A Study On The Solvency Supervision Of Health Insurance Company

Health insurance is an important part of our multi-level medical security system, protect people’s health and improving people’s livelihood and safeguard social fairness and promote the building of a harmonious society and have an important role can best embody the insurance functions of social management. From1999to2011, the health insurance market premium income grew by nearly18times, the strong momentum of development. So far, China has four health insurance companies, professional management of the health insurance. Although the development of health insurance in China has achieved good results, but the overall development is still lagging behind in2011, China’s health insurance premium income accounted for only7%of the total life insurance premiums; the average level of developed countries is30percent. In order to further promote the development of China’s health insurance, better play the role of health insurance in the medical security system, health insurance as a separate regulatory and property and casualty insurance, life insurance tied for the third field implementation. Solvency regulation is the core of China’s insurance regulators.Our solvency regulatory system, the implementation of a full range of solvency regulation, drawing on two levels of the U.S. regulatory system, for both rates in preparation for gold indicators regulatory, and supervision of the solvency margin, but in the solvency margin supervision in our country there is no common RBC method, but draws on the ideas of the EU’s solvency supervision. Attaches great importance to the CIRC on the regulatory regime for the construction of the health insurance company, issued a series of files, the main guidance on accelerating the development of health insurance, health insurance management measures,"" health insurance statistics system solvency margin of insurance companies and regulatory indicators provides that the insurance company solvency regulations and insurance company solvency compiled a report rules, health insurance company solvency regulation framework has been basically formed. In practical operation, the health insurance company’s solvency regulation is a general reference to the life insurance company solvency regulation. Health insurance products, pricing is based on the incidence of disease and medical cost data, the pricing of life insurance products is based on the life table, and property insurance products, pricing is based on the incidence of property damage. The main health insurance in addition to the insurer and the insured person, but also involves medical service organizations and government Social Security department. Health insurance is different from the production life of these operating characteristics, objectively determine the solvency regulation of the health insurance company cannot simply reference the regulatory mode of life or property and casualty insurance, health insurance company products must be referenced on the basis of particularity of the adjustment and improvement.Domestic health insurance solvency regulation is confined to the qualitative analysis, and simply describes the principles and methods of the national health insurance solvency regulation, and does not describe the feasibility of the method of calculation of the specific indicators and learn from foreign experience. This paper attempts to foreign solvency supervision from an actuarial point of view, the introduction of foreign solvency experience at the same time, given the specific steps and calculation methods in accordance with national regulatory characteristics summarize the emergence stage of China’s health insurance company solvency regulation can learn from the experience. And then analyze the current situation and existing problems of the domestic health insurance company solvency regulation, given the relevant recommendations to improve the health insurance company solvency regulation system.This article is divided into five chapters, the basic idea and structure of the arrangement as follows:The first chapter is the introduction, the background and significance of health insurance status quo, the importance of health insurance and health insurance company’s development, what is the importance of solvency, solvency and China the status quo of the health insurance company’s solvency regulation, why should further study the regulatory system of health insurance company’s solvency. The major research learn from the United States, Australia, the European Union solvency II solvency supervisory experience, summed up the present stage, health insurance companies can learn to analyze the current situation of the commercial health insurance company’s solvency regulation, the problem presented related proposals, the last rate regulation, reserve regulatory and solvency reporting system design and regulatory targets for further analysis. Used in this research method is literature analysis, logical reasoning method. Study abroad have been some results, health insurance solvency regulation is limited to qualitative analysis, but simply introduces the principles and methods of national solvency regulation, and no specific indicators, calculation methods and abroad Experience the feasibility.The second chapter is to learn from foreign health insurance company solvency regulation and experience. This chapter is divided into three parts, elaborated and introduced in the first part of the U.S. the the HRBC model and interest rate sensitive cash flow analysis model; the second part of the Australian health insurance solvency standards and capital adequacy standards; The third section describes the EU solvency II project.HRBC U.S. health insurance company solvency regulation, health insurance company must submit its annual financial report of the company’s risk-based capital, the actual authorized capital and surplus. This paper introduces the calculation method of HRBC, risk classification and HRBC ratio range set by five regulatory levels.Cash flow testing to simulate the company’s financial position under certain circumstances, regulatory bodies is easier to understand the insurance company’s future financial difficulties may China is not the introduction of cash flow testing models, to use this tool to a certain degree of difficulty for the domestic insurance market in the early stages of development. Dynamic solvency testing in the future of each test stage, look at the assets and premium income of the company’s ability to meet payments or compensation, as well as ability to meet cash outflows. Australia is the double standards of the statutory fund solvency standards and capital adequacy standards. This paper describes the solvency of these two standards to prepare the Jinnee capital adequacy reserve calculation principle. Solvency standards for existing business is the assessment of static; capital adequacy standards for future operations, assessment of the dynamic. In essence, the statutory fund of a double standard with the U.S. venture capital method has the same place, taking into account health insurance company’s assets and liabilities of the various risks and by the linear sum of the risk reserve to get the corresponding funding requirements.Solvency II is the direction of the future solvency regulatory developments, it has established a more complete and comprehensive risk management system, both from the individual to consider a single insurance company solvency adequacy ratio and other indicators, but also from the whole to consider the structure of governance of insurance companies internal control, risk prevention, information disclosure, industry competition in the market at different levels, is the idea of qualitative analysis and quantitative analysis of a combination of regulatory analysis to predict changes in the coming year, company’s financial position, based not only on the current financial situation, but also the introduction of a forward-looking regulatory philosophy.China has built up a relative solvency regulatory framework system,"risk management" in the second pillar and third pillar "risk disclosure" aspect, the CIRC issued a large number of systems, including corporate governance, internal control, executives Qualifications requirements, information disclosure procedures, the basic international standards.Chapter III analyzes the domestic health insurance company’s solvency regulatory status and existing problems, give advice based on these issues targeted. The main problems are:(1) the solvency regulation of the domestic health insurance companies generally with reference to the life insurance company solvency regulation;(2) the solvency reporting, accounting systems and financial reporting system is not perfect;(3) Solvency indicators The design is not comprehensive. The main reason for these problems:(1) the level of development of the industry is limited; the lack of basic data and.information systems are weak;(2) weak actuarial basis, the actuarial system is not perfect. Recommendations to improve the following aspects:(1) rates of strengthening the reserve regulation;(2) improve the information disclosure, and to establish risk-based reporting system;(3) establishment of an independent regulation of the accounting system;(4) the establishment of health insurance actuary system.Chapter IV analyzes the premium rate and reserve regulation. The direct purpose of the premium rate regulation is to safeguard the survival of the insurance market, to prevent the vicious price competition caused by the lack of solvency of insurance companies. Measures for the Administration of force on December30,2011, the life insurance company insurance clauses and premium rates to further strengthen the supervision of insurance companies to develop premium rates, insurance companies in the relevant actuarial report, including pricing methods, pricing assumptions, profit the test parameters and sensitivity analysis of key parameters change.The responsibilities of the health insurance company’s reserves include unearned premium reserves and outstanding claims reserve, as well as long-term health insurance liability reserve. Different types of health insurance business of health insurance the reserves need to use different methods and assumptions, and different actuarial technology and prudent degree of focus on supervision of the health insurance companies to prepare gold of the extraction, can be effective to ensure that health insurance companies solvency and operational efficiency.The fifth chapter is solvency reporting system and regulatory indicators. Health insurance companies, regulatory agencies in accordance with the provisions of the CIRC, regular or irregular submit solvency report. In the annual report of the solvency report and is not related to the method of calculation of minimum capital for health insurance companies. The proposed health insurance companies the minimum capital is the sum of long-term health insurance business of the minimum capital and minimum capital of the short-term health insurance business. The main contribution of the paper:Domestic health insurance solvency regulation is confined to the qualitative analysis, and simply describes the principles and methods of the national health insurance solvency regulation, and does not describe the feasibility of the method of calculation of the specific indicators and learn from foreign experience. This paper attempts to foreign solvency supervision from an actuarial point of view, the introduction of foreign solvency experience at the same time, given the specific steps and calculation methods in accordance with national regulatory characteristics summarize the emergence stage of China’s health insurance company solvency regulation can learn from the experience. And then analyze the current situation and existing problems of the domestic health insurance company solvency regulation, given the relevant recommendations to improve the health insurance company solvency regulation system.Inadequacies of the paper:Exposure to Practice less, did not improve the solvency regulation suggested a deeper excavation. Disparities of the four health insurance companies business level, the use of common minimum standards, in terms of the companies is not a fair and impartial way. Foreign experience for reference, taking into account the level of development of foreign economic environment and its insurance market cannot blindly copy the domestic policy environment is quite different and foreign, need to be adjusted accordingly so learn from experience, cannot be arbitrarily apply the model. Due to the limitations of their own professional insurance accounting system did not begin. Study on the establishment of a health insurance actuary system, because I no relevant experience, so no longer elaborated. The author’s own research is limited, the health insurance company’s solvency regulation only preliminary exploration, there are many inadequacies...