Question

Please describe how insurance is purchased and regulated. Do you think the regulations are sufficient when managing the risk of a healthcare organization? Support your answer!

Answer 1

Insurance is regulated by laws and health policies. Insurance is purchased by various stakeholders and regulators who regulate insurance policies. Insurance companies agent must be licensed to sell insurance plans within the state. The insurance companies are audited regularly with the annual report to regulate their expenses. The audit also audits the risk of insurers against the investment. Some of the laws also determine the eligibility and benefit of policyholders against different policies. The insurance company collects the minimum premium for future health care liabilities. The policy forms and payment rate are regulated by the state insurance department.

The insurance regulation still finds difficulties in regulating new marketers, effective use of big data, reimbursement of payment. It is facing problems in data security and privacy. Premiums are not regulated and exist disease condition are not under coverage. It also needs to concern about the ongoing development of the insurance plan.