Establishing an Analytical Framework for Measuring the Role of Reinsurance in the Health Insurance Market. D. Results


In this section, we review the results of our efforts to locate information on the reinsurance arrangements in the three markets.

We generally were unable to identify either data sources or existing research that would enable us to quantify the risk being ceded to reinsurers in the three markets. The problems we encountered differed across the three markets. While a substantial amount of information is available about the reinsurance transactions of indemnity (non-HMO) health insurers, the data is aggregated in ways that make it difficult to specifically identify transactions related to primary health insurance offered to groups and individuals. The information available from state insurance filings about reinsurance purchased by HMOs is more useful in understanding the level of risk that HMOs cede to reinsurers, but lack of detail and inconsistencies in the way that HMOs report the information in their annual statements reduces its analytic potential. And, despite the substantial amount of information available about the prevalence of self-funding and the use of reinsurance by self-funded employers, there is virtually no reliable data about the level of risk being transferred to reinsurers in these arrangements.

These findings are presented in more detail below, separated by the target markets.