Healthcare Products Flashcards
Things to think about when considering healthcare products
Legislation
Key product features
Underwriting
Contract design
Setting contribution or premium rates
Provisioning
Mutuality, solidarity and community rating
Reinsurance
Investment strategy
Types of entities providing cover
Key risks
Reimbursement mechanisms
Medical trends
Private medical insurance
Short term
Indemnify policyholder for medical costs incurred according to benefit rules
Moral hazard - policyholders visiting healthcare providers more frequently and choosing more elective options that are not needed
Critical illness insurance
Long term
Lump sum provided in the event of contracting defined critical illness
Could also be an income (annuity)
Long term care insurance
Long term
Helps provide for care in old age
Extent of cover depends on level of incapacity measured by activities of daily living (toileting, feeding, transferring, mobility, etc.)
Either an immediate needs or pre-funded basis
Cash benefits
Major medical expenses: lump sum paid on surgery
Hospital cash plans: lump sum paid per day staying in hospital
Medical shortfall (gap) cover: covers the difference between medical costs incurred and that covered by PMI
Personal accident: lump sum paid on injury or disability due to accident
