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Full-Text Articles in Insurance

The Pricing Impact Of The Decreasing Competitiveness Of The Health Insurance Market, Lauren N. Patterson May 2018

The Pricing Impact Of The Decreasing Competitiveness Of The Health Insurance Market, Lauren N. Patterson

EURēCA: Exhibition of Undergraduate Research and Creative Achievement

The Affordable Care Act created the national insurance exchanges of qualified health plans to encourage a higher insured rate, larger risk pools, and lower prices for quality health coverage. Consolidation of insurers can have opposing effects. The insurers’ risk pools will grow, allowing insurers to better hedge for risk. However, consolidation decreases the prevalence of competition in the market, and past research shows that insurer consolidation decreases market competition and increases prices.

I examine how the number of plans offered in a set market, pricing components, and county health variables impact the monthly premium pricing of plans sold on the ...


Insurance Coverage Policies For Pharmacogenomic And Multi-Gene Testing For Cancer, Christine Y. Lu, Stephanie Loomer, Rachel Ceccarelli, Kathleen M. Mazor, James Sabin, Ellen Wright Clayton, Geoffrey S. Ginsburg, Ann Chen Wu May 2018

Insurance Coverage Policies For Pharmacogenomic And Multi-Gene Testing For Cancer, Christine Y. Lu, Stephanie Loomer, Rachel Ceccarelli, Kathleen M. Mazor, James Sabin, Ellen Wright Clayton, Geoffrey S. Ginsburg, Ann Chen Wu

Open Access Articles

Insurance coverage policies are a major determinant of patient access to genomic tests. The objective of this study was to examine differences in coverage policies for guideline-recommended pharmacogenomic tests that inform cancer treatment. We analyzed coverage policies from eight Medicare contractors and 10 private payers for 23 biomarkers (e.g., HER2 and EGFR) and multi-gene tests. We extracted policy coverage and criteria, prior authorization requirements, and an evidence basis for coverage. We reviewed professional society guidelines and their recommendations for use of pharmacogenomic tests. Coverage for KRAS, EGFR, and BRAF tests were common across Medicare contractors and private payers, but ...


Accounting For Geographic Variation In Social Security Disability Program Participation, John Gettens, Pei-Pei Lei, Alexis D. Henry May 2018

Accounting For Geographic Variation In Social Security Disability Program Participation, John Gettens, Pei-Pei Lei, Alexis D. Henry

Commonwealth Medicine Publications

There is wide geographic variation in Social Security Disability Insurance and Supplementary Security Income participation across the United States. Some policymakers and members of the public may assume that interregional administrative inconsistencies are a major reason for the geographic variation. To test this assumption, and to reveal other potential explanations for the variation, we decompose the total variation into components by examining regional differences in disability prevalence and in program participation among persons with disabilities as well as the correlation between those two factors. We further decompose the variation in participation among persons with disabilities into socioeconomic components. Our findings ...


Evolution Of Insurance: A Telematics-Based Personal Auto Insurance Study, Yuanjing Yao May 2018

Evolution Of Insurance: A Telematics-Based Personal Auto Insurance Study, Yuanjing Yao

Honors Scholar Theses

Insurance has been constantly evolving since its inception; nowadays, insurance has become an indispensable part of people’s daily life. Nonetheless, very few individuals understand the mechanism behind their insurance coverage. This paper focuses on the evolution of personal auto insurances. The first part of the paper summarizes traditional pricing techniques for personal auto insurance and discusses their deficiencies. The second part of the paper introduces telematics insurance, an innovative form of auto insurance. This new kind of insurance integrates telematics as well as other technologies in the premium calculation process. The study proceeds to evaluate the pros and cons ...


The Pricing Impact Of Decreasing Competitiveness Of The Health Insurance Market, Lauren N. Patterson May 2018

The Pricing Impact Of Decreasing Competitiveness Of The Health Insurance Market, Lauren N. Patterson

Chancellor’s Honors Program Projects

No abstract provided.


External Forces That Impact Profitability In The Insurance Industry, Christopher P. Pellegrino Apr 2018

External Forces That Impact Profitability In The Insurance Industry, Christopher P. Pellegrino

Senior Honors Theses

The insurance industry is influenced by many factors that impact profitability. Insurers must do their best to make predictions based on expectations to remain solvent and profitable. Inevitably, they are faced with external factors that are outside of their control. Insurers must be aware of these external forces that may impact profits. External forces impact entire sub-industries of the insurance industry and some companies maintain profitability while others fail. This work intends to take a look at the major external forces that each insurance sub-industry faces and discuss some of the potential solutions that have been developed to minimize the ...


Terrorism Risk Insurance: Is It Really Working?, Rebecca Demarest Apr 2018

Terrorism Risk Insurance: Is It Really Working?, Rebecca Demarest

Honors Projects in Mathematics

This paper investigates terrorism risk insurance in the United States as well as those programs offered in other countries throughout the world. In the United States, particular attention is devoted to the interaction of government with private insurers to maintain an effective insurance program. An analysis is performed comparing terrorism insurance before and after the attacks on the World Trade Center on September 11, 2001. The paper looks into actual terrorist events that have occurred focusing on 56 world-wide events that are associated with property losses greater than $10 million. This paper not only investigates the losses that were incurred ...


Glossary Of Business Evidence, Paul C. Boyd Apr 2018

Glossary Of Business Evidence, Paul C. Boyd

MBA Faculty Conference Papers & Journal Articles

No abstract provided.


Splitting The Bill: Estimating Personal Consumption In Case Of Wrongful Death, Kathleen Ellis, David I. Rosenbaum Apr 2018

Splitting The Bill: Estimating Personal Consumption In Case Of Wrongful Death, Kathleen Ellis, David I. Rosenbaum

UCARE Research Products

In cases of wrongful death, the decedent’s survivors may sue alleged responsible parties for lost financial support. Forensic experts estimate a deceased individual’s personal consumption rate in order to separate the portion of the decedent’s income spent on him- or herself from the amount available as financial support for dependents. This paper enhances the prevailing estimation process by regressing consumption rates over individual households surveyed by the United States Bureau of Labor Statistics in its annual Consumer Expenditure Survey. We contend that this method improves the precision of estimates by accounting for the inherent heterogeneity in consumption ...


Toward Better Management Of Flood Losses: Flood Insurance In A Wetter World, Michael K. Mcshane, Juita-Elena (Wie) Yusuf Jan 2018

Toward Better Management Of Flood Losses: Flood Insurance In A Wetter World, Michael K. Mcshane, Juita-Elena (Wie) Yusuf

Finance Faculty Publications

Flood is the most frequent and costly of U.S. natural disasters with losses expected to increase due to climate change. The National Flood Insurance Program (NFIP) mandates flood insurance purchase for properties with federally backed mortgages in the 100-year floodplain. We propose that mandatory flood insurance purchase be extended to all property in the 500-year floodplain. Following flood events, payments would be directly provided for more properties that suffer flood loss, reducing federal disaster aid spending. The mandate could put more pressure on local governments to increase their Community Rating System score, such as through infrastructure investments and management ...


Factors Affecting Health Insurance Premiums: Explorative And Predictive Analysis, Tarunpreet Kaur Jan 2018

Factors Affecting Health Insurance Premiums: Explorative And Predictive Analysis, Tarunpreet Kaur

Creative Components

The main foundational block of health insurance industry is to estimate the future events and measure the associated risk/value of these events, hence it is needless to say that predictive analytics is used widely to determine the risk, insurance premium and enrich overall customer experience.

The health insurance industry has always been a slow-moving industry when it comes to adopting the data analytics practices into its business models. With the advent of advanced data analytics technologies, it has become important more than ever to take advantage of such sophisticated analytics to accurately assess and predict the insurance premiums for ...


Out-Of-Pocket Cost For Individuals Being Treated For Opioid Dependence In Rutland County, Vermont, Christopher T. Veal Jan 2018

Out-Of-Pocket Cost For Individuals Being Treated For Opioid Dependence In Rutland County, Vermont, Christopher T. Veal

Family Medicine Clerkship Student Projects

Each day more than 140 Americans die from drug overdoses, 91 specifically due to opioids. In Vermont, more than 50 people die each year from opioid poisoning. With insurance coverage being a critical component of Opioid Dependence Recovery, many people seeking treatment are unaware of the financial barriers to recovery- namely the out-of-pocket costs associated with treatment. This study sought to provide insight on the financial impact of Opioid Dependence Treatment on the patient, and provide financial assistance information to the Rutland County community.


Automobile Insurance Quote Comparisons And Swot Analysis: State Farm, Jennifer Warsaw Jan 2018

Automobile Insurance Quote Comparisons And Swot Analysis: State Farm, Jennifer Warsaw

A with Honors Projects

This honors project comes in two parts. The first is a survey of insurance providers and product options using automobile quote comparisons. The second piece is an analysis of the strengths, weaknesses, opportunities and threats (SWOT) of one the insurance company compared in the first part of the project.


Small And Medium Enterprises' Risk Exposures And Mitigation Approaches In Nigeria, Joshua Solomon Adeyele, Olubunmi Florence Osemene Jan 2018

Small And Medium Enterprises' Risk Exposures And Mitigation Approaches In Nigeria, Joshua Solomon Adeyele, Olubunmi Florence Osemene

The Journal of Entrepreneurial Finance

Risks militating against small and medium enterprises (SMEs) have been on the increase due to how risks mitigations are conducted by the owners/operators. Although thorough understanding of businesses undertaken by the owners of SMEs enables them to have a clear picture of risks affecting their businesses so as to act in proactive manner in order to mitigate or avoid the impending risks. To assess the risk exposures of SMEs, a random sampling technique was used to select 209 SMEs within Lagos and Benin City. Both descriptive and inferential statistics such as Phi and Gamma were used to analyse the ...


Virginia Homeowners Handbook: Helping Homeowners Prepare For Hurricanes And Other Natural Hazards, Jon Cawley Sep 2017

Virginia Homeowners Handbook: Helping Homeowners Prepare For Hurricanes And Other Natural Hazards, Jon Cawley

News Items

No abstract provided.


Stabilizing Individual Health Insurance Markets With Subsidized Reinsurance, Scott E. Harrington Sep 2017

Stabilizing Individual Health Insurance Markets With Subsidized Reinsurance, Scott E. Harrington

Issue Briefs

Subsidized reinsurance represents a potentially important tool to help stabilize individual health insurance markets. This brief describes alternative forms of subsidized reinsurance and the mechanisms by which they spread risk and reduce premiums. It summarizes specific state initiatives and Congressional proposals that include subsidized reinsurance. It compares approaches to each other and to more direct subsidies of individual market enrollment. For a given amount of funding, a particular program’s efficacy will depend on how it affects insurers’ risk and the risk margins built into premiums, incentives for selecting or avoiding risks, incentives for coordinating and managing care, and the ...


Narrow Networks On The Individual Marketplace In 2017, Daniel Polsky, Janet Weiner, Yuehan Zhang Sep 2017

Narrow Networks On The Individual Marketplace In 2017, Daniel Polsky, Janet Weiner, Yuehan Zhang

Issue Briefs

This Issue Brief describes the breadth of physician networks on the ACA marketplaces in 2017. We find that the overall rate of narrow networks is 21%, which is a decline since 2014 (31%) and 2016 (25%). Narrow networks are concentrated in plans sold on state-based marketplaces, at 42%, compared to 10% of plans on federally-facilitated marketplaces. Issuers that have traditionally offered Medicaid coverage have the highest prevalence of narrow network plans at 36%, with regional/local plans and provider-based plans close behind at 27% and 30%. We also find large differences in narrow networks by state and by plan type.


The Forfeiture Of Coverage Defenses Rule: An Economic Analysis, Tom Baker, Ezra Friedman, Kyle D. Logue Jul 2017

The Forfeiture Of Coverage Defenses Rule: An Economic Analysis, Tom Baker, Ezra Friedman, Kyle D. Logue

Faculty Scholarship at Penn Law

In liability insurance, the duty to defend is broader than the duty to cover. Thus it is possible that an insurer that has a duty to defend a suit may not have the duty to cover the policyholder's liabilities in the suit. However, if the penalty for a breach of the duty to defend is limited to actual legal costs spent by the defendant, the insurer may have an incentive to refuse to defend, even when the duty to defend is clear. This occurs because the insurer will not internalize the consequences of an inadequate defense when it ultimately ...


Property And Pecuniary Risk Exposures: An Investigation Into Smes’ Shutdown And Mitigation Methods In Nigeria, Joshua Solomon Adeyele, Olubunmi Florence Osemene, Idowu Emmanuel Olubodun Jul 2017

Property And Pecuniary Risk Exposures: An Investigation Into Smes’ Shutdown And Mitigation Methods In Nigeria, Joshua Solomon Adeyele, Olubunmi Florence Osemene, Idowu Emmanuel Olubodun

The Journal of Entrepreneurial Finance

Business Interruption (BI) insurance is not popular among the operators/owners of Small and Medium Enterprises (SMEs) in Nigeria. This study is an attempt to investigate causes of SMEs’ failure and to assist the owners on how to use BI to protect both the physical assets as well as future profits of their businesses. Hence, 389 SMEs were purposively selected from four major cities in Niger Delta Region (NDR) in Nigeria for this purpose. The statistical tools used for analysis were Phi and Cramer’s V. The extent of SMEs losses through means of sourcing for materials and strategy employed ...


35 Years In The Singaporean Life Insurance Industry, Singapore Management University Jul 2017

35 Years In The Singaporean Life Insurance Industry, Singapore Management University

Perspectives@SMU

How one man kept up with, and excelled in, an ever-changing landscape


A Discussion Of Social Protection And Private Insurance, Gary S. Fields Jun 2017

A Discussion Of Social Protection And Private Insurance, Gary S. Fields

Gary S Fields

[Excerpt] This is a thoughtful and thought-provoking paper, informative and interesting. I learned a lot from reading this and have already passed it on to others. In my comments, I would like to do four things: highlight the major points and the rationale for them, raise a few quibbles, put forth some additional issues, and propose a possible resolution of a dilemma raised in the paper. But let us first try to be clear about what we are talking about. Professor Pestieau characterizes social insurance as being mandatory, universal, and redistributive. I would define it slightly differently: “Social insurance is ...


The Effect Of Health Insurance Coverage Expansions On Auto Liability Claims And Costs, Srikanth Kadiyala, Paul Heaton Jun 2017

The Effect Of Health Insurance Coverage Expansions On Auto Liability Claims And Costs, Srikanth Kadiyala, Paul Heaton

Faculty Scholarship at Penn Law

How do the Affordable Care Act health insurance coverage expansions affect payment for medical care provided through liability insurance, such as auto insurance? Theoretically, expanding coverage might lead to a substitution of health insurance disbursements for automobile insurance disbursements. Alternatively, expanding health insurance coverage might increase utilization of medical care, increasing auto liability claims payments. The net effect of these two mechanisms can only be determined empirically. We evaluate the health insurance-auto insurance interaction by examining the 2010 ACA dependent coverage expansion. Prior to 2010, individuals 19 and older were excluded from health insurance coverage under their parental health insurance ...


A Changing Industry: An Analysis Of The Effects Of Direct-To-Consumer Advertising On The Insurance Industry, James Bonvicini May 2017

A Changing Industry: An Analysis Of The Effects Of Direct-To-Consumer Advertising On The Insurance Industry, James Bonvicini

Honors Scholar Theses

Direct-to-consumer selling is a shift in the strategies of many companies. As technology continues to play a prominent role in business, companies need to adapt to accommodate, and take advantage of, new opportunities that become available. Many insurance companies are now focusing on improving their direct-to-consumer selling efforts and attracting consumers with new online selling platforms. This thesis looks at the changes inside and outside of the industry that led to this direct method of selling and the impact that this has on the intermediaries in the industry, with a focus on property and casualty businesses. Additionally, this thesis takes ...


A Mixed-Methods Study: Self-Efficacy And Barriers To Participation In Workplace Wellness Programs, Massiel Perez-Calhoon Apr 2017

A Mixed-Methods Study: Self-Efficacy And Barriers To Participation In Workplace Wellness Programs, Massiel Perez-Calhoon

Dissertations

America needs a healthy workforce to sustain the country. The scourge of obesity continues to plague Americans despite government initiatives such as the Affordable Care Act and wellness programs in the workplace to combat this epidemic. However, despite initiatives to make America healthy, barriers continued to impede the nation’s health. Lack of awareness and sensitivity to what motivates individual participants versus group participants built formidable barriers to accessing all workplace employees equitably. The purpose of this study was twofold. First, the intent of this study was to explore the relationship between self-efficacy and the impact on participation and engagement ...


Equity And Community-Based Health Insurance: How Does Insurance Coverage Affect Health Seeking Behavior Among Disadvantaged Groups In India?, Hazel Hering Apr 2017

Equity And Community-Based Health Insurance: How Does Insurance Coverage Affect Health Seeking Behavior Among Disadvantaged Groups In India?, Hazel Hering

Independent Study Project (ISP) Collection

The objective of this study is to examine how Community-Based Health Insurance (CBHI) can promote equity by improving health seeking behavior across gender and geography. Using a CBHI scheme from the Self-Employed Women’s Association (SEWA) as a case study, trends in claims filed between October 2016 and March 2017 are compared to the distribution of memberships in order to investigate whether health insurance coverage positively impacts health seeking behavior among disadvantaged groups, and what barriers to access exist when the burden of medical costs are reduced. This study concludes that the number of male and female claims in the ...


The Economic Realities Of Replacing The Affordable Care Act, Hanming Fang Mar 2017

The Economic Realities Of Replacing The Affordable Care Act, Hanming Fang

Wharton Public Policy Initiative Issue Briefs

Using simulations based on a new economic model, this brief empirically examines the pivotal mechanisms of the Affordable Care Act, such as the individual mandate, employer mandate, and premium subsidies, to inform the debate over repealing and replacing the Affordable Care Act. The research suggests that the ACA, if left intact, in the long run significantly reduces the uninsured rate. The simulations also suggest that the employer mandate is not a crucial pillar for the success of the ACA. The analysis indicates it is the premium subsidy, rather than the employer mandate or the individual mandate, that is crucial for ...


Risk Appetites And Empirical Survival Pattern Of Small And Medium Enterprises In Nigeria, Joshua S. Adeyele Dr., Osazee G. Omorokunwa Dr. Feb 2017

Risk Appetites And Empirical Survival Pattern Of Small And Medium Enterprises In Nigeria, Joshua S. Adeyele Dr., Osazee G. Omorokunwa Dr.

The Journal of Entrepreneurial Finance

ABSTRACT

Small and medium enterprises (SMEs) are vital to economic growth and development of a nation. However, many of them fail in the first five years of incorporation due to their exposures to risk financing and strategies employed to meet customers’ need during business shutdown. Hence, this study is designed to verify how SMEs’ risk financing affect their continuity, and to model their survival patterns in context of risk financing and risk management approach employed by the operators. Two hundred and nine copies of valid questionnaire distributed to the respondents were filled and returned. Cramer’s V and multiple regressions ...


Demand For Health Insurance: Evidence From The California And Washington Aca Marketplaces, Evan Saltzman Jan 2017

Demand For Health Insurance: Evidence From The California And Washington Aca Marketplaces, Evan Saltzman

Health Care Management Papers

I estimate demand for health insurance using consumer-level data from the California and Washington ACA marketplaces. I use the demand estimates to simulate the impact of policies targeting adverse selection, including subsidies and the individual mandate. I find (1) high own-premium elasticities of —6.9 to —7.8, but low insurance coverage elasticities of —0.5 to —0.6; (2) minimal response to the mandate penalty amount, but significant response to the penalty's existence, suggesting consumers have a "taste for compliance"; (3) mandate repeal has minimal effect on consumer surplus because ACA subsidies already mitigate adverse selection by shielding ...


Consumer Financial Protection In Health Care, Erin C. Fuse Brown Jan 2017

Consumer Financial Protection In Health Care, Erin C. Fuse Brown

Faculty Publications By Year

There are inadequate consumer protections from harmful medical billing practices that result in unavoidable, unexpected, and often financially devastating medical bills. The problem stems from the increasing costs shifting to patients in American health care and the inordinate complexity that makes health care transactions nearly impossible for consumers to navigate. A particularly outrageous example is the phenomenon of surprise medical bills, which refers to unanticipated and involuntary out-of-network bills in emergencies or from out-of-network providers at in-network facilities. Other damaging medical billing practices include the opaque and à la carte nature of medical bills, epitomized by added “facility fees,” as ...


Social Health Insurance Coverage And Financial Protection Among Rural-To-Urban Internal Migrants In China: Evidence From A Nationally Representative Cross-Sectional Study, Wen Chen, Qi Zhang, Andre M. N. Renzaho, Fangjing Zhou, Hui Zhang, Li Ling Jan 2017

Social Health Insurance Coverage And Financial Protection Among Rural-To-Urban Internal Migrants In China: Evidence From A Nationally Representative Cross-Sectional Study, Wen Chen, Qi Zhang, Andre M. N. Renzaho, Fangjing Zhou, Hui Zhang, Li Ling

Community & Environmental Health Faculty Publications

INTRODUCTION: Migrants are a vulnerable population and could experience various challenges and barriers to accessing health insurance. Health insurance coverage protects migrants from financial loss related to illness and death. We assessed social health insurance (SHI) coverage and its financial protection effect among rural-to-urban internal migrants (IMs) in China.

METHODS: Data from the '2014 National Internal Migrant Dynamic Monitoring Survey' were used. We categorised 170 904 rural-to-urban IMs according to their SHI status, namely uninsured by SHI, insured by the rural SHI scheme (new rural cooperative medical scheme (NCMS)) or the urban SHI schemes (urban employee-based basic medical insurance (UEBMI ...