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Ziyaad Mathee
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Decks in this class (32)
0, 5 - (Intro to and) Healthcare
Features of healthcare market dis...,
Short term vs long term contracts,
Mutuality solidarity community ra...
10
cards
1. Health and care products - PMI and related
Benefits in hospital vs out of ho...,
Private medical insurance,
Claims experience and risk rating
20
cards
2. Health and Care Insurance Products - CI
Critical illness insurance,
Ci product types,
Criteria for inclusion of an illness
7
cards
3. Health and Care products - LTCI
Meeting specific needs ltci,
Product specific risk ltci generi...,
Long term care
9
cards
4. Health and care products - Group products
Group cover can arise,
Why employer purchase group cover,
Factors to consider in setting fcl
4
cards
6. Product design and stakeholder interests - (1)
Introduction,
Four specific needs met by health...,
Meeting specific needs pmi
12
cards
7. Product design and stakeholder interests - (2)
Insurer as the stakeholder,
Profitability return on capital,
Administrative systems implications
7
cards
8. Distribution Channels
Main distribution channels,
Reason health and care products l...,
Ways insurance intermediary may h...
13
cards
9. General Business Environment
Reasons health and care insurance...,
Aim of regulation,
Government may impose controls on...
5
cards
10. Risk Adjustment
Health outcomes are expected to v...,
Examples of clinical factors by w...,
Examples of attitudes and percept...
8
cards
11. State Healthcare Provision
New universalism involves balancing,
Objectives of state provision,
Other ways the state could enhanc...
12
cards
12. Modelling
Uses of models,
Requirements of a good model,
Deterministic and stochastic mode...
8
cards
13. Data
Sources of data,
Desirable characteristics of data,
Data required to estimate claim r...
12
cards
14. Assumptions (1) - General Considerations
General considerations when setti...,
General process for setting assum...,
Assumptions for health and care i...
8
cards
15. Assumptions (2) - Demographic assumptions
Main demographic assumptions,
Insured lives will depend on,
Factors by which to split long te...
7
cards
16. Assumptions (3) - Financial Assumptions
Financial assumptions,
Benefit amount,
Pmi reimbursement models
5
cards
17. Assumptions (4) - Other assumptions
New business assumptions,
Risk discount rate
2
cards
18. Generalised Linear Modelling
Explanatory variable,
Response variable,
Interaction terms
8
cards
19. Pricing (1) - Individual Business
Deriving the risk premium,
Factors to consider when selectin...,
Internal data sources likely to b...
11
cards
20. Pricing (2) - Group Business
Special characteristics of group ...,
Control of intermediary,
Limited insured information
9
cards
21. Pricing (3) - Other considerations
Profit criteria,
Marketability,
Competitiveness
7
cards
22. Pricing (4) - Options and Guarantees
Mortality and morbidity health op...,
Cost of option,
Factors affecting health options
8
cards
23. Reserves and Solvency Capital Requirements
Reasons for calculating reserves,
Purpose for estimating liabilitie...,
Types of reserves
13
cards
24. Nature of Risks (1)
Risk classification,
Risk in estimating the cost of pm...,
Expenses
4
cards
25. Nature of Risks (2)
There are risks associated with,
Management action,
Reputation
5
cards
26. Nature of Risks (3)
Aim of insurer and the actuary,
Aims of the actuary,
Problems confronting the actuary ...
3
cards
27. Managed Care
Managed care organisations,
Reasons for increased cost of hea...,
Objectives of managed care organi...
7
cards
28. Reinsurance
Reasons for reinsurance,
Factors affecting insurer appetit...,
Advantages of quota share to insurer
5
cards
29. Other Risk Management Techniques
Risk management techniques under pmi,
Reimbursement methods how healthc...
2
cards
30. Investment
Principle of investment,
Regulator can affect the assets h...,
Steps in developing an appropriat...
6
cards
31. Monitoring and feedback into the control cycle
Corrective actions that can be ta...,
Management of risk depends on ade...,
Reasons for monitoring experience
13
cards
32. Glossary/ Definitions/ Concepts
Treatment protocol,
Burning cost premium,
Moratorium underwriting
6
cards
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F101 - Health and Care Insurance Principles
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