Guaranteed renewability uniquely prevents adverse selection in individual health insurance (original) (raw)
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Guaranteed renewability in insurance
Insurance: Mathematics and Economics, 1995
We propose a guaranteed renewability (GR) insurance in which a sequence of premiums would enable insurers to break even and would be chosen by both low-and high-risk buyers, whether or not they had suffered a loss. The premium schedule would continually decline over time, as the insurer collects more information to determine who the low-risk buyers are. The highest premiums are charged initially to protect the insurer if low-risk individuals leave for the spot market. The concluding portion of the article discusses the limitations of a GR policy in the health and environmental liability area, the most serious being instability in estimates of underlying loss trends.
Adverse selection and moral hazard in health insurance
In this paper, we want to characterize the optimal health insurance contract with adverse selection and moral hazard. We assume that policyholders di¤er by the permanent health status loss and choose an unobservable preventive e¤ort in order to reduce the probability of illness which is ex-ante identical. The di¤erence in illness'after-e¤ect modi…es policyholders' preventive actions. By the way, they di¤er in probabilities of illness leading to a situation close to Rothschild and Stiglitz 'model. In this case, we show that the optimal contract exhibits a deductible for the high health risk type since a higher after e¤ect implies a higher preventive e¤ort and then a lower probability of illness rather than for the low health risk type.
2012
This paper constructs a dynamic model of health insurance to evaluate the short-and long run effects of policies that prevent firms from conditioning wages on health conditions of their workers, and that prevent health insurance companies from charging individuals with adverse health conditions higher insurance premia. Our study is motivated by recent US legislation that has tightened regulations on wage discrimination against workers with poorer health status (Americans with Disability Act of 2009, ADA, and ADA Amendments Act of 2008, ADAAA) and that will prohibit health insurance companies from charging different premiums for workers of different health status starting in 2014 (Patient Protection and Affordable Care Act, PPACA). In the model, a trade-off arises between the static gains from better insurance against poor health induced by these policies and their adverse dynamic incentive effects on household efforts to lead a healthy life. Using household panel data from the PSID we estimate and calibrate the model and then use it to evaluate the static and dynamic consequences of no-wage discrimination and no-prior conditions laws for the evolution of the cross-sectional health and consumption distribution of a cohort of households, as well as ex-ante lifetime utility of a typical member of this cohort. In our quantitative analysis we find that although a combination of both policies is effective in providing full consumption insurance period by period, it is suboptimal to introduce both policies jointly since such policy innovation induces a more rapid deterioration of the cohort health distribution over time. This is due to the fact that combination of both laws severely undermines the incentives to lead healthier lives. The resulting negative effects on health outcomes in society more than offset the static gains from better consumption insurance so that expected discounted lifetime utility is lower under both policies, relative to only implementing wage nondiscrimination legislation.
Optimal insurance in the presence of multiple policyholders
Journal of Economic Behavior & Organization, 2020
The literature on optimal insurance typically considers optimal risk sharing between one insurer (or reinsurer) and one insurance prospect. However, the insurance business is based on diversification benefits that arise when pooling many insurance policies. In this paper, we first show that the classical results on optimal insurance in the case of a single insurance prospect remain valid when there are multiple prospects, provided their insurance claims are independent. Specifically, all prospects receive coverage. However, due to phenomena such as medical progress, longevity risk, and natural or man-made disasters, insurance claims tend to be correlated. We show that in the case of interdependent insurance policies, it may become optimal for the insurer to refuse to sell insurance to some prospects, and this decision is driven by the prospects' attitudes towards risk and their risk exposure characteristics. This finding calls for government policies to ensure that insurance remains available and affordable to everyone.
Full Insurance, Bayesian Updated Premiums, and Adverse Selection
The Geneva Papers on Risk and Insurance Theory, 1997
In the classic Rothschild-Stiglitz model of adverse selection in a competitive environment, we analyse a "no-claims bonus" type contract (bonus-malus). We show that, under full insurance coverage, if the insurance company applies Bayes's rule to learn about client probability types over time and uses this information in premium calculations for contract renewals, then there exist conditions under which all client types strictly prefer the Bayesian updating contract to the classic Rothschild-Stiglitz separating equilibrium.
Impact of Preferences on Optimal Insurance in the Presence of Multiple Policyholders
Social Science Research Network, 2018
In the optimal insurance literature one typically studies optimal risk sharing between one insurer (or reinsurer) and one policyholder. However, the insurance business is based on diversification benefits that arise when pooling many insurance policies. In this paper, we first show that results on optimal insurance that are valid in the case of a single policyholder extend to the case of multiple policyholders, provided their insurance claims are independent. However, due to natural catastrophes, increasing life expectancy and terrorism events, insurance claims show tendency to be correlated. Interestingly, in the case of interdependent insurance policies, it may become optimal for the insurer to refuse selling insurance to some prospects, based on their attitude towards risk or due to their risk exposure characteristics. This finding calls for government policies to ensure that insurance stays available and affordable to everyone.
Journal of Health Economics, 2000
A competitive market for individual health insurance tends to risk-adjusted premiums. Premium rate restrictions are often considered a tool to increase access to coverage for high-risk individuals in such a market. However, such regulation induces selection which may have several adverse effects. As an alternative approach we consider risk-adjusted premium subsidies. Empirical results of simulated premium models and subsidy formulae are presented. It is shown that sufficiently adjusted subsidies eliminate the need for premium rate restrictions and consequently avoid their adverse effects. Therefore, the subsidy approach is the preferred strategy to increase access to coverage for high-risk individuals. q
Adverse selection in the annuity market with sequential and simultaneous insurance demand
The Geneva Risk and Insurance Review, 2006
This paper investigates the effect of adverse selection on the private annuity market in a model with two periods of retirement and two types of individuals, who differ in their life expectancy. In order to introduce the existence of limited-time pension insurance, we consider a model where for each period of retirement separate contracts can be purchased. Demand for the two periods can be decided either sequentially or simultaneously. We show that only a situation where all risk types choose sequential contracts can be an equilibrium and that this outcome is favourable for the long-living, but is unfavourable for the short-living individuals.