tailieunhanh - Lecture Risk management and insurance - Lecture No 28: Employee benefits: Group life and health insurance

This chapter’s objectives are to: Meaning of employee benefits, fundamentals of group insurance, group life insurance plans, group medical expense insurance, traditional indemnity plans, managed care plans, consumer-directed health plans, recent developments in employer-sponsored health plans, | Employee Benefits: Group Life and Health Insurance Lecture No. 28 1 Objectives Meaning of Employee Benefits Fundamentals of Group Insurance Group Life Insurance Plans Group Medical Expense Insurance Traditional Indemnity Plans Managed Care Plans Consumer-directed Health Plans Recent Developments in Employer-Sponsored Health Plans Group Medical Expense Contractual Provisions Group Dental Insurance Group Disability-Income Insurance Cafeteria Plans 2 3 Underwriting Unit is a Group Group insurance plans cover more than one person Underwriting is based on group characteristics rather than on evidence of insurability for individuals within the group Membership in a group that has been formed for purposes other than obtaining insurance is often sufficient evidence of insurability for an insurer For example, if an employee is well enough to go to work, he or she likely will be judged well enough to be insured without passing a medical examination 4 Underwriting Unit is a Group One of the . | Employee Benefits: Group Life and Health Insurance Lecture No. 28 1 Objectives Meaning of Employee Benefits Fundamentals of Group Insurance Group Life Insurance Plans Group Medical Expense Insurance Traditional Indemnity Plans Managed Care Plans Consumer-directed Health Plans Recent Developments in Employer-Sponsored Health Plans Group Medical Expense Contractual Provisions Group Dental Insurance Group Disability-Income Insurance Cafeteria Plans 2 3 Underwriting Unit is a Group Group insurance plans cover more than one person Underwriting is based on group characteristics rather than on evidence of insurability for individuals within the group Membership in a group that has been formed for purposes other than obtaining insurance is often sufficient evidence of insurability for an insurer For example, if an employee is well enough to go to work, he or she likely will be judged well enough to be insured without passing a medical examination 4 Underwriting Unit is a Group One of the underwriting considerations for group insurance is the purpose for which the group exists If members have been assembled for the sole purpose of obtaining group coverage The prospective insurer will be very concerned about the presence of adverse selection For employee groups, however, this possibility is not a problem 5 Underwriting Unit is a Group Other factors that may be important in underwriting employee group insurance include The group’s size Insurers prefer larger groups to smaller ones in order to minimize the likelihood of severe adverse selection Age composition It is also considered best from an underwriting perspective if there is a flow of persons through the group so that the younger members replace the older members over time The average age of persons in the group is fairly constant and loss experience tends to be more stable Expected losses Insurers are often interested in specific design features of a group insurance program because such features may have an impact on .

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