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by yourapostasy
3251 days ago
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> ...you're in the individual market... Is the actuarial and outcomes data corpus of the health insurance industry so bad that it makes actuarial sense to segment the markets to individual, medium group, large group, etc.? I've always wondered what the explanation is for so many cohorts. Are state insurance regulations preventing medical insurance providers using more sophisticated risk modeling to create larger pools, or co-marketing with life insurance companies that gather pretty detailed data on individuals before underwriting? |
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Especially post-ACA, there are very strict limits on what factors can be used to set premiums. Risk-based assessments are basically outlawed except for a few defined variables like age and smoking habits.