Health uninsurance premium and mortgage interest rates

I show that lenders charge higher interest rates on mortgage-financed houses in areas with a higher rate of health uninsurance to protect themselves against a potential future bankruptcy of the borrower caused by health uninsurance. The health uninsurance premium is higher for applicants who are more likely to file for bankruptcy and for mortgage-financed houses in areas where there are greater benefits to obtaining insurance or where there is a higher percentage of uninsured people who cannot afford insurance. The premium is lower following the implementation of the requirement to have qualifying health insurance coverage under the Affordable Care Act.     

Subsidization and Choice in the Group Health Insurance Market

This study investigates the effect of group health insurance plan choice on insurance unit price. The empirical findings suggest that the unit price of insurance, as measured by the ratio of the premium to expected indemnity benefits, is lower in group plans that offer employees a choice of different insurance options and require a premium contribution than it is in plans lacking at least one of these two features. The analyses suggest that lower unit prices are related to an increase in indemnity benefits and that the reduction in the unit price is greater for lower risks. The findings indicate that although subsidization of high risks by low risks occurs with group health insurance, the degree of subsidization is less when employees are offered a choice of health insurance plans.     

A Game‐Theoretical Interpretation of Guaranteed Renewability in Health Insurance

A game‐theoretical model is developed here that can explain why the premiums of the health insurance contracts in the individual health insurance market do not vary that much over time, even in absence of any legal restriction on premiums. In this model the insurer and the individuals interact for an infinite number of periods, and the threats of punishments in case of deviations force both the insurer and the individuals to stay on a constant premium path. This model, unlike the other models of guaranteed renewability, does not presume commitment of the insurer.     

The Impact of the Health Insurance Market on Small Firm Employment

Small firms that offer health insurance to their employees may face variable premiums if they hire employees with high expected health costs. To avoid expensive premium variability, small firms may attempt to maintain a workforce with low expected health costs. This results in employment distortions. I examine the magnitude of these employment distortions using the 1987 National Medical Expenditure Survey and the 1996 Medical Expenditure Panel Survey. Based on the underwriting behavior of insurance companies in 1988, I classify medical conditions into three categories: conditions that led to denial of coverage; conditions that led to exclusion restrictions; and, conditions that led to higher premiums. In 1987, I find that insured small firms were less likely to employ workers with families that had conditions that led to higher premiums than insured large firms. However, in 1996, possibly due to the passage of small group health insurance reforms that restrict insurers' ability to exclude or deny coverage, insured small firms were less likely to employ workers with denial conditions compared to insured large firms. These results suggest that the pattern of employment distortions in insured small firms is consistent with the evolving small group health insurance market.     

“The Time of Recovery and the Maximum Severity of Ruin in a Sparre Andersen Model,” Shuanming Li,October 2008

Abstract

In a first-party recovery scheme for automobile property damage, the first-party insurer compensates not-at-fault vehicular damage. In this scheme, adjusters may not have the incentive to assign liability when the driver is, in fact, at fault for the accident. This is due to adjusters not having to coordinate with a third-party adjuster, and, for insureds that carry collision coverage, the assignment of fault does not appreciably affect the compensation paid out. This in turn reduces the effectiveness of the experience-rating component of the insurance premium. Empirical evidence that supports the presence of incorrect fault assignment is provided. A stochastic model of experience rating analyzing the impact of incorrect fault assignment on driving record classes confirms that low-risk insureds pay more for insurance than if fault was correctly assigned.     

Limiting the ACA's Threats to Small Group Health Insurance Markets

We identify three threats to small group health insurance markets that may result from the 2014 implementation of certain provisions in the Affordable Care Act (ACA). First, small employers with predominantly low‐income employees may tend to opt out of small group markets because their employees will be better off with subsidized individual coverage. Second, small employers with employees of heterogeneous income levels will have strong incentives to offer coverage that is either “unaffordable” or fails to provide “minimum value” in order to preserve the availability of government subsidies for their low‐income employees. Finally, small employers that continue to offer group plans will face increased incentives to self‐insure those plans, further contracting small group markets and subjecting them to adverse selection. Collectively, these forces may destabilize small group markets and increase the ACA's fiscal cost. We therefore conclude by offering various reforms aimed at offsetting these risks and preserving the viability of small group markets.     

Health Benefit Downward Rigidity: Employers’ Responses to Rising Insurance Costs

The article examines employers’ responses to rising insurance costs using Census Bureau Medical Expenditure Panel Survey–Insurance Component data from 1997 to 2005. The findings confirm that employers did not take dramatic actions to reduce benefit in response to the rising insurance cost during our study period. Most employers did not drop health insurance coverage, reduce workers’ eligibility for insurance, or substantially scale back their health insurance coverage. Instead, companies controlled the insurance cost in more subtle ways by adopting cost‐efficient health plans and requesting employee contribution to the insurance premium and out‐of‐pocket expenses for medical treatments. Our results show that the effect of those tactics was limited. The share of employee spending did not rise along with the growth of insurance premiums. Employers absorbed a large portion of the increased insurance cost.     

Die Haftpflichtversicherung nach der VVG-Reform

The reform of the German Insurance Contract Act (Versicherungsvertragsgesetz, ?VVG“) also targets key aspects of third-party liability insurance. The changes go beyond the findings made by both the courts and legal authorities to date.Compulsory insurance aside, the law still provides that an injured third party has no standing to assert a claim directly against the tortfeasor’s liability insurer. The tortfeasor may assign its indemnity claim against the insurer solely to the injured third party and may no longer be precluded from doing so under the General Insurance Conditions (AVB). Consequently, the tortfeasor’s indemnity claim against the insurer effectively becomes a pecuniary claim. This is criticised by the insurance industry particularly with regard to eliminating the prohibition against acknowledgment and satisfaction of claims.In the future, third parties will be able to assert claims directly against the tortfeasor’s insurer and this will be the case for compulsory insurance across the board. Provisions currently in effect in the motor vehicle liability insurance industry will be carried over to the entire compulsory insurance sector. Compulsory insurance does permit agreements involving self-deductibles. However, such agreements are generally effective only as between the insurer and the tortfeasor inter se, i.e. they are not effective as against third parties — in contrast to valid disclaimers of risk.Another change in compulsory insurance is the hierarchy of claims for compensatory damages and relief in the event the insured amount is inadequate. Specifically, the hierarchy gives preference to individual claims of injured parties which are not otherwise covered, such as claims for pain and suffering.The prohibition against the retroactive loss of provisional coverage for failure to pay the first premium, which had been criticised primarily by motor vehicle liability insurers, has been omitted in the Government bill.     

The Bankruptcy Cost of the Life Insurance Industry Under Regulatory Forbearance

Abstract

In this study the Taiwan Insurance Guaranty Fund (TIGF) is introduced to investigate the ex ante assessment insurance guaranty scheme. We study the bankruptcy cost when a financially troubled life insurer is taken over by TIGF. The pricing formula of the fair premium of TIGF incorporating the regulatory forbearance is derived. The embedded Parisian option due to regulatory forbearance on fair premiums is investigated. The numerical results show that leverage ratio, asset volatility, grace period, and intervention criterion influence the default costs. Asset volatility has a significant effect on the default option, while leverage ratio is shown to aggravate the negative influence from the volatility of risky asset. Furthermore, the numerical analysis concludes that the premium for the insurance guaranty fund is risk sensitive and that a risk-based premium scheme could be implemented, hence, to ease the moral hazard.     

Feintuning im Recht der Lebensversicherung zu § 169 Abs. 5 VVG – Neues zum Stornoabzug bei Einmalbeitr?gen sowie zu separaten Abschlusskostenvereinbarungen

The first part of this article deals with surrender charges. Due to the incredible increase of single premium life assurances this already written off instrument came back to discussion. The increase is based on the high income within the range of life assurances compared to interest income for safe investments. Speculations against to the collective of insured become possible as the right of the policyholder to notice a life assurance at any time, §?168 VVG, is inalienable, even concerning single premium assurances. Alerted by that, the Federal Financial Supervisory Authority (??BaFin??) demands appropriate surrender charges within the single premium matters. However, literature prefers a surrender charge caused by capital market which is consolidated into a lump sum to the amount of 0,2 per cent regarding the total payment of interest, for each year by which the single premium contract is going to be terminated before expiring after 10 years. This point of view can basically be followed. For reasons of principle consideration, the surrender charge must certainly be determined significantly lower than proposed, namely with 0,1 per cent each year. De lege ferenda, the alternative to make restrictions to the right to give notice for single premium assurances may be taken into consideration. The second part of this article deals with acquisition costs. The regional court of Rostock considers a separate agreement relating to cost averaging??whereby the policyholder must continue to pay the instalments for the acquisition costs even after the termination of the life assurance??to be a ??Umgehungsgesch?ft?? (evasive transaction) to §?169 V 2 VVG and is for that reason void. This cannot be followed. A?thoroughly interpretation of the provision shows that it does not prohibit the result, namely the deduction of the surrender value below the value which is determined by §?169 III VVG. The result is rather then prohibited when it is achieved by the non-transparent way of a set off of the costs with the paid assurance premium. That point of view of the regional court of Rostock is therefore contra legem. As the right to modify law is reserved to the legislative authority, it is well advised to observe the actual development for a certain period of time. In regard to that result the policyholder is not made vulnerable. Oftentimes, the liability for consulting activities of the insurer and his intermediaries will interfere in his favour.     

论投保人缴纳保费或保险公司签发保单附条件条款的法律效力

我国保险实践中普遍将投保人缴纳保费或者保险公司签发保单作为保险合同的成立、生效或者保险责任开始的条件。但该条件不是新《保险法》规定的附条件保险合同所指的条件。同时该附条件条款赋予了保险公司对要约进行承诺时或者履行合同义务时不受时间限制的权利,该附条件条款因不具有合理性应为无效合同条款。     

Who Obtains Greater Discounts on Automobile Insurance Premiums?

Insurance purchasers obtain varied discounts for insurance. This paper examines what drives these differences, specifically whether the loss probability and the wealth of the insured affect the size of the premium discount in automobile insurance. To describe a bargain between a client and an insurer over premiums and coverage, we first develop a sequential insurance bargaining game where the client has an outside option to bargain with another insurer. We find that the equilibrium involves full coverage and, based on the results of comparative statics, we propose hypotheses regarding the effects of the loss probability and the wealth of the insured on the size of the premium discount. We then use a unique data set of 85,806 observations of Taiwanese automobile liability insurance for property damage to empirically test the predictions. After controlling for underwriting and macroeconomic variables, we find that both (1) the insured with a lower claim probability (as a proxy for the insured with a lower loss probability) and (2) the insured with a higher salvage value car (as a proxy for the wealthier insured) receive a greater premium discount. These results support our theoretical results.     

Betriebliche Altersversorgung durch Direktversicherungen: Eine finanzwirtschaftliche Analyse aus Arbeitnehmerund Eigentümersicht

Corporate pension schemes are part of the total remuneration of employees. In this paper we analyze the?Direktversicherung“ — a life insurance on behalf of the employee paid for by the employer — from the viewpoints of shareholders and employees alike. Firstly we examine, what implications this life insurance contract has on the cash flows to shareholders and employees. Social security payments and tax payments on individual and company level are accounted for. Secondly, we deduce possible substitution quotas q: We ask, what insurance premium the employer can afford to pay at most in place of a given amount of salary, without penalizing his shareholders. Next we deduce the minimum insurance premium an employee has to ask for to replace a given part of his salary in order not to worsen his financial position. From the findings, we conclude that a corporate pension scheme via the?Direktversicherung“ has the potential to lead to a win-win situation, with both parties better off than before. Our findings are also interesting for insurance companies offering those contracts to employers.     

Optimal Loss Mitigation and Contract Design

This work examines the interaction between the premium rates set by an insurer and the incentives of an individual to purchase market insurance and undertake mitigation to reduce the size of a potential loss. A risk‐neutral monopolistic insurer prices insurance according to the price‐elasticity of demand for coverage. The elasticity of demand is affected by the presence of both mitigation and government intervention. The availability of loss reduction activities increases the consumer's elasticity of demand and lowers the optimal rate charged by the monopolist. Government intervention reduces both expenditures on mitigation and the rate charged by the monopolistic insurer.     

Health insurers' use of quality improvement expenses to achieve a minimum medical loss ratio requirement

Health insurer medical loss ratios (MLRs) are the percentage of premium dollar spent on medical claims and healthcare quality improvement expenses (QIEs). QIEs include activities to improve patient health outcomes and safety, reduce medical errors, and prevent hospital readmissions. The Affordable Care Act mandates minimum MLRs in certain health insurance markets lest rebates be paid to policyholders. QIEs are reported in all markets regardless of whether that market is subject to minimum MLR requirements. Using health insurer statutory filings for a sample of group market insurers from 2010 to 2018, we employ a mixed regression discontinuity/regression kink approach to evaluate whether QIEs are used by insurers as a potential strategy for meeting the minimum MLR requirement. We show that health insurers' QIE increase in the loss ratio until meeting the minimum MLR requirement, have a significant discontinuous jump at the threshold, and decrease above the threshold after the introduction of the MLR mandate.     

Statistical Implications of the Revenue Transfer Methodology in the Affordable Care Act

The Affordable Care Act (ACA) includes a permanent revenue transfer methodology that provides financial incentives to health insurance plans that have higher than average actuarial risk. In this article, we derive some statistical implications of the revenue transfer methodology in the ACA. We treat as random variables the revenue transfers between individual insurance plans in a given marketplace, where each plan’s revenue transfer amount is measured as a percentage of the plan’s total premium. We analyze the means and variances of those random variables and deduce from the zero-sum nature of the revenue transfers that there is no limit to the magnitude of revenue transfer payments relative to plans’ total premiums. Using data provided by the American Academy of Actuaries and by the Centers for Medicare & Medicaid Services, we obtain an explanation for empirical phenomena that revenue transfers were more variable and can be substantially greater for insurance plans with smaller market shares. We show that it is often the case that an insurer that has decreasing market share will also have increased volatility in its revenue transfers.     

Health Insurance Choice with Flexible Spending Accounts

I model the interaction of flexible spending accounts (FSAs) and conventional insurance. I show that FSA participation reduces the desired level of insurance coverage. I also show that FSA participation can reduce the total tax cost of health insurance premium and FSA contribution exclusions.     

The role of stakeholders on rejection of bankruptcy applications in the case of “poverty” of the estate: A Polish case study

The aim of this article is to supplement the Law and Economics area of science with regard to the scope of the ex ante effectiveness of bankruptcy law using the example of Poland. Bankruptcy law is effective in the ex ante stage when it eliminates from the market insolvent entrepreneurs who cannot even afford to cover the costs of bankruptcy proceedings. In these cases, the bankruptcy court should dismiss the petition for bankruptcy because of “poverty” of the insolvent estate. As a result, the insolvent debtor should be liquidated and deleted from the register of companies. This paper investigates entities whose bankruptcy petition has been rejected due to “poverty” of the insolvent estate. The study shows that, after the filing has been dismissed, the majority of these entities are not liquidated. To determine who is responsible for this state of affairs, the article identifies the stakeholders at the time that applications are filed for bankruptcy proceedings and also after the bankruptcy petition has been rejected. The article highlights stakeholders' diverging interests, strengths, and weaknesses to assess their potential impact on bankruptcy procedures that should be dismissed due to “poverty” of the insolvent estate.     

Premiums and reserves,adjusted by distortions

The net premium principle is considered to be the most genuine and fair premium principle in actuarial applications. However, actuarial due diligence requires additional caution in pricing of insurance contracts to avoid, for example, at least bankruptcy of the insurer. This paper addresses the distorted premium principle from various angles. Distorted premiums are typically computed by underweighting or ignoring low, but overweighting high losses. Dual characterizations, which are elaborated in a first part of the paper, support this interpretation. The main contribution consists in an opposite point of view—an alternative characterization—which leaves the probability measure unchanged, but modifies (increases) the outcomes instead in a consistent way. It turns out that this new point of view is natural in actuarial practice,as it can be used for premium calculations, but equally well to determine the reserve process in subsequent years in a time consistent way.     

Why small businesses don't have health insurance: results of a Florida survey

While most of the insured population has health insurance under an employer-sponsored group plan, the majority of the working uninsured are employed by small firms. Increasing the number of small firms that provide health insurance plans to their employees is important for decreasing the number of uninsured. This article summarizes the results of a survey designed to study characteristics of the firms that do not have health insurance, the obstacles to their getting insurance, and small business owners' interest in having a group health plan.