Premium Determination Of Coronary Heart Disease Insurance

Coronary heart disease has become the most serious chronic diseases that cause serious harm to health,with high prevalence,high recurrence rate and many complications.However,the existing health insurance focuses on the protection of critical illness.A few guarantees for chronic diseases are limited to complications of diabetes,and the products that specifically protect coronary heart disease have not yet appeared.The necessity and feasibility of coronary heart disease insurance are highlighted by the analysis of the current situation and burden of coronary heart disease,the gap of basic medical insurance fund,the pattern of commercial health insurance market,and the analysis of insurance awareness and policy,the existing chronic disease insurance and the insurance technology development.Therefore,it is imperative to design a specialized insurance product to protect the coronary heart disease.The coronary heart disease insurance products designed in this paper are divided into two levels of protection.The first level is to reimburse the annual medical expenses related to coronary heart disease,and the second level is to pay the fixed amount of coronary heart disease complications.Based on the design ideas,premium determination is the key point of insurance product development.For the premium determination of the first level,it should be focused on the fit of individual annual medical costs associated with coronary heart disease.According to the characteristics of its right and long tail,the Log-normal Distribution,Pareto Distribution,Weber Distribution and Gamma Distribution are used to perform the distribution fitting test.Then the best distribution of goodness of fit was chosen and its parameters were taken into the short-term reimbursement type of medical insurance premium determination formula to get the premium rate.For the premium determination of the second level,based on the Markov chain,using the Chapman-Kolmogorov equation and the nature of the transition probability,the rate determination equation can be derived by substituting the corresponding transition probability and metastatic intensity from coronary heart disease without the associated complication to coronary heart disease with of the complication state.At the same time,the urban employee medical insurance data of city Z in 2017 was used to empirically analyze the determination of the first guarantee level rate.It was found that the annual medical expenses related to coronary heart disease obey the lognormal distribution.Combined with the prevalence of different populations,the premium rate for the reimbursement of coronary heart disease medical treatment charge was fund.The studies of coronary heart disease insurance premium rate provide ideas for insurance product innovation,and provide reference for improving the pricing model of chronic disease insurance.Meanwhile,the coronary heart disease insurance can not only pass on the risk of insufficient basic medical insurance,but also protect the risk of complications of coronary heart disease patients who are refused insurance by critical illness insurance which makes up the protection gap of the existing health insurance market.In addition,through cooperation with mobile medical and health management institutions,the insurer's health management awareness can be enhanced by means of additional renewal conditions and floating insurance coverage to promote their health management and improve group health.