors, and Disability Insurance (OASDI) benefits at the state level in...

  13. OASDI Beneficiaries and Benefits by State- 2015

    Data.gov (United States)

    Social Security Administration — This annual map focuses on the Social Security beneficiary population receiving Old-Age, Survivors, and Disability Insurance (OASDI) benefits at the state level in...

  14. Prevention in insurance markets

    OpenAIRE

    Marie-Cécile FAGART; Bidénam KAMBIA-CHOPIN

    2006-01-01

    This paper considers a competitive insurance market under moral hazard and adverse selection, in which preventive efforts and self-protection costs are unobservable by insurance companies. Under reasonable assumptions, the conclusions of Rothschild and Stiglitz (1976) are preserved in our context even if it involves moral hazard. The riskier agents in equilibrium, who would also be the riskier agents under perfect information, receive their moral hazard contract. For other agents, adverse sel...

  15. Gender, Colonialism and Rabbinical Courts in Mandate Palestine

    Directory of Open Access Journals (Sweden)

    Lisa Fishbayn

    2011-11-01

    Full Text Available The distribution of powers between the state and religious groups plays an important role in shaping how controversies over multicultural toleration and women’s rights under religious law can be resolved. Some structures encourage dialogue while others make it difficult. In Israel, the presence of multiple systems of personal religious law limits the possibilities for the transformation of discriminatory religious laws. There is no civil marriage or divorce in Israel. When the modern State of Israel was created, exclusive power over family law disputes involving Jewish citizens was placed in the hands of rabbinical courts. This arrangement has been called one to retain the ‘status quo’. However, it was not a continuation of Jewish tradition or of the arrangements in place during the long period of Ottoman rule in Palestine. It reflected strengthened powers that had been given to rabbinical courts during the period of the British Mandate for Palestine. This article will trace the ways in which British policies for colonial rule and the interests of Jewish religious leaders coalesced to create a regime of religious family law that is resistant to feminist demands for change.

  16. Mandated empowerment: handing antipoverty policy back to the poor?

    Science.gov (United States)

    Banerjee, Abhijit V; Duflo, Esther

    2008-01-01

    The current trend in antipoverty policy emphasizes mandated empowerment: the poor are being handed the responsibility for making things better for themselves, largely without being asked whether this is what they want. Beneficiary control is now being built into public service delivery, while microcredit and small business promotion are seen as better ways to help the poor. The clear presumption is that the poor are both able and happy to exercise these new powers. This essay uses two examples to raise questions about these strategies. The first example is about entrepreneurship among the poor. Using data from a number of countries, we argue that there is no evidence that the median poor entrepreneur is trying his best to expand his existing businesses, even if we take into account the many constraints he faces. While many poor people own businesses, this seems to be more a survival strategy than something they want to do. The second example comes from an evaluation of a program in India that aims to involve poor rural parents in improving local public schools. The data suggest that despite being informed that they now have both the right to intervene in the school and access to funds for that purpose, and despite being made aware of how little the children were learning, parents opt to not get involved. Both examples raise concerns about committing ourselves entirely to antipoverty strategies that rely on the poor doing a lot of the work.

  17. Telemental health: responding to mandates for reform in primary healthcare.

    Science.gov (United States)

    Myers, Kathleen M; Lieberman, Daniel

    2013-06-01

    Telemental health (TMH) has established a niche as a feasible, acceptable, and effective service model to improve the mental healthcare and outcomes for individuals who cannot access traditional mental health services. The Accountability Care Act has mandated reforms in the structure, functioning, and financing of primary care that provide an opportunity for TMH to move into the mainstream healthcare system. By partnering with the Integrated Behavioral Healthcare Model, TMH offers a spectrum of tools to unite primary care physicians and mental health specialist in a mind-body view of patients' healthcare needs and to activate patients in their own care. TMH tools include video-teleconferencing to telecommute mental health specialists to the primary care setting to collaborate with a team in caring for patients' mental healthcare needs and to provide direct services to patients who are not progressing optimally with this collaborative model. Asynchronous tools include online therapies that offer an efficient first step to treatment for selected disorders such as depression and anxiety. Patients activate themselves in their care through portals that provide access to their healthcare information and Web sites that offer on-demand information and communication with a healthcare team. These synchronous and asynchronous TMH tools may move the site of mental healthcare from the clinic to the home. The evolving role of social media in facilitating communication among patients or with their healthcare team deserves further consideration as a tool to activate patients and provide more personalized care.

  18. Beyond Your Paycheck: An Employee Benefits Primer.

    Science.gov (United States)

    Stanton, Michael

    1990-01-01

    Discusses fringe benefits and points out that employee benefits in medium and large firms account for more than 27 percent of total compensation. Differentiates among statutory (required by law), compensatory (wages paid for time not worked such as vacation and sick leave), and supplementary (including insurance and pension plans) benefits and…

  19. 44 CFR 19.525 - Fringe benefits.

    Science.gov (United States)

    2010-10-01

    ... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Fringe benefits. 19.525... Programs or Activities Prohibited § 19.525 Fringe benefits. (a) “Fringe benefits” defined. For purposes of these Title IX regulations, fringe benefits means: Any medical, hospital, accident, life insurance, or...

  20. Calculation of benefit reserves based on true m-thly benefit premiums

    Science.gov (United States)

    Riaman; Susanti, Dwi; Supriatna, Agus; Nurani Ruchjana, Budi

    2017-10-01

    Life insurance is a form of insurance that provides risk mitigation in life or death of a human. One of its advantages is measured life insurance. Insurance companies ought to give a sum of money as reserves to the customers. The benefit reserves are an alternative calculation which involves net and cost premiums. An insured may pay a series of benefit premiums to an insurer equivalent, at the date of policy issue, to the sum of to be paid on the death of the insured, or on survival of the insured to the maturity date. A balancing item is required and this item is a liability for one of the parties and the other is an asset. The balancing item, in loan, is the outstanding principle, an asset for the lender and the liability for the borrower. In this paper we examined the benefit reserves formulas corresponding to the formulas for true m-thly benefit premiums by the prospective method. This method specifies that, the reserves at the end of the first year are zero. Several principles can be used for the determined of benefit premiums, an equivalence relation is established in our discussion.

  1. Consumer in insurance law

    Directory of Open Access Journals (Sweden)

    Čorkalo Milena

    2016-01-01

    Full Text Available The paper analyses the notion of consumer in the European Union law, and, in particular, the notion of consumer in insurance law. The author highligts the differences between the notion of consumer is in aquis communautaire and in insurance law, discussing whether the consumer can be defined in both field in the same way, concerning that insurance services differ a lot from other kind of services. Having regarded unequal position of contracting parties and information and technical disadvantages of a weaker party, author pleads for broad definition of consumer in insurance law. In Serbian law, the consumer is not defined in consistent way. That applies on Serbian insurance law as well. Therefore, the necessity of precise and broad definition of consumes is underlined, in order to delimit the circle of subject who are in need for protection. The author holds that the issue of determination of the circle of persons entitled to extended protection as consumers is of vital importance for further development of insurance market in Serbia.

  2. Universal health insurance through incentives reform.

    Science.gov (United States)

    Enthoven, A C; Kronick, R

    1991-05-15

    Roughly 35 million Americans have no health care coverage. Health care expenditures are out of control. The problems of access and cost are inextricably related. Important correctable causes include cost-unconscious demand, a system not organized for quality and economy, market failure, and public funds not distributed equitably or effectively to motivate widespread coverage. We propose Public Sponsor agencies to offer subsidized coverage to those otherwise uninsured, mandated employer-provided health insurance, premium contributions from all employers and employees, a limit on tax-free employer contributions to employee health insurance, and "managed competition". Our proposed new government revenues equal proposed new outlays. We believe our proposal will work because efficient managed care does exist and can provide satisfactory care for a cost far below that of the traditional fee-for-service third-party payment system. Presented with an opportunity to make an economically responsible choice, people choose value for money; the dynamic created by these individual choices will give providers strong incentives to render high-quality, economical care. We believe that providers will respond to these incentives.

  3. Response to health insurance by previously uninsured rural children.

    Science.gov (United States)

    Tilford, J M; Robbins, J M; Shema, S J; Farmer, F L

    1999-08-01

    To examine the healthcare utilization and costs of previously uninsured rural children. Four years of claims data from a school-based health insurance program located in the Mississippi Delta. All children who were not Medicaid-eligible or were uninsured, were eligible for limited benefits under the program. The 1987 National Medical Expenditure Survey (NMES) was used to compare utilization of services. The study represents a natural experiment in the provision of insurance benefits to a previously uninsured population. Premiums for the claims cost were set with little or no information on expected use of services. Claims from the insurer were used to form a panel data set. Mixed model logistic and linear regressions were estimated to determine the response to insurance for several categories of health services. The use of services increased over time and approached the level of utilization in the NMES. Conditional medical expenditures also increased over time. Actuarial estimates of claims cost greatly exceeded actual claims cost. The provision of a limited medical, dental, and optical benefit package cost approximately $20-$24 per member per month in claims paid. An important uncertainty in providing health insurance to previously uninsured populations is whether a pent-up demand exists for health services. Evidence of a pent-up demand for medical services was not supported in this study of rural school-age children. States considering partnerships with private insurers to implement the State Children's Health Insurance Program could lower premium costs by assembling basic data on previously uninsured children.

  4. Captive insurance: is it the right choice for your insurance exposures?

    Science.gov (United States)

    Frese, Richard C

    2015-12-01

    Potential benefits of a captive insurance company include: Broader coverage Improved cash flow and stability. Direct access to reinsurance markets. Tax advantages. Better handling and control of risk management and claims. Potential drawbacks and challenges include: Startup capitalization. Underwriting losses. Administration and commitment.

  5. 78 FR 38483 - Area Risk Protection Insurance Regulations and Area Risk Protection Insurance Crop Provisions

    Science.gov (United States)

    2013-06-26

    ... premium rates for ARPI that are sufficient to cover expected losses plus a reasonable reserve. The premium... that maximize net benefits (including potential economic, environmental, public health and safety... establish their insurance guarantees, and compute premium amounts. Whether a producer has 10 acres or 1000...

  6. Mandated college students' response to sequentially administered alcohol interventions in a randomized clinical trial using stepped care.

    Science.gov (United States)

    Borsari, Brian; Magill, Molly; Mastroleo, Nadine R; Hustad, John T P; Tevyaw, Tracy O'Leary; Barnett, Nancy P; Kahler, Christopher W; Eaton, Erica; Monti, Peter M

    2016-02-01

    Students referred to school administration for alcohol policies violations currently receive a wide variety of interventions. This study examined predictors of response to 2 interventions delivered to mandated college students (N = 598) using a stepped care approach incorporating a peer-delivered 15-min brief advice (BA) session (Step 1) and a 60- to 90-min brief motivational intervention (BMI) delivered by trained interventionists (Step 2). Analyses were completed in 2 stages. First, 3 types of variables (screening variables, alcohol-related cognitions, mandated student profile) were examined in a logistic regression model as putative predictors of lower risk drinking (defined as 3 or fewer heavy episodic drinking [HED] episodes and/or 4 or fewer alcohol-related consequences in the past month) 6 weeks following the BA session. Second, we used generalized estimating equations to examine putative moderators of BMI effects on HED and peak blood alcohol content compared with assessment only (AO) control over the 3-, 6-, and 9-month follow-ups. Participants reporting lower scores on the Alcohol Use Disorders Identification Test, more benefits to changing alcohol use, and those who fit the "Bad Incident" profile at baseline were more likely to report lower risk drinking 6 weeks after the BA session. Moderation analyses revealed that Bad Incident students who received the BMI reported more HED at 9-month follow-up than those who received AO. Current alcohol use as well as personal reaction to the referral event may have clinical utility in identifying which mandated students benefit from treatments of varying content and intensity. (c) 2016 APA, all rights reserved).

  7. Employer-Sponsored Health Insurance: Are Employers Good Agents for Their Employees?

    OpenAIRE

    Peele, Pamela B.; Lave, Judith R.; Black, Jeanne T.; Evans III, John H.

    2000-01-01

    Employers in the United States provide many welfare-type benefits, such as life insurance, disability insurance, health insurance, and pensions, to their employees. Employers can be viewed as performing an agency role in purchasing pension, health, and other welfare benefits for their employees. An exploration of their competence in this role as agents for their employees indicates that large employers are very helpful to their employees in this arena. They seem to contribute to individual em...

  8. Solidarity and cost management: Swiss citizens' reasons for priorities regarding health insurance coverage.

    Science.gov (United States)

    Schindler, Mélinée; Danis, Marion; Goold, Susan D; Hurst, Samia A

    2018-04-14

    Approaches to priority-setting for scarce resources have shifted to public deliberation as trade-offs become more difficult. We report results of a qualitative analysis of public deliberation in Switzerland, a country with high health-care costs, an individual health insurance mandate and a strong tradition of direct democracy with frequent votes related to health care. We adapted the Choosing Healthplans All Together (CHAT) tool, an exercise developed to transform complex health-care allocation decisions into easily understandable choices, for use in Switzerland. We conducted focus groups in twelve Swiss cities, recruiting from a range of socio-economic backgrounds in the three language regions. Participants developed strategic arguments based on the importance of basic coverage for all, and of cost-benefit evaluation. They also expressed arguments relying on a principle of solidarity, in particular the importance of protection for vulnerable groups, and on the importance of medical care. They struggled with the place of personal responsibility in coverage decisions. In commenting on the exercise, participants found the degree of consensus despite differing opinions surprising and valuable. The Swiss population is particularly attentive to the costs of health care and means of reducing these costs. Swiss citizens are capable of making trade-offs and setting priorities for complex health issues. © 2018 The Authors Health Expectations published by John Wiley & Sons Ltd.

  9. Insurance Coverage Policies for Personalized Medicine

    Directory of Open Access Journals (Sweden)

    Andrew Hresko

    2012-10-01

    Full Text Available Adoption of personalized medicine in practice has been slow, in part due to the lack of evidence of clinical benefit provided by these technologies. Coverage by insurers is a critical step in achieving widespread adoption of personalized medicine. Insurers consider a variety of factors when formulating medical coverage policies for personalized medicine, including the overall strength of evidence for a test, availability of clinical guidelines and health technology assessments by independent organizations. In this study, we reviewed coverage policies of the largest U.S. insurers for genomic (disease-related and pharmacogenetic (PGx tests to determine the extent that these tests were covered and the evidence basis for the coverage decisions. We identified 41 coverage policies for 49 unique testing: 22 tests for disease diagnosis, prognosis and risk and 27 PGx tests. Fifty percent (or less of the tests reviewed were covered by insurers. Lack of evidence of clinical utility appears to be a major factor in decisions of non-coverage. The inclusion of PGx information in drug package inserts appears to be a common theme of PGx tests that are covered. This analysis highlights the variability of coverage determinations and factors considered, suggesting that the adoption of personal medicine will affected by numerous factors, but will continue to be slowed due to lack of demonstrated clinical benefit.

  10. Development of the Health Insurance Literacy Measure (HILM): Conceptualizing and Measuring Consumer Ability to Choose and Use Private Health Insurance

    Science.gov (United States)

    Paez, Kathryn A.; Mallery, Coretta J.; Noel, HarmoniJoie; Pugliese, Christopher; McSorley, Veronica E.; Lucado, Jennifer L.; Ganachari, Deepa

    2014-01-01

    Understanding health insurance is central to affording and accessing health care in the United States. Efforts to support consumers in making wise purchasing decisions and using health insurance to their advantage would benefit from the development of a valid and reliable measure to assess health insurance literacy. This article reports on the development of the Health Insurance Literacy Measure (HILM), a self-assessment measure of consumers' ability to select and use private health insurance. The authors developed a conceptual model of health insurance literacy based on formative research and stakeholder guidance. Survey items were drafted using the conceptual model as a guide then tested in two rounds of cognitive interviews. After a field test with 828 respondents, exploratory factor analysis revealed two HILM scales, choosing health insurance and using health insurance, each of which is divided into a confidence subscale and likelihood of behavior subscale. Correlations between the HILM scales and an objective measure of health insurance knowledge and skills were positive and statistically significant which supports the validity of the measure. PMID:25315595

  11. A Logistic Regression Based Auto Insurance Rate-Making Model Designed for the Insurance Rate Reform

    Directory of Open Access Journals (Sweden)

    Zhengmin Duan

    2018-02-01

    Full Text Available Using a generalized linear model to determine the claim frequency of auto insurance is a key ingredient in non-life insurance research. Among auto insurance rate-making models, there are very few considering auto types. Therefore, in this paper we are proposing a model that takes auto types into account by making an innovative use of the auto burden index. Based on this model and data from a Chinese insurance company, we built a clustering model that classifies auto insurance rates into three risk levels. The claim frequency and the claim costs are fitted to select a better loss distribution. Then the Logistic Regression model is employed to fit the claim frequency, with the auto burden index considered. Three key findings can be concluded from our study. First, more than 80% of the autos with an auto burden index of 20 or higher belong to the highest risk level. Secondly, the claim frequency is better fitted using the Poisson distribution, however the claim cost is better fitted using the Gamma distribution. Lastly, based on the AIC criterion, the claim frequency is more adequately represented by models that consider the auto burden index than those do not. It is believed that insurance policy recommendations that are based on Generalized linear models (GLM can benefit from our findings.

  12. 20 CFR 336.2 - Duration of normal unemployment benefits.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Duration of normal unemployment benefits. 336... UNEMPLOYMENT INSURANCE ACT DURATION OF NORMAL AND EXTENDED BENEFITS Normal Benefits § 336.2 Duration of normal unemployment benefits. (a) 130 compensable day limitation. A qualified employee who has satisfied the waiting...

  13. 20 CFR 325.4 - Claim for unemployment benefits.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Claim for unemployment benefits. 325.4 Section 325.4 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD UNEMPLOYMENT INSURANCE ACT REGISTRATION FOR RAILROAD UNEMPLOYMENT BENEFITS § 325.4 Claim for unemployment benefits. (a...

  14. RISK CORRIDORS AND REINSURANCE IN HEALTH INSURANCE MARKETPLACES: Insurance for Insurers

    OpenAIRE

    LAYTON, TIMOTHY J.; MCGUIRE, THOMAS G.; SINAIKO, ANNA D.

    2016-01-01

    In order to encourage entry and lower prices, most regulated markets for health insurance include policies that seek to reduce the uncertainty faced by insurers. In addition to risk adjustment of premiums paid to plans, the Health Insurance Marketplaces established by the Affordable Care Act implement reinsurance and risk corridors. Reinsurance limits insurer costs associated with specific individuals, while risk corridors protect against aggregate losses. Both tighten the insurer's distribut...

  15. Policy Watch: The Federal Employees Health Benefits Plan

    OpenAIRE

    Roger Feldman; Kenneth E. Thorpe; Bradley Gray

    2002-01-01

    This short feature describes the Federal Employees Health Benefits Plan (FEHBP), which provides health insurance benefits to active and retired federal employees and their dependents. The article discusses the FEHBP as a touchstone for research on employment-based health insurance and as a touchstone for health policy reform.

  16. 29 CFR 1405.11 - Effect on employee benefits.

    Science.gov (United States)

    2010-07-01

    ... to coverage under the Federal Employees Group Life Insurance and Federal Employees Health Benefits Programs. The Government contribution for health insurance of eligible part-time employees will be prorated... 29 Labor 4 2010-07-01 2010-07-01 false Effect on employee benefits. 1405.11 Section 1405.11 Labor...

  17. ENDOWMENT LIFE INSURANCE

    Directory of Open Access Journals (Sweden)

    Zeljko Sain

    2013-06-01

    Full Text Available The aim of the paper that treats the actuarial model of insurance in case of survival or early death is to show the actuarial methods and methodology for creating a model and an appropriate number of sub-models of the most popular form of life insurance in the world. The paper applies the scientific methodology of the deductive character based on scientific, theoretical knowledge and practical realities. Following the basic theoretical model’s determinants, which are at the beginning of the paper, the basic difference between models further in this paper was carried out according to the character of the premium to be paid. Finally, the financial repercussions of some models are presented at examples in insurance companies. The result of this paper is to show the spectrum of possible forms of capital endowment insurance which can be, without major problems, depending on the financial policy of the company, applied in actual practice. The conclusion of this paper shows the theoretical and the practical reality of this model, life insurance, and its quantitative and qualitative guidelines.

  18. Are Teachers Prepared? Predictors of Teachers' Readiness to Serve as Mandated Reporters of Child Abuse

    Science.gov (United States)

    Greytak, Emily A.

    2009-01-01

    The Child Abuse Prevention and Treatment Act (1974) requires that states receiving U.S. federal funds directed at child abuse implement mandated reporting laws. As a result, all states have adopted legislation requiring teachers and other professionals who deal with children to report suspicions of child abuse. The federal mandate for such…

  19. Serbian insurance market: Select issues

    Directory of Open Access Journals (Sweden)

    Obadović Mirjana M.

    2010-01-01

    Full Text Available Every day insurance companies face a number of risks arising from the insurance industry itself, as well as risks arising from insurance company operations. In this constant fight against risks insurance companies use different models and methods that help them better understand, have a more comprehensive view of, and develop greater tolerance towards risks, in order to reduce their exposure to these risks. The model presented in this paper has been developed for implementation in insurance risk management directly related to insurance company risk, i.e. it is a model that can reliably determine the manner and intensity with which deviations in the initial insurance risk assessment affect insurance company operations, in the form of changes in operational risks and consequently in insurance companies’ business strategies. Additionally we present the implementation of the model in the Serbian market for the period 2005-2010.

  20. Dental insurance! Are we ready?

    Directory of Open Access Journals (Sweden)

    Ravi SS Toor

    2011-01-01

    Full Text Available Dental insurance is insurance designed to pay the costs associated with dental care. The Foreign Direct Investment (FDI bill which was put forward in the winter session of the Lok Sabha (2008 focused on increasing the foreign investment share from the existing 26% to 49% in the insurance companies of India. This will allow the multibillion dollar international insurance companies to enter the Indian market and subsequently cover all aspects of insurance in India. Dental insurance will be an integral a part of this system. Dental insurance is a new concept in Southeast Asia as very few countries in Southeast Asia cover this aspect of insurance. It is important that the dentists in India should be acquainted with the different types of plans these companies are going to offer and about a new relationship which is going to emerge in the coming years between dentist, patient and the insurance company.

  1. Policy Options to Reduce Fragmentation in the Pooling of Health Insurance Funds in Iran.

    Science.gov (United States)

    Bazyar, Mohammad; Rashidian, Arash; Kane, Sumit; Vaez Mahdavi, Mohammad Reza; Akbari Sari, Ali; Doshmangir, Leila

    2016-02-11

    There are fragmentations in Iran's health insurance system. Multiple health insurance funds exist, without adequate provisions for transfer or redistribution of cross subsidy among them. Multiple risk pools, including several private secondary insurance schemes, have resulted in a tiered health insurance system with inequitable benefit packages for different segments of the population. Also fragmentation might have contributed to inefficiency in the health insurance systems, a low financial protection against healthcare expenditures for the insured persons, high coinsurance rates, a notable rate of insurance coverage duplication, low contribution of well-funded institutes with generous benefit package to the public health insurance schemes, underfunding and severe financial shortages for the public funds, and a lack of transparency and reliable data and statistics for policy-making. We have conducted a policy analysis study, including qualitative interviews of key informants and document analysis. As a result we introduce three policy options: keeping the existing structural fragmentations of social health insurance (SHI)schemes but implementing a comprehensive "policy integration" strategy; consolidation of existing health insurance funds and creating a single national health insurance scheme; and reducing fragmentation by merging minor well-resourced funds together and creating two or three large insurance funds under the umbrella of the existing organizations. These policy options with their advantages and disadvantages are explained in the paper. © 2016 by Kerman University of Medical Sciences.

  2. Policy Options to Reduce Fragmentation in the Pooling of Health Insurance Funds in Iran

    Science.gov (United States)

    Bazyar, Mohammad; Rashidian, Arash; Kane, Sumit; Vaez Mahdavi, Mohammad Reza; Akbari Sari, Ali; Doshmangir, Leila

    2016-01-01

    There are fragmentations in Iran’s health insurance system. Multiple health insurance funds exist, without adequate provisions for transfer or redistribution of cross subsidy among them. Multiple risk pools, including several private secondary insurance schemes, have resulted in a tiered health insurance system with inequitable benefit packages for different segments of the population. Also fragmentation might have contributed to inefficiency in the health insurance systems, a low financial protection against healthcare expenditures for the insured persons, high coinsurance rates, a notable rate of insurance coverage duplication, low contribution of well-funded institutes with generous benefit package to the public health insurance schemes, underfunding and severe financial shortages for the public funds, and a lack of transparency and reliable data and statistics for policy-making. We have conducted a policy analysis study, including qualitative interviews of key informants and document analysis. As a result we introduce three policy options: keeping the existing structural fragmentations of social health insurance (SHI)schemes but implementing a comprehensive "policy integration" strategy; consolidation of existing health insurance funds and creating a single national health insurance scheme; and reducing fragmentation by merging minor well-resourced funds together and creating two or three large insurance funds under the umbrella of the existing organizations. These policy options with their advantages and disadvantages are explained in the paper. PMID:27239868

  3. CURRENT CHANGES ON INSURANCE MARKET

    Directory of Open Access Journals (Sweden)

    Madalina Giorgiana MANGRA

    2016-12-01

    Full Text Available The offer of insurance products is about the requirements and needs of the consumer who must always have information regarding: the type of insurance risk covered and the excluded risks, the sum insured, the payment of premiums and their duration. The accurate information of customer requires, from the commencement of contract and throughout its duration, that he or she is aware of the obligations throughout the contractual period. Most of the Romanians are turning their attention to one of the insurance companies found in the top 10 in 2016, supervised by F.S.A. (Financial Supervision Authority, preferring to have a policy of mandatory household and goods insurance, auto liability or life insurance, but are also interested in travel health insurance when going abroad, private health insurance or private pension insurance. Romanians' reluctance regarding the conclusion of an insurance comes from their distrust in insurance companies (see the situations of companies like Astra Insurance, Carpatica Insurance etc., their personal financial situation and the fear that they will not receive protection if the risk is covered but the insured sum is insufficient

  4. Long Dated Life Insurance and Pension Contracts

    OpenAIRE

    Aase, Knut K.

    2011-01-01

    We discuss the "life cycle model" by first introducing a credit market with only biometric risk, and then market risk is introduced via risky securities. This framework enables us to find optimal pension plans and life insurance contracts where the benefits are state dependent. We compare these solutions both to the ones of standard actuarial theory, and to policies offered in practice. Two related portfolio choice puzzles are discussed in the light of recent research, one is the horizon prob...

  5. Insured without moral hazard in the health care reform of China.

    Science.gov (United States)

    Wong, Chack-Kie; Cheung, Chau-Kiu; Tang, Kwong-Leung

    2012-01-01

    Public insurance possibly increases the use of health care because of the insured person's interest in maximizing benefits without incurring out-of-pocket costs. A newly reformed public insurance scheme in China that builds on personal responsibility is thus likely to provide insurance without causing moral hazard. This possibility is the focus of this study, which surveyed 303 employees in a large city in China. The results show that the coverage and use of the public insurance scheme did not show a significant positive effect on the average employee's frequency of physician consultation. In contrast, the employee who endorsed public responsibility for health care visited physicians more frequently in response to some insurance factors. On balance, public insurance did not tempt the average employee to consult physicians frequently, presumably due to personal responsibility requirements in the insurance scheme.

  6. Extended unemployment and UI benefits

    OpenAIRE

    Robert G. Valletta; Katherine Kuang

    2010-01-01

    During the current labor market downturn, unemployment duration has reached levels well above its previous highs. Analysis of unemployment data suggests that extended unemployment insurance benefits have not been important factors in the increase in the duration of unemployment or in the elevated unemployment rate.

  7. Insurance Companies Adapting to Trends by Adopting Medical Tourism.

    Science.gov (United States)

    Paul, David P; Barker, Tyler; Watts, Angela L; Messinger, Ashley; Coustasse, Alberto

    Health care costs in the United States are rising every year, and patients are seeking new ways to control their expenditures and save money. Going abroad to receive health care is a cheaper alternative than receiving the same or similar care at home. Insurance companies are beginning to realize the benefits of medical tourism for both themselves and their beneficiaries and have therefore started to introduce medical tourism plans for their clients as an option for their beneficiaries. This research study explores the benefits and risks of medical tourism and examines the US insurance market's reaction to the trend of increasing medical tourism. The US medical tourism industry mirrors that of the United Kingdom in recent years, with more patients seeking care abroad than in the United States. Insurance companies have introduced new plans providing the option of traveling abroad to countries such as India and Costa Rica. Medical tourism is gaining popularity with US residents, and insurance companies are recognizing this trend.

  8. Insurance against nuclear risks

    International Nuclear Information System (INIS)

    Dow, J.C.

    1976-01-01

    Virtually any type of nuclear risk is insurable in principle, providing, of course, that the necessary standards of safety and control are met. Some of the risks are of a relatively minor character and no more hazardous than a simple conventional risk. But insurers would not consider as a minor risk anything which involves the use of nuclear fuel or other nuclear materials which are in a critical state or capable of releasing dangerous levels of radioactivity. These would include nuclear reactors or, indeed, any type of assembly which can not be regarded as subcritical. Most insurers would also regard installations involved in the manufacturing, processing and enriching of nuclear fuel, and certainly those concerned with the reprocessing of irradiated fuel and plutonium extraction, as major risks. (HP) [de

  9. Substance use, symptom, and employment outcomes of persons with a workplace mandate for chemical dependency treatment.

    Science.gov (United States)

    Weisner, Constance; Lu, Yun; Hinman, Agatha; Monahan, John; Bonnie, Richard J; Moore, Charles D; Chi, Felicia W; Appelbaum, Paul S

    2009-05-01

    This study examined the role of workplace mandates to chemical dependency treatment in treatment adherence, alcohol and drug abstinence, severity of employment problems, and severity of psychiatric problems. The sample included 448 employed members of a private, nonprofit U.S. managed care health plan who entered chemical dependency treatment with a workplace mandate (N=75) or without one (N=373); 405 of these individuals were followed up at one year (N=70 and N=335, respectively), and 362 participated in a five-year follow up (N=60 and N=302, respectively). Propensity scores predicting receipt of a workplace mandate were calculated. Logistic regression and ordinary least-squares regression were used to predict length of stay in chemical dependency treatment, alcohol and drug abstinence, and psychiatric and employment problem severity at one and five years. Overall, participants with a workplace mandate had one- and five-year outcomes similar to those without such a mandate. Having a workplace mandate also predicted longer treatment stays and improvement in employment problems. When other factors related to outcomes were controlled for, having a workplace mandate predicted abstinence at one year, with length of stay as a mediating variable. Workplace mandates can be an effective mechanism for improving work performance and other outcomes. Study participants who had a workplace mandate were more likely than those who did not have a workplace mandate to be abstinent at follow-up, and they did as well in treatment, both short and long term. Pressure from the workplace likely gets people to treatment earlier and provides incentives for treatment adherence.

  10. Substance Use, Symptom, and Employment Outcomes of Persons With a Workplace Mandate for Chemical Dependency Treatment

    Science.gov (United States)

    Weisner, Constance; Lu, Yun; Hinman, Agatha; Monahan, John; Bonnie, Richard J.; Moore, Charles D.; Chi, Felicia W.; Appelbaum, Paul S.

    2010-01-01

    Objective This study examined the role of workplace mandates to chemical dependency treatment in treatment adherence, alcohol and drug abstinence, severity of employment problems, and severity of psychiatric problems. Methods The sample included 448 employed members of a private, nonprofit U.S. managed care health plan who entered chemical dependency treatment with a workplace mandate (N=75) or without one (N=373); 405 of these individuals were followed up at one year (N=70 and N=335, respectively), and 362 participated in a five-year follow up (N=60 and N=302, respectively). Propensity scores predicting receipt of a workplace mandate were calculated. Logistic regression and ordinary least-squares regression were used to predict length of stay in chemical dependency treatment, alcohol and drug abstinence, and psychiatric and employment problem severity at one and five years. Results Overall, participants with a workplace mandate had one- and five-year outcomes similar to those without such a mandate. Having a workplace mandate also predicted longer treatment stays and improvement in employment problems. When other factors related to outcomes were controlled for, having a workplace mandate predicted abstinence at one year, with length of stay as a mediating variable. Conclusions Workplace mandates can be an effective mechanism for improving work performance and other outcomes. Study participants who had a workplace mandate were more likely than those who did not have a workplace mandate to be abstinent at follow-up, and they did as well in treatment, both short and long term. Pressure from the workplace likely gets people to treatment earlier and provides incentives for treatment adherence. PMID:19411353

  11. 20 CFR 404.330 - Who is entitled to wife's or husband's benefits.

    Science.gov (United States)

    2010-04-01

    ... marriage occurs.) (2) You and the insured are the natural parents of a child; or (3) In the month before...-age or disability benefit based upon a primary insurance amount that is equal to or larger than the...

  12. Leaving "Hotel California" : How Incentives Affect Flows of Benefit Recipients in the Netherlands

    NARCIS (Netherlands)

    van Ours, J.C.

    2006-01-01

    This paper discusses developments in the Netherlands concerning unemployment insurance, unemployment assistance and disability insurance.The emphasis is on how incentives for individual workers and firms affect flows of benefit recipients.

  13. Nuclear insurance and indemnity

    International Nuclear Information System (INIS)

    Kovan, D.

    1976-01-01

    A brief account is given of insurance protection in the nuclear industry, and the legislation involved. Aspects discussed are: third part liability and the role of government in setting the maximum amount of compensation; the development and concept of channelling the liability exclusively to the operator; the development of nuclear insurance facilities in Europe and the USA; and the emergence in Europe of international agreements on third party liability for protection of neighbouring countries in the event of a major accident. The development of liability law in the USA from the time of the Price Anderson Act of 1957 through subsequent legislation is described. (U.K.)

  14. American nuclear insurers

    International Nuclear Information System (INIS)

    Oliveira, R.A.

    1988-01-01

    Nuclear liability insurance covers liability for damages directly caused by the nuclear energy hazard. This coverage includes offsite bodily injury and property damage sustained by members of the general public, and bodily injury to onsite third party personnel. Recent nuclear liability claims allege bodily injury and property damage resulting from releases or radioactive materials to the environmental and occupational radiation worker exposures. Routine reactor operations involving radioactive waste have the potential to result in such claims. The nuclear insurance Pools believe that one way such claims can be minimized is through the implementation of an effective radioactive waste management program

  15. Lectures on insurance models

    CERN Document Server

    Ramasubramanian, S

    2009-01-01

    Insurance has become a necessary aspect of modern society. The mathematical basis of insurance modeling is best expressed in terms of continuous time stochastic processes. This introductory text on actuarial risk theory deals with the Cramer-Lundberg model and the renewal risk model. Their basic structure and properties, including the renewal theorems as well as the corresponding ruin problems, are studied. There is a detailed discussion of heavy tailed distributions, which have become increasingly relevant. The Lundberg risk process with investment in risky asset is also considered. This book will be useful to practitioners in the field and to graduate students interested in this important branch of applied probability.

  16. How Does Retiree Health Insurance Influence Public Sector Employee Saving?

    OpenAIRE

    Robert Clark; Olivia S. Mitchell

    2013-01-01

    Economic theory predicts that employer-provided retiree health insurance (RHI) benefits have a crowd-out effect on household wealth accumulation, not dissimilar to the effects reported elsewhere for employer pensions, Social Security, and Medicare. Nevertheless, we are unaware of any similar research on the impacts of retiree health insurance per se. Accordingly, the present paper utilizes a unique data file on respondents to the Health and Retirement Study, to explore how employer-provided r...

  17. Looking at nuclear liability and insurance in Russia

    International Nuclear Information System (INIS)

    Schwartz, J.

    1997-01-01

    A recent seminar in Moscow has addressed the issue of nuclear liability and insurance in the Russian nuclear industry since the breakup of the Soviet Union. The potential benefits of joining the international liability regime and adopting comprehensive nuclear liability legislation were discussed. The need to establish appropriate nuclear insurance structures and provide indemnity to cover the liability were also debated. Whether these changes can be put into action or not is less certain than the need for them. (UK)

  18. Duplicate Health Insurance Coverage: Determinants of Variation Across States

    OpenAIRE

    Luft, Harold S.; Maerki, Susan C.

    1982-01-01

    Although it is recognized that many people have duplicate private health insurance coverage, either through separate purchase or as health benefits in multi-earner families, there has been little analysis of the factors determining duplicate coverage rates. A new data source, the Survey of Income and Education, offers a comparison with the only previous source of state level data, the estimates from the Health Insurance Association of America. The R2 between the two sets is only .3 and certai...

  19. Optimal Taxation and Social Insurance in a Lifetime Perspective

    DEFF Research Database (Denmark)

    Bovenberg, A. Lans; Sørensen, Peter Birch

    Advances in information technology have improved the administrative feasibility of redistribution based on lifetime earnings recorded at the time of retirement. We study optimal lifetime income taxation and social insurance in an economy in which redistributive taxation and social insurance serve...... to insure (ex ante) against skill heterogeneity as well as disability risk. Optimal disability benefits rise with previous earnings so that public transfers depend not only on current earnings but also on earnings in the past. Hence, lifetime taxation rather than annual taxation is optimal. The optimal tax...

  20. Disability Insurance and Health Insurance Reform: Evidence from Massachusetts

    OpenAIRE

    Nicole Maestas; Kathleen J. Mullen; Alexander Strand

    2014-01-01

    As health insurance becomes available outside of the employment relationship as a result of the Affordable Care Act (ACA), the cost of applying for Social Security Disability Insurance (SSDI)–potentially going without health insurance coverage during a waiting period totaling 29 months from disability onset–will decline for many people with employer-sponsored health insurance. At the same time, the value of SSDI and Supplemental Security Income (SSI) participation will decline for individuals...

  1. BUSINESS PROCESS MANAGEMENT IN INSURANCE CASE OF JADRANSKO INSURANCE COMPANY

    OpenAIRE

    Sanja Coric; Danijel Bara

    2014-01-01

    Selling insurance products in conditions of today’s modern technological solutions is faced with numerous challenges. Business processes in insurance as well as the results of these business processes are the real interface to policyholders. Modeling and analysis of business process in insurance ensure organizations to focus on the customer and increase the efficiency and quality of work. Managing critical business processes in every single organization, likewise in insurance is a key factor ...

  2. 78 FR 56583 - Deposit Insurance Regulations; Definition of Insured Deposit

    Science.gov (United States)

    2013-09-13

    ... as a potential global deposit insurer, preserve confidence in the FDIC deposit insurance system, and... the United States.\\2\\ The FDIC generally pays out deposit insurance on the next business day after a... since 2001 and total approximately $1 trillion today. In many cases, these branches do not engage in...

  3. 20 CFR 404.277 - When does the frozen minimum primary insurance amount increase because of cost-of-living...

    Science.gov (United States)

    2010-04-01

    ... insurance amount increase because of cost-of-living adjustments? 404.277 Section 404.277 Employees' Benefits... Primary Insurance Amounts Cost-Of-Living Increases § 404.277 When does the frozen minimum primary insurance amount increase because of cost-of-living adjustments? (a) What is the frozen minimum primary...

  4. Voluntary Public Unemployment Insurance

    DEFF Research Database (Denmark)

    O. Parsons, Donald; Tranæs, Torben; Bie Lilleør, Helene

    Denmark has drawn much attention for its active labor market policies, but is almost unique in offering a voluntary public unemployment insurance program requiring a significant premium payment. A safety net program – a less generous, means-tested social assistance plan – completes the system...

  5. Insurance: Covering the bases

    International Nuclear Information System (INIS)

    Burr, M.T.

    1992-01-01

    This article addresses steps to take to improve the economics and risk profiles for independent power projects. The topics discussed in the article include the results of competition in the power industry, custom packages and the lack of competition among insurers in the power industry, mitigating risk through providing technical information, and developing programs

  6. Consumers’ Collision Insurance Decisions

    DEFF Research Database (Denmark)

    Austin, Laurel; Fischhoff, Baruch

    Using interviews with 74 drivers, we elicit and analyse how people think about collision coverage and, more generally, about insurance decisions. We compare the judgments and behaviours of these decision makers to the predictions of a range of theoretical models: (a) A model developed by Lee (200...

  7. Trends in pension insurance

    Directory of Open Access Journals (Sweden)

    D. Shterev

    2017-12-01

    Full Text Available This article deals with a topical for our country problem which is related to the State Social Insurance. It provides a review of the factors having an adverse effect onto the financial state of the Bulgarian pension system. Discussed are the basic parameters related to the economic incentives in connection with the optimal functioning of the pension system

  8. HOUSING INSURANCE IN ROMANIA

    Directory of Open Access Journals (Sweden)

    FLOREA IANC MARIA MIRABELA

    2014-12-01

    Full Text Available Last few years have shown that Romania is not protected from the consequences of climate change. It is clear that type flood events may cause social problems and losses is difficult financing from public resources, especially in the context of the existence of budget constraints. The only viable system to cope with such disasters is insurance system that has the ability to spread risks by reinsurance Natural disasters - earthquakes, floods, landslides - are just some of the risks that may threaten your home. And if natural disasters can seem distant danger, think as fires, floods caused by broken pipes or theft of household goods are trouble can happen anytime to anyone. To protect yourself in such unpleasant situations, whose frequency is unfortunately on the rise, it is necessary to be assured. Thus, you will be able to recover losses in the event that they occur. The house is undoubtedly one of the most important assets we own. Therefore, the Romans began to pay increasingly more attention to domestic insurance products. Since 2011, voluntary home insurance, life insurance with, were the most dynamic segments of the market.

  9. Business intelligence for insurance companies

    OpenAIRE

    IGNATIUK A.

    2016-01-01

    The current state and future trends for the world and domestic insurance markets are analyzed. The description of business intelligence methodology, tools and their practical implication for insurance companies are provided.

  10. BUSINESS INTELLIGENCE FOR INSURANCE COMPANIES

    Directory of Open Access Journals (Sweden)

    A. Ignatiuk

    2016-06-01

    Full Text Available The current state and future trends for the world and domestic insurance markets are analyzed. The description of business intelligence methodology, tools and their practical implication for insurance companies are provided.

  11. Expanding insurance coverage through tax credits, consumer choice, and market enhancements: the American Medical Association proposal for health insurance reform.

    Science.gov (United States)

    Palmisano, Donald J; Emmons, David W; Wozniak, Gregory D

    2004-05-12

    Recent reports showing an increase in the number of uninsured individuals in the United States have given heightened attention to increasing health insurance coverage. The American Medical Association (AMA) has proposed a system of tax credits for the purchase of individually owned health insurance and enhancements to individual and group health insurance markets as a means of expanding coverage. Individually owned insurance would enable people to maintain coverage without disruption to existing patient-physician relationships, regardless of changes in employers or in work status. The AMA's plan would empower individuals to choose their health plan and give patients and their physicians more control over health care choices. Employers could continue to offer employment-based coverage, but employees would not be limited to the health plans offered by their employer. With a tax credit large enough to make coverage affordable and the ability to choose their own coverage, consumers would dramatically transform the individual and group health insurance markets. Health insurers would respond to the demands of individual consumers and be more cautious about increasing premiums. Insurers would also tailor benefit packages and develop new forms of coverage to better match the preferences of individuals and families. The AMA supports the development of new health insurance markets through legislative and regulatory changes to foster a wider array of high-quality, affordable plans.

  12. PREMIUMS CALCULATION FOR LIFE INSURANCE

    Directory of Open Access Journals (Sweden)

    ANA PREDA

    2012-10-01

    Full Text Available The paper presents the techniques and the formulas used on international practice for establishing the premiums for a life policy. The formulas are generally based on a series of indicators named mortality indicators which mainly point out the insured survival probability, the death probability and life expectancy at certain age. I determined, using a case study, the unique net premium, the annual net premium for a survival insurance, whole life insurance and mixed life insurance.

  13. Forest insurance market participants’ game behavior in China: An analysis based on tripartite dynamic game model

    Directory of Open Access Journals (Sweden)

    Ning Ma

    2015-11-01

    Full Text Available Purpose: In forest insurance market, there are three main participants including the insurance company, the forest farmer and the government. As different participant has different benefit object, there will be a complex and dynamic game relationship among all participants. The purpose of this paper is to make the game relationship among all participants in forest insurance market clear, and then to put forward some policy suggestions on the implementation of forest insurance from the view of game theory. Design/methodology/approach: Firstly, the static game model between the insurance company and the forest farmer is set up. According to the result of static game model, it’s difficult to implement forest insurance without government. Secondly, the tripartite dynamic game model among the government, the insurance company and the forest farmer is proposed, and the equilibrium solution of tripartite dynamic game model is acquired. Finally, the behavioral characteristics of all participants are analyzed according to the equilibrium solution of tripartite dynamic game model. Findings: the government’s allowance will be an important positive factor to implement forest insurance. The loss of the insurance company, which the lower insurance premium brings, can be compensated by the allowance from the government. The more the government provides allowance, the more actively the insurance company will implement forest insurance at a low insurance premium. In this situation, the forest farmer will be more likely to purchase the forest insurance, then the scope of forest insurance implementation will expend. Originality/value: There is a complex and dynamic game relationship among all participants in forest insurance market. Based on the tripartite dynamic game model, to make the game relationship between each participant clear is conducive to the implementation of forest insurance market in China.

  14. Insurance - Piper Alpha ''et al''

    International Nuclear Information System (INIS)

    Hales, K.

    1995-01-01

    This paper opens with some brief information about the Piper Alpha loss, how the loss was handled and its final cost. More importantly, it discusses the effect of the Piper Alpha loss on the world insurance market including the oil insurance captives such as O.I.L Limited. Finally, the insurance market current status and prognosis for the future are considered. (Author)

  15. Premium Forecasting of an Insurance Company: Automobile Insurance

    OpenAIRE

    Fouladvand, M. Ebrahim; Darooneh, Amir H.

    2002-01-01

    We present an analytical study of an insurance company. We model the company's performance on a statistical basis and evaluate the predicted annual income of the company in terms of insurance parameters namely the premium, total number of the insured, average loss claims etc. We restrict ourselves to a single insurance class the so-called automobile insurance. We show the existence a crossover premium p_c below which the company is loss-making. Above p_c, we also give detailed statistical ana...

  16. PRICING AND ASSESSING UNIT-LINKED INSURANCE CONTRACTS WITH INVESTMENT GUARANTEES

    Directory of Open Access Journals (Sweden)

    Ciumas Cristina

    2014-07-01

    Full Text Available One of the most interesting life insurance products to have emerged in recent years in the Romanian insurance market has been the unit-linked contract. Unit-linked insurance products are life insurance policies with investment component. A unit-linked life insurance has two important components: protection and investment. The protection component refers to the insured sum in case of the occurrence of insured risks and the investment component refers to the policyholders’ account that represents the present value of the units from the chosen investment funds. Due to the financial instability caused by the Global Crisis and the amplification of market competitiveness, insurers from international markets have started to incorporate guarantees in unit-linked products. So a unit- linked life insurance policy with an asset value guarantee is an insurance policy whose benefit payable on death or at maturity consists of the greater of some guaranteed amount and the value of the units from the investment funds. One of the most challenging issues concerns the pricing of minimum death benefit and maturity benefit guarantees and the establishing of proper reserves for these guarantees. Insurers granting guarantees of this type must estimate the cost and include the cost in the premium. An important component of the activity carried out by the insurance companies is the investment of the premiums paid by policyholders in various types of assets, in order to obtain higher yields than those guaranteed by the insurance contracts, while providing the necessary liquidity for the payment of insurance claims in case of occurrence of the assumed risks. So the guaranteed benefits can be broadly matched or immunized with various types of financial assets, especially with fixed-interest instruments. According to Romanian legislation which regulates the unit-linked life insurance market, unit-linked life insurance contracts pass most of the investment risk to the

  17. The Role of Public Health Insurance in Reducing Child Poverty.

    Science.gov (United States)

    Wherry, Laura R; Kenney, Genevieve M; Sommers, Benjamin D

    2016-04-01

    Over the past 30 years, there have been major expansions in public health insurance for low-income children in the United States through Medicaid, the Children's Health Insurance Program (CHIP), and other state-based efforts. In addition, many low-income parents have gained Medicaid coverage since 2014 under the Affordable Care Act. Most of the research to date on health insurance coverage among low-income populations has focused on its effect on health care utilization and health outcomes, with much less attention to the financial protection it offers families. We review a growing body of evidence that public health insurance provides important financial benefits to low-income families. Expansions in public health insurance for low-income children and adults are associated with reduced out of pocket medical spending, increased financial stability, and improved material well-being for families. We also review the potential poverty-reducing effects of public health insurance coverage. When out of pocket medical expenses are taken into account in defining the poverty rate, Medicaid plays a significant role in decreasing poverty for many children and families. In addition, public health insurance programs connect families to other social supports such as food assistance programs that also help reduce poverty. We conclude by reviewing emerging evidence that access to public health insurance in childhood has long-term effects for health and economic outcomes in adulthood. Exposure to Medicaid and CHIP during childhood has been linked to decreased mortality and fewer chronic health conditions, better educational attainment, and less reliance on government support later in life. In sum, the nation's public health insurance programs have many important short- and long-term poverty-reducing benefits for low-income families with children. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  18. Assessing Alternative Modifications to the Affordable Care Act: Impact on Individual Market Premiums and Insurance Coverage.

    Science.gov (United States)

    Eibner, Christine; Saltzman, Evan

    2015-03-20

    The goals of the Affordable Care Act (ACA) are to enable all legal U.S. residents to have access to affordable health insurance and to prevent sicker individuals (such as those with preexisting conditions) from being priced out of the market. The ACA also instituted several policies to stabilize premiums and to encourage enrollment among healthy individuals of all ages. The law's tax credits and cost-sharing subsidies offer a "carrot" that may encourage enrollment among some young and healthy individuals who would otherwise remain uninsured, while the individual mandate acts as a "stick" by imposing penalties on individuals who choose not to enroll. In this article, the authors use the COMPARE microsimulation model, an analytic tool that uses economic theory and data to predict the effects of health policy reforms, to estimate how eliminating the ACA's individual mandate, eliminating the law's tax credits, and combined scenarios that change these and other provisions of the act might affect 2015 individual market premiums and overall insurance coverage. Underlying these estimates is a COMPARE-based analysis of how premiums and insurance coverage outcomes depend on young adults' propensity to enroll in insurance coverage. The authors find that eliminating the ACA's tax credits and eliminating the individual mandate both increase premiums and reduce enrollment on the individual market. They also find that these key features of the ACA help to protect against adverse selection and stabilize the market by encouraging healthy people to enroll and, in the case of the tax credit, shielding subsidized enrollees from premium increases. Further, they find that individual market premiums are only modestly sensitive to young adults' propensity to enroll in insurance coverage, and ensuring market stability does not require that young adults make up a particular share of enrollees.

  19. "Aging Out" of Dependent Coverage and the Effects on US Labor Market and Health Insurance Choices.

    Science.gov (United States)

    Dahlen, Heather M

    2015-11-01

    I examined how labor market and health insurance outcomes were affected by the loss of dependent coverage eligibility under the Patient Protection and Affordable Care Act (ACA). I used National Health Interview Survey (NHIS) data and regression discontinuity models to measure the percentage-point change in labor market and health insurance outcomes at age 26 years. My sample was restricted to unmarried individuals aged 24 to 28 years and to a period of time before the ACA's individual mandate (2011-2013). I ran models separately for men and women to determine if there were differences based on gender. Aging out of this provision increased employment among men, employer-sponsored health insurance offers for women, and reports that health insurance coverage was worse than it was 1 year previously (overall and for young women). Uninsured rates did not increase at age 26 years, but there was an increase in the purchase of non-group health coverage, indicating interest in remaining insured after age 26 years. Many young adults will turn to state and federal health insurance marketplaces for information about health coverage. Because young adults (aged 18-29 years) regularly use social media sites, these sites could be used to advertise insurance to individuals reaching their 26th birthdays.

  20. 46 CFR 308.403 - Insured amounts.

    Science.gov (United States)

    2010-10-01

    ... total amount of war risk insurance obtainable from companies authorized to do an insurance business in a... MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION EMERGENCY OPERATIONS WAR RISK INSURANCE War Risk Builder's Risk Insurance § 308.403 Insured amounts. (a) Prelaunching period. The amount insured during...

  1. Health Insurance without Single Crossing

    DEFF Research Database (Denmark)

    Boone, Jan; Schottmüller, Christoph

    2017-01-01

    Standard insurance models predict that people with high risks have high insurance coverage. It is empirically documented that people with high income have lower health risks and are better insured. We show that income differences between risk types lead to a violation of single crossing...... in an insurance model where people choose treatment intensity. We analyse different market structures and show the following: If insurers have market power, the violation of single crossing caused by income differences and endogenous treatment choice can explain the empirically observed outcome. Our results do...

  2. Compassionate Care Leave & Benefits. CAUT Briefing Note

    Science.gov (United States)

    Canadian Association of University Teachers, 2016

    2016-01-01

    Compassionate care leave and benefits were introduced in 2003/04 to help employees cope with this difficult work-life balance challenge. Employment Standards legislation and the Employment Insurance program (EI) were amended to provide leave without pay, with payment of EI benefits for compassionate care leave. Collective agreements have been…

  3. 45 CFR 86.56 - Fringe benefits.

    Science.gov (United States)

    2010-10-01

    ... available to employees or make fringe benefits available to spouses, families, or dependents of employees... Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION NONDISCRIMINATION ON THE BASIS OF..., accident, life insurance or retirement benefit, service, policy or plan, any profit-sharing or bonus plan...

  4. Designing Surveillance of Healthcare-Associated Infections in the Era of Automation and Reporting Mandates

    NARCIS (Netherlands)

    van Mourik, Maaike S M; Perencevich, Eli N; Gastmeier, Petra; Bonten, Marc J M

    2018-01-01

    Surveillance and feedback of infection rates to clinicians and other stakeholders is a cornerstone of healthcare-associated infection (HAI) prevention programs. In addition, HAIs are increasingly included in public reporting and payment mandates. Conventional manual surveillance methods are resource

  5. Designing Surveillance of Healthcare-Associated Infections in the Era of Automation and Reporting Mandates.

    NARCIS (Netherlands)

    van Mourik, Maaike S M; Perencevich, Eli N; Gastmeier, Petra; Bonten, Marc J M

    2018-01-01

    Surveillance and feedback of infection rates to clinicians and other stakeholders is a cornerstone of healthcare-associated infection (HAI) prevention programs. In addition, HAIs are increasingly included in public reporting and payment mandates. Conventional manual surveillance methods are resource

  6. The Big Five Health Insurers' Membership And Revenue Trends: Implications For Public Policy.

    Science.gov (United States)

    Schoen, Cathy; Collins, Sara R

    2017-12-01

    The five largest US commercial health insurance companies together enroll 125 million members, or 43 percent of the country's insured population. Over the past decade these insurers have become increasingly dependent for growth and profitability on public programs, according to an analysis of corporate reports. In 2016 Medicare and Medicaid accounted for nearly 60 percent of the companies' health care revenues and 20 percent of their comprehensive plan membership. Although headlines have focused on losses in the state Marketplaces created by the Affordable Care Act (ACA), the Marketplaces represent only a small fraction of insurers' members. Overall, the five largest insurers have remained profitable since passage of the ACA as a result of profits in other market segments. Notably, companies with significant Medicare or Medicaid enrollment have continued to insure beneficiaries in states where the insurers do not participate in Marketplaces. Given the insurers' dependence on public programs, there is potential to improve access if federal or state governments, or both, required insurers that participate in Medicare or Medicaid to also participate in the Marketplaces in the same geographic area. Such requirements could ensure more viable and less volatile insurance, benefiting people insured within each market as well as those who cycle on and off public and private insurance.

  7. Health insurance and use of medical services by men infected with HIV.

    Science.gov (United States)

    Katz, M H; Chang, S W; Buchbinder, S P; Hessol, N A; O'Malley, P; Doll, L S

    1995-01-01

    Among 178 HIV-infected men from the San Francisco City Clinic Cohort (SFCCC), we examined the association between health insurance and use of outpatient services and treatment. For men with private insurance, we also assessed the frequency of avoiding the use of health insurance. Men without private insurance reported fewer outpatient visits than men with fee-for-service or managed-care plans. Use of zidovudine for eligible men was similar for those with fee-for-service plans (74%), managed-care plans (77%), or no insurance (61%). Use of Pneumocytstis carinii pneumonia prophylaxis was similar for those with fee-for-service (93%) and managed-care plans (83%) but lower for those with no insurance (63%). Of 149 men with private insurance, 31 (21%) reported that they had avoided using their health insurance for medical expenses in the previous year. In multivariate analysis, the independent predictors of avoiding the use of insurance were working for a small company and living outside the San Francisco Bay Area. Having private insurance resulted in higher use of outpatient services, but the type of private insurance did not appear to affect the use of service or treatment. Fears of loss of coverage and confidentiality may negate some benefits of health insurance for HIV-infected persons.

  8. 48 CFR 1602.170-9 - Health benefits plan.

    Science.gov (United States)

    2010-10-01

    ... EMPLOYEES HEALTH BENEFITS ACQUISITION REGULATION GENERAL DEFINITIONS OF WORDS AND TERMS Definitions of FEHBP Terms 1602.170-9 Health benefits plan. Health benefits plan means a group insurance policy, contract... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Health benefits plan. 1602...

  9. 29 CFR 4044.75 - Other lump sum benefits.

    Science.gov (United States)

    2010-07-01

    ... sum benefits. The value of a lump sum benefit which is not covered under § 4044.73 or § 4044.74 is equal to— (a) The value under the qualifying bid, if an insurer provides the benefit; or (b) The present value of the benefit as of the date of distribution, determined using reasonable actuarial assumptions...

  10. Active and retired public employees' health insurance: potential data sources.

    Science.gov (United States)

    Morrill, Melinda Sandler

    2014-12-01

    Employer-provided health insurance for public sector workers is a significant public policy issue. Underfunding and the growing costs of benefits may hinder the fiscal solvency of state and local governments. Findings from the private sector may not be applicable because many public sector workers are covered by union contracts or salary schedules and often benefit modifications require changes in legislation. Research has been limited by the difficulty in obtaining sufficiently large and representative data on public sector employees. This article highlights data sources researchers might utilize to investigate topics concerning health insurance for active and retired public sector employees. Copyright © 2014 Elsevier B.V. All rights reserved.

  11. Insurance against climate change and flood risk: Insurability and decision processes of insurers

    Science.gov (United States)

    Hung, Hung-Chih; Hung, Jia-Yi

    2016-04-01

    1. Background Major portions of the Asia-Pacific region is facing escalating exposure and vulnerability to climate change and flood-related extremes. This highlights an arduous challenge for public agencies to improve existing risk management strategies. Conventionally, governmental funding was majorly responsible and accountable for disaster loss compensation in the developing countries in Asia, such as Taiwan. This is often criticized as an ineffective and inefficient measure of dealing with flood risk. Flood insurance is one option within the toolkit of risk-sharing arrangement and adaptation strategy to flood risk. However, there are numerous potential barriers for insurance companies to cover flood damage, which would cause the flood risk is regarded as uninsurable. This study thus aims to examine attitudes within the insurers about the viability of flood insurance, the decision-making processes of pricing flood insurance and their determinants, as well as to examine potential solutions to encourage flood insurance. 2. Methods and data Using expected-utility theory, an insurance agent-based decision-making model was developed to examine the insurers' attitudes towards the insurability of flood risk, and to scrutinize the factors that influence their decisions on flood insurance premium-setting. This model particularly focuses on how insurers price insurance when they face either uncertainty or ambiguity about the probability and loss of a particular flood event occurring. This study considers the factors that are expected to affect insures' decisions on underwriting and pricing insurance are their risk perception, attitudes towards flood insurance, governmental measures (e.g., land-use planning, building codes, risk communication), expected probabilities and losses of devastating flooding events, as well as insurance companies' attributes. To elicit insurers' utilities about premium-setting for insurance coverage, the 'certainty equivalent,' 'probability

  12. Modern problems in insurance mathematics

    CERN Document Server

    Martin-Löf, Anders

    2014-01-01

    This book is a compilation of 21 papers presented at the International Cramér Symposium on Insurance Mathematics (ICSIM) held at Stockholm University in June, 2013. The book comprises selected contributions from several large research communities in modern insurance mathematics and its applications. The main topics represented in the book are modern risk theory and its applications, stochastic modelling of insurance business, new mathematical problems in life and non-life insurance, and related topics in applied and financial mathematics. The book is an original and useful source of inspiration and essential reference for a broad spectrum of theoretical and applied researchers, research students and experts from the insurance business. In this way, Modern Problems in Insurance Mathematics will contribute to the development of research and academy–industry co-operation in the area of insurance mathematics and its applications.

  13. Financing and insurance problems

    International Nuclear Information System (INIS)

    Laurenge, M.-T.

    1975-01-01

    The author analyses the papers presented at the Paris Conference on the maturity of nuclear energy. It is evident that financing possibilities will be a determinant factor in the rate of development of nuclear power during the years to come. After having evaluated the capital requirements necessitated for the development of nuclear programmes, the parties intervening have examined the means at the disposal of electricity manufacturers to meet these needs (self-financing, recourse to external financing, regrouping, on an international scale of the electricity manufacturers of the setting up of high capacity plants). As concerns the insurance problems, they are becoming more and more involved as nuclear applications, are further diversified and intensified. The parties intervening have discussed new tarification techniques likely to be applied and pointed out the possibilities offered by regrouping or pooling of insurers (Market Pool) which allow for a maximum of risks to be covered without exceeding the means proper to each company concerned [fr

  14. Nuclear energy and insurance

    International Nuclear Information System (INIS)

    Ekener, H.

    1997-01-01

    It examines the technical, scientific and legal issues relating to the peaceful use of atomic energy in Turkey. The first fifteen chapters give a general overview of the atom and radioactivity; the chapters which follow this section are more technical and deal with the causes of nuclear accidents in reactors.A number of chapters cover legal issues, for example the conditions and procedures involved in the insurance market and the risks linked to operation of a nuclear power plant.The following subjects are examined in relation to nuclear insurance: risks during construction; fire during operation of the plants and other causes of accidents; risks due to the transport of radioactive materials and waste etc. The final chapters reproduce the principle legislative texts in force in Turkey in the field of nuclear energy, and also certain regulations which establish competent regulatory bodies

  15. Consolidating the social health insurance schemes in China: towards an equitable and efficient health system.

    Science.gov (United States)

    Meng, Qingyue; Fang, Hai; Liu, Xiaoyun; Yuan, Beibei; Xu, Jin

    2015-10-10

    Fragmentation in social health insurance schemes is an important factor for inequitable access to health care and financial protection for people covered by different health insurance schemes in China. To fulfil its commitment of universal health coverage by 2020, the Chinese Government needs to prioritise addressing this issue. After analysing the situation of fragmentation, this Review summarises efforts to consolidate health insurance schemes both in China and internationally. Rural migrants, elderly people, and those with non-communicable diseases in China will greatly benefit from consolidation of the existing health insurance schemes with extended funding pools, thereby narrowing the disparities among health insurance schemes in fund level and benefit package. Political commitments, institutional innovations, and a feasible implementation plan are the major elements needed for success in consolidation. Achievement of universal health coverage in China needs systemic strategies including consolidation of the social health insurance schemes. Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. Life insurance mathematics

    CERN Document Server

    Gerber, Hans U

    1997-01-01

    This concise introduction to life contingencies, the theory behind the actuarial work around life insurance and pension funds, will appeal to the reader who likes applied mathematics. In addition to model of life contingencies, the theory of compound interest is explained and it is shown how mortality and other rates can be estimated from observations. The probabilistic model is used consistently throughout the book. Numerous exercises (with answers and solutions) have been added, and for this third edition several misprints have been corrected.

  17. Improvement of life insurance-related accounting opera-tions within the New Economy

    Directory of Open Access Journals (Sweden)

    Marinică DOBRIN

    2010-06-01

    Full Text Available This paper outlines the life insurance-related accounting operations, in consideration to the harmonization of the Romanian legislation with the International Financial Reporting Standards. The main accounting operations specific to the life insurance sector include: accounting of revenues and expenses derived from life insurance operations (recording the premiums written, recording the payment of insurance premiums, termination of insurance policy, recording the compensation expenses, accounting of operations related to the setting up and using the technical reserves for life insurance (general principles, accounting of premium reserves, accounting of loss reserve, accounting of the reserve for benefits and discounts, accounting of mathematical reserve, accounting of other life insurance-related technical reserves.

  18. 5 CFR 870.403 - Withholdings and contributions following a Living Benefit election.

    Science.gov (United States)

    2010-01-01

    ... Cost of Insurance § 870.403 Withholdings and contributions following a Living Benefit election. (a) Withholdings and contributions for Basic insurance for an individual who elects a full Living Benefit under... a Living Benefit election. 870.403 Section 870.403 Administrative Personnel OFFICE OF PERSONNEL...

  19. Individual health insurance within the family : can subsidies promote family coverage?

    OpenAIRE

    Kanika Kapur; M. Susan Marquis; José J. Escarce

    2007-01-01

    This paper examines the role of price in health insurance coverage decisions within the family to guide policy in promoting whole family coverage. We analyze the factors that affect individual health insurance coverage among families, and explore family decisions about whom to cover and whom to leave uninsured. The analysis uses household data from California combined with abstracted individual health plan benefit and premium data. We find that premium subsidies for individual insurance would...

  20. The shareholder wealth effects of insurance securitization: preliminary evidence from the catastrophe bond market

    OpenAIRE

    Hagendorff, Bjoern; Hagendorff, Jens; Keasey, Kevin

    2013-01-01

    Insurance securitization has long been hailed as an important tool to increase theunderwriting capacity for companies exposed to catastrophe-related risks. However, globalvolumes of insurance securitization have remained surprisingly low to date which raisesquestions over its benefits. In this paper, we examine changes in the market value ofinsurance and reinsurance firms which announce their engagement in insurance securitizationby issuing catastrophe (Cat) bonds. Consistent with the hithert...

  1. Types of employee benefits in Lithuania – information disclosed in companies’ financial statements

    OpenAIRE

    Legenzova, Renata

    2012-01-01

    Employees have always been recognized among the most important resources of the companies. To attract, retain and motivate their employees, companies introduce various motivation and compensation methods. In accounting they are commonly named as employee benefits. Employee benefits typically refer to wages and salaries, retirement plans, health insurance, life insurance, disability insurance, vacation and employee stock ownership plans. The aim of this paper is to assess what employee benefit...

  2. Analysis of Satisfaction Degree of the Public Insurance System Beneficiaries

    Directory of Open Access Journals (Sweden)

    Manuela PANAITESCU

    2013-08-01

    Full Text Available The public insurance system provides financial benefits to individuals that are obtained by collecting the due contributions. The analysis of satisfaction degree of the beneficiaries of the system was carried out to determine the challenges the system is facing and for determining the needs of the beneficiaries. In order to reduce the financial constraints the public insurance system is facing, it is necessary to create an appropriate insurance system that meets the needs of the beneficiaries. The research took into account that the public insurance system determines the quality of life of the population and has a strong influence on the economy, particularly on the labour market and the capital market.

  3. [Reimbursement of health apps by the German statutory health insurance].

    Science.gov (United States)

    Gregor-Haack, Johanna

    2018-03-01

    A reimbursement category for "apps" does not exist in German statutory health insurance. Nevertheless different ways for reimbursement of digital health care products or processes exist. This article provides an overview and a description of the most relevant finance and reimbursement categories for apps in German statutory health insurance. The legal qualifications and preconditions of reimbursement in the context of single contracts with one health insurance fund will be discussed as well as collective contracts with national statutory health insurance funds. The benefit of a general outline appeals especially in respect to the numerous new players and products in the health care market. The article will highlight that health apps can challenge existing legal market access and reimbursement criteria and paths. At the same time, these criteria and paths exist. In terms of a learning system, they need to be met and followed.

  4. Life Insurance Contribution, Insurance Development and Economic Growth in China

    Directory of Open Access Journals (Sweden)

    Wang Ying

    2017-07-01

    Full Text Available Under L-type economy, remodelling the growth power in the medium and long term is essential. The insurance industry during the 13th Five-year Plan period has been given a heavy expectation on promoting economic quality and upgrading economic efficiency, so it will try to accelerate its innovation and development process which serves national needs, market demand and people's requirements. Referring to the previous researches of Solow and Zhang and measuring Capital Stock and Total Factor Productivity independently, the paper analyses the inherent correlation between insurance (including life insurance and non-life insurance and economic growth, reveals the contribution law of the insurance development in economic growth in the short and long term from both economic scale and quality respectively. It also shows enlightenments on policy decision for insurance industry, thus helps economic stability under the downturn periods.

  5. Insurance of nuclear power stations

    International Nuclear Information System (INIS)

    Debaets, M.

    1992-01-01

    Electrical utility companies have invested large sums in the establishment of nuclear facilities. For this reason it is normal for these companies to attempt to protect their investments as much as possible. One of the methods of protection is recourse to insurance. For a variety of reasons traditional insurance markets are unable to function normally for a number of reasons including, the insufficient number of risks, an absence of meaningful accident statistics, the enormous sums involved and a lack of familiarity with nuclear risks on the part of insurers, resulting in a reluctance or even refusal to accept such risks. Insurers have, in response to requests for coverage from nuclear power station operators, established an alternative system of coverage - insurance through a system of insurance pools. Insurers in every country unite in a pool, providing a net capacity for every risk which is a capacity covered by their own funds, and consequently without reinsurance. All pools exchange capacity. The inconvenience of this system, for the operators in particular, is that it involves a monopolistic system in which there are consequently few possibilities for the negotiation of premiums and conditions of coverage. The system does not permit the establishment of reserves which could, over time, reduce the need for insurance on the part of nuclear power station operators. Thus the cost of nuclear insurance remains high. Alternatives to the poor system of insurance are explored in this article. (author)

  6. The Effect of Unemployment Insurance Exhaustion

    DEFF Research Database (Denmark)

    Lyk-Jensen, Stéphanie; Weatherall, Cecilie Dohlmann

    In this article we investigate how the long-term unemployed react to the threat of running out of unemployment insurance (UI) in a system in which other social benefits are available. The empirical analysis is based on very precise administrative records of unemployment spells in Denmark...... risk model to estimate the conditional probability of leaving unemployment to enter employment or receive other social benefits. We restrict our analysis to men aged 25-44 in 1998. Our results show that even for men having an initial UI entitlement for 4 years the threat of running out of UI indeed....... To identify the effect of UI exhaustion, we exploit the 1999 legislative change in the duration of benefit that progressively reduced regular UI entitlement from five to four years. According to time of entry into the UI system, all UI recipients had their potential UI period shortened. We use a competing...

  7. Demand for voluntary basic medical insurance in urban China: panel evidence from the Urban Resident Basic Medical Insurance scheme.

    Science.gov (United States)

    Chen, Gang; Yan, Xiao

    2012-12-01

    This paper investigates the key factors associated with the demand for Urban Resident Basic Medical Insurance (URBMI), which was established in 2007 and aims to cover all Chinese urban residents. Two waves of longitudinal household survey data are used, and a three-level random-intercept logit model is used for the analysis. Two different sets of explanatory variables were identified for adults and children, separately. Results suggest for both the adult and the child samples that income, health status, age and health risk behaviours are key influencing factors for basic medical insurance demand. The household head's characteristics are also significantly related to other household members' medical insurance demands. Specifically, household heads who are more educated or retired are more likely to purchase medical insurance for their children. These findings suggest that an expansion of the special subsidy to the poor or, probably more important, a risk-adjusted benefit package may be needed for voluntary basic medical insurance in China. In addition, adverse selection consistently exists and is a major challenge for the sustainability of medical insurance financing. To expand insurance coverage for children, especially those under school age, special efforts (possibly through health education or health promotion) should be focused on the household head, particularly those engaging in risky health behaviours.

  8. The Dynamics of Market Insurance, Insurable Assets, and Wealth Accumulation

    OpenAIRE

    Koeniger, Winfried

    2002-01-01

    We analyze dynamic interactions between market insurance, the stock of insurable assets and liquid wealth accumulation in a model with non-durable and durable consumption. The stock of the durable is exposed to risk against which households can insure. Since the model does not have a closed form solution we first provide an analytical approximation for the case in which households own abundant liquid wealth. It turns out that precautionary motives still matter because of fluctuations of the p...

  9. 20 CFR 726.103 - Application for authority to self-insure; effect of regulations contained in this part.

    Science.gov (United States)

    2010-04-01

    ... § 726.103 Application for authority to self-insure; effect of regulations contained in this part. As... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Application for authority to self-insure; effect of regulations contained in this part. 726.103 Section 726.103 Employees' Benefits EMPLOYMENT...

  10. Brief report: Quantifying the impact of autism coverage on private insurance premiums.

    Science.gov (United States)

    Bouder, James N; Spielman, Stuart; Mandell, David S

    2009-06-01

    Many states are considering legislation requiring private insurance companies to pay for autism-related services. Arguments against mandates include that they will result in higher premiums. Using Pennsylvania legislation as an example, which proposed covering services up to $36,000 per year for individuals less than 21 years of age, this paper estimates potential premium increases. The estimate relies on autism treated prevalence, the number of individuals insured by affected plans, mean annual autism expenditures, administrative costs, medical loss ratio, and total insurer revenue. Current treated prevalence and expenditures suggests that premium increases would approximate 1%, with a lower bound of 0.19% and an upper bound of 2.31%. Policy makers can use these results to assess the cost-effectiveness of similar legislation.

  11. Mandates, buyouts and fuel-tax rebates: Some economic aspects of biofuel policies using the UK as an example

    International Nuclear Information System (INIS)

    Swinbank, Alan; Tranter, Richard; Jones, Philip

    2011-01-01

    Many governments mandate the blending of biofuels with fossil fuel supplies. The paper raises the possibility that some firms might choose not to respect such mandates, and cites the UK's experience, where a buyout of the obligation is possible. A simple economic framework is then used to explore some implications of mandate buyouts, including situations when buyouts and road-fuel-tax rebates are applied together. Finally, it discusses the design of buyout-mandate schemes that could release raw materials from biofuel production, following a future world food price shock. - Research Highlights: → Many governments mandate the blending of biofuels with fossil fuels. → Some allow firms to buyout the obligation. → Buyouts change the economic incentives firms face. → We use an economic framework to analyse buyouts of biofuel mandates. → Buyouts could alleviate the impact of biofuel mandates on rising food prices.

  12. 78 FR 4478 - Federal Employees Dental and Vision Insurance Program: Application Process for Contract Awards

    Science.gov (United States)

    2013-01-22

    ... process is being changed to be in line with the process used for the Federal Employees Health Benefits... OFFICE OF PERSONNEL MANAGEMENT Federal Employees Dental and Vision Insurance Program: Application... Process for Federal Employees Dental and Vision Insurance Program Contract Awards. SUMMARY: The U. S...

  13. 20 CFR 702.161 - Liens against assets of insurance carriers and employers.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Liens against assets of insurance carriers... AND PROCEDURE General Provisions Liens on Compensation § 702.161 Liens against assets of insurance..., be subrogated to all the rights of the person receiving such payments. The Secretary may institute...

  14. Should catastrophic risks be included in a regulated competitive health insurance market?

    NARCIS (Netherlands)

    W.P.M.M. van de Ven (Wynand); F.T. Schut (Erik)

    1994-01-01

    textabstractIn 1988 the Dutch government launched a proposal for a national health insurance based on regulated competition. The mandatory benefits package should be offered by competing insurers and should cover both non-catastrophic risks (like hospital care, physician services and drugs) and

  15. Impact of community-based health insurance in rural India on self-medication & financial protection of the insured

    Directory of Open Access Journals (Sweden)

    David M Dror

    2016-01-01

    Full Text Available Background & objectives: The evidence-base of the impact of community-based health insurance (CBHI on access to healthcare and financial protection in India is weak. We investigated the impact of CBHI in rural Uttar Pradesh and Bihar s0 tates of India on insured households′ self-medication and financial position. Methods: Data originated from (i household surveys, and (ii the Management Information System of each CBHI. Study design was "staggered implementation" cluster randomized controlled trial with enrollment of one-third of the treatment group in each of the years 2011, 2012 and 2013. Around 40-50 per cent of the households that were offered to enroll joined. The benefits-packages covered outpatient care in all three locations and in-patient care in two locations. To overcome self-selection enrollment bias, we constructed comparable control and treatment groups using Kernel Propensity Score Matching (K-PSM. To quantify impact, both difference-in-difference (DiD, and conditional-DiD (combined K-PSM with DiD were used to assess robustness of results. Results: Post-intervention (2013, self-medication was less practiced by insured HHs. Fewer insured households than uninsured households reported borrowing to finance care for non-hospitalization events. Being insured for two years also improved the HH′s location along the income distribution, namely insured HHs were more likely to experience income quintile-upgrade in one location, and less likely to experience a quintile-downgrade in two locations. Interpretation & conclusions: The realized benefits of insurance included better access to healthcare, reduced financial risks and improved economic mobility, suggesting that in our context health insurance creates welfare gains. These findings have implications for theoretical, ethical, policy and practice considerations.

  16. Estimation of a hedonic pricing model for Medigap insurance.

    Science.gov (United States)

    Robst, John

    2006-12-01

    This paper uses a unique database to examine premiums paid by beneficiaries for Medigap supplemental coverage. Average premiums charged by insurers are reported, as well as premiums by enrollee age and gender, and additional policy characteristics. Marginal prices for Medigap benefits are estimated using hedonic price regressions. In addition, the paper considers how additional policy characteristics and geographic differences in the use and cost of medical care affect premiums. A comprehensive database on premiums paid by beneficiaries for newly issued Medigap policies in the year 2000 along with state-level characteristics. Hedonic pricing equations are used to estimate implicit prices for Medigap benefits. The Centers for Medicare & Medicaid Services contracted for the creation of a detailed database on Medigap premiums. Data were collected in three stages. First, letters were sent directly to insurers requesting premium data. Second, letters were directly to state insurance commissioner's offices requesting premium data. Last, each state insurance commissioner's office was visited to collect missing data. With the exceptions of the part B deductible and drug benefit, Medigap supplemental insurance is priced consistent with the actuarial value of benefits offered under the standardized plans. Premiums vary substantially based on rating method, whether the policy is guaranteed issue, Medigap Select, or explicitly for smokers. Premiums increase with enrollee age, but do not vary between men and women. The relationship between premiums and enrollee age varies across rating methods. Attained-age policies show the strongest relationship between age and premiums, while community-rated premiums, by definition, do not vary with age. Medigap supplemental insurance premiums are higher in states with poorer health, greater utilization, and greater managed care penetration. Despite the high cost, Medigap plans are generally priced in accordance with the actuarial value of

  17. Estimation of a Hedonic Pricing Model for Medigap Insurance

    Science.gov (United States)

    Robst, John

    2006-01-01

    Objective This paper uses a unique database to examine premiums paid by beneficiaries for Medigap supplemental coverage. Average premiums charged by insurers are reported, as well as premiums by enrollee age and gender, and additional policy characteristics. Marginal prices for Medigap benefits are estimated using hedonic price regressions. In addition, the paper considers how additional policy characteristics and geographic differences in the use and cost of medical care affect premiums. Data Sources/Study Setting A comprehensive database on premiums paid by beneficiaries for newly issued Medigap policies in the year 2000 along with state-level characteristics. Study Design Hedonic pricing equations are used to estimate implicit prices for Medigap benefits. Data Collection/Extraction Methods The Centers for Medicare & Medicaid Services contracted for the creation of a detailed database on Medigap premiums. Data were collected in three stages. First, letters were sent directly to insurers requesting premium data. Second, letters were directly to state insurance commissioner's offices requesting premium data. Last, each state insurance commissioner's office was visited to collect missing data. Principal Findings With the exceptions of the part B deductible and drug benefit, Medigap supplemental insurance is priced consistent with the actuarial value of benefits offered under the standardized plans. Premiums vary substantially based on rating method, whether the policy is guaranteed issue, Medigap Select, or explicitly for smokers. Premiums increase with enrollee age, but do not vary between men and women. The relationship between premiums and enrollee age varies across rating methods. Attained-age policies show the strongest relationship between age and premiums, while community-rated premiums, by definition, do not vary with age. Medigap supplemental insurance premiums are higher in states with poorer health, greater utilization, and greater managed care

  18. Constant Proportion Portfolio Insurance

    DEFF Research Database (Denmark)

    Jessen, Cathrine

    2014-01-01

    on the theme, originally proposed by Fischer Black. In CPPI, a financial institution guarantees a floor value for the “insured” portfolio and adjusts the stock/bond mix to produce a leveraged exposure to the risky assets, which depends on how far the portfolio value is above the floor. Plain-vanilla portfolio...... insurance largely died with the crash of 1987, but CPPI is still going strong. In the frictionless markets of finance theory, the issuer’s strategy to hedge its liability under the contract is clear, but in the real world with transactions costs and stochastic jump risk, the optimal strategy is less obvious...

  19. COMPARATIVE ANALYSIS OF THE LIFE INSURANCE IN REPUBLIC OF MACEDONIA AND REPUBLIC OF SERBIA

    Directory of Open Access Journals (Sweden)

    GORDANA VITANOVA

    2015-12-01

    Full Text Available The insurance companies are important participants in the capital market. They have significant contributions in providing financial stability and encouraging competitiveness on the financial market. The insurance companies mobilize huge financial resources, investing them into different financial instruments, and so it is real to expect that they will take a role of leading institutional mediators in future. The insurance companies offer life and common insurance. Policies for life insurance offer possibility to invest into own safety and easier tackling with life challenges and uncertainties. They are especially important for the individual , because he/she is constantly exposed to risks during his/her life and work, that are manifested into decreasing of working ability and lack of resources for life in some defined period. In the developed countries, there is a tradition for possessing policies for life insurance, but it is not a case in R.Macedonia. Therefore, in this study, we shall carry out comparative analysis of life insurance in R. Macedonia and R. Serbia, the politics of insurance companies and supervision of the insurance sector, and we shall give proposals for encouraging development of insurance market in these two countries, and for increasing individual’s awareness of the benefits of having policies for life insurance.

  20. ETHICS IN THE INSURANCE INDUSTRY

    OpenAIRE

    Gavriletea Marius

    2008-01-01

    The present paper debates the main aspects related to ethics, into an industry that recorded exponential growth in Romania insurance field. A very important role for a good business is enhanced by the ethics. The specialists appreciate that ethics represent a key factor for business success. Obviously, the insurance field into a competition market must follow all the aspects related to ethics. The ethics should be an essential element of every insurance company management. If we talk about et...