Research On The Adjustment Mechanism Of Long-term Medical Insurance Rate

The new "Health Insurance Management Rules" opened the prelude of longterm medical insurance with adjustable rates.However,due to the existence of many operational risks.Once the insurance company underestimates the risk in the initial stage,it may have to adjust the premium substantially in order to alleviate the deterioration of the loss rate in the later stage.Therefore,this paper aims to solve this problem through theoretical research and give a perfect rate adjustment mechanism.The paper first describes the policy environment of long-term medical insurance.This includes the introduction of China’s medical security system,the development of medical insurance and the long-term medical insurance regulations.After that,it analyzes the main risks faced by long-term medical insurance in the process of operation,including medical inflation,continuous treatment,death spiral and so on.Then,in the model building,these risk points are fully considered and covered.For example,the medical inflation rate estimated by Getzen model is calculated in the pricing model,and the policy status adopts the double reduction factor model considering the surrender rate.In the adjustment mechanism model of the subsequent years of the policy,we give two options for the insurance company to adjust the premium and the reserve.Make the mechanism more flexible,so that insurance companies can take certain measures to adjust the insurance policy without triggering the premium adjustment conditions.In the numerical case study,this paper simulates the future operating environment,and calculates a set of initial rate table and rate adjustment data under different adjustment mechanisms in subsequent years.It also shows the rate adjustment of surrender premium and non-surrender premium respectively.It is found that although the price of the pricing model is slightly expensive at the beginning,its price advantage gradually appears with the passage of time.The rate change range of less than5% has successfully avoided the risk of large-scale surrender in the future.Compared with the model without surrender premium,the model with surrender premium improves the fault tolerance rate of surrender rate estimation,but there are some problems in the operation process,such as more cumbersome operation and higher surrender rate.Finally,according to the policy requirements of our country,this paper gives two sets of adjustment mechanisms,so that insurance companies can realize internal self-adjustment when they fail to trigger the premium adjustment conditions and control the increase range reasonably when they trigger the premium adjustment conditions.